Is Detoxification Needed in Medication-overuse Headache?

NCT ID: NCT02993289

Last Updated: 2020-06-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

115 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-10-24

Study Completion Date

2023-11-30

Brief Summary

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Medication-overuse headache (MOH) is a disabling condition, yet treatable. According to European guidelines and based on evidence, multidisciplinary detoxification is the first choice of treatment for MOH. However, consensus about the details in such detoxification programs is lacking. Contrary, other headache specialists believe more in treating chronic headache with medication overuse with single-therapy of prophylaxis and no withdrawal of acute medication, based on randomized controlled double-blinded placebo trial with prophylaxes. Only a single RCT has compared single-therapy with prophylaxis to detoxification. However there was no significant difference.

AIM:

1. To compare three different treatment protocols in order to improve the therapy of MOH.
2. To test several baseline variables for being potential predictors for good treatment outcome.
3. To examine the role of epigenetics in MOH.

Detailed Description

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Conditions

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Medication Overuse Headache

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Detoxification and pharmacological prophylactic treatment

Group A: Two months detoxification program combined with pharmacological prophylactic treatment from start.

Group Type ACTIVE_COMPARATOR

Different well-known treatments

Intervention Type OTHER

Pharmacological prophylactic treatment

Pharmacological prophylactic treatment from start without detoxification.

Group Type ACTIVE_COMPARATOR

Different well-known treatments

Intervention Type OTHER

Detoxification

Two months detoxification program with postponed pharmacological prophylactic treatment after ended detoxification.

Group Type ACTIVE_COMPARATOR

Different well-known treatments

Intervention Type OTHER

Control group 1: Episodic migraine

Group Type NO_INTERVENTION

No interventions assigned to this group

Control group 2: Healthy volunteers

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Different well-known treatments

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Confirmed MOH diagnosis according to the ICHD-III beta (1).
* Eligible for outpatient treatment based on type of medication overuse (without massive pure opioids and barbiturates overuse), and personal resources and motivation.
* Capable of completing headache diary/calendar.
* Age ≥ 18 years old and capable of providing informed consent.
* Medication-overuse headache based on initial tension-type headache (TTH) or migraine.
* Signed informed consent.

Exclusion Criteria

* Severe physical illness or psychiatric disorders.
* Addiction to alcohol or other drugs.
* Current treatment with headache prophylaxis. Patients can be included minimum 5 weeks after stop of prophylaxis.
* Pregnancy, breastfeeding or planned pregnancy within the next 12 months.
* Inability to provide reliable information about medical history.

Criteria for Control group 1 - Episodic migraineurs:

* Episodic migraine, with/without concomitant tension-type headache, according to the ICHD-III beta.
* Headache days / month ≤ 6 at time of inclusion.
* Days with analgesics / month ≤ 6 at time of inclusion.
* Prophylactics are allowed.
* Age ≥ 18 years old.
* Ability to fill out headache calendar.
* No previous medication overuse.
* No significant co-morbid pain, physical or psychiatric disorders.
* No addiction to alcohol or drug-abuse.
* No pregnancy, breastfeeding or planned pregnancy within the next 12 months.

Criteria for Control group 2 - Healthy volunteers:

•≥ 2 days with headache in the past month at time of inclusion.

* Days with analgesics / month ≤ 6 at time of inclusion.
* Age ≥ 18 years old.
* No significant co-morbid pain, physical or psychiatric disorders.
* No addiction to alcohol or drug-abuse.
* No pregnancy, breastfeeding or planned pregnancy within the next 12 months.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Danish Headache Center

OTHER

Sponsor Role lead

Responsible Party

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Louise Carlsen

Medical doctor, PhD-student

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Danish Headache Center

Glostrup Municipality, Copenhagen, Denmark

Site Status

Countries

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Denmark

References

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Carlsen LN, Hansen CS, Kogelman LJA, Werge TM, Ullum H, Bybjerg-Grauholm J, Hansen TF, Jensen RH. DNA-methylation and immunological response in medication overuse headache. Cephalalgia. 2023 Mar;43(3):3331024221147482. doi: 10.1177/03331024221147482.

Reference Type DERIVED
PMID: 36786322 (View on PubMed)

Carlsen LN, Munksgaard SB, Nielsen M, Engelstoft IMS, Westergaard ML, Bendtsen L, Jensen RH. Comparison of 3 Treatment Strategies for Medication Overuse Headache: A Randomized Clinical Trial. JAMA Neurol. 2020 Sep 1;77(9):1069-1078. doi: 10.1001/jamaneurol.2020.1179.

Reference Type DERIVED
PMID: 32453406 (View on PubMed)

Other Identifiers

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H-16029763

Identifier Type: -

Identifier Source: org_study_id

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