Unsatisfactory response to acute medications does not affect the medication overuse headache development in pediatric chronic migraine.
Acute treatment
Adolescents
Childhood
Chronic migraine
Medication overuse headache
Journal
The journal of headache and pain
ISSN: 1129-2377
Titre abrégé: J Headache Pain
Pays: England
ID NLM: 100940562
Informations de publication
Date de publication:
23 Apr 2024
23 Apr 2024
Historique:
received:
29
02
2024
accepted:
04
04
2024
medline:
23
4
2024
pubmed:
23
4
2024
entrez:
22
4
2024
Statut:
epublish
Résumé
Chronic migraine (CM) negatively impacts the quality of life of 2 to 4% of pediatric patients. In adults, CM is frequently linked to medication overuse headache (MOH), but there is a much lower prevalence of MOH in children. A suboptimal response to acute therapies may lead to their reduced use, thus preventing MOH development in children and adolescents. The frequency of patients with CM who do not respond to acute therapies was examined in the present study. We investigated whether the prevalence of MOH was different between responders and non-responders. We also examined whether patients receiving prophylactic therapy had an improved response to acute therapy. Finally, we investigated if there was a difference in the frequency of psychiatric comorbidities between responders and non-responders. We retrospectively analysed clinical data of all chronic pediatric migraineurs under the age of 18 referred to the Headache Centre at Bambino Gesù Children Hospital in June 2021 and February 2023. ICHD3 criteria were used to diagnose CM and MOH. We collected demographic data, including the age at onset of migraine and the age of the CM course. At baseline and after 3 months of preventive treatment, we evaluated the response to acute medications. Neuropsychiatric comorbidities were referred by the children's parents during the first attendance evaluation. Seventy patients with CM were assessed during the chosen period. Paracetamol was tried by 41 patients (58.5%), NSAIDs by 56 patients (80.0%), and triptans by 1 patient (1.4%). Fifty-one participants (73%) were non-responder to the abortive treatment. The presence of MOH was detected in 27.1% of the whole populations. Regarding our primary aim, MOH was diagnosed in 29% of non-responder patients and 22% of responders (p > 0.05). All patients received preventative treatment. After 3 months of preventive pharmacological therapy, 65.4% of patients who did not respond to acute medications achieved a response, while 34.6% of patients who were non-responder remain non-responder (p < 0.05). Prophylactic therapy was also effective in 69% of patients who responded to acute medication (p < 0.05). Psychiatric comorbidities were detected in 68.6% of patients, with no difference between responders and non-responders (72.2% vs. 67.3%; p = 0.05). Despite the high prevalence of unresponsiveness to acute therapies in pediatric CM, it does not act as a protective factor for MOH. Moreover, responsiveness to acute drugs is improved by pharmacological preventive treatment and it is not affected by concomitant psychiatric comorbidities.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic migraine (CM) negatively impacts the quality of life of 2 to 4% of pediatric patients. In adults, CM is frequently linked to medication overuse headache (MOH), but there is a much lower prevalence of MOH in children. A suboptimal response to acute therapies may lead to their reduced use, thus preventing MOH development in children and adolescents. The frequency of patients with CM who do not respond to acute therapies was examined in the present study. We investigated whether the prevalence of MOH was different between responders and non-responders. We also examined whether patients receiving prophylactic therapy had an improved response to acute therapy. Finally, we investigated if there was a difference in the frequency of psychiatric comorbidities between responders and non-responders.
METHODS
METHODS
We retrospectively analysed clinical data of all chronic pediatric migraineurs under the age of 18 referred to the Headache Centre at Bambino Gesù Children Hospital in June 2021 and February 2023. ICHD3 criteria were used to diagnose CM and MOH. We collected demographic data, including the age at onset of migraine and the age of the CM course. At baseline and after 3 months of preventive treatment, we evaluated the response to acute medications. Neuropsychiatric comorbidities were referred by the children's parents during the first attendance evaluation.
RESULTS
RESULTS
Seventy patients with CM were assessed during the chosen period. Paracetamol was tried by 41 patients (58.5%), NSAIDs by 56 patients (80.0%), and triptans by 1 patient (1.4%). Fifty-one participants (73%) were non-responder to the abortive treatment. The presence of MOH was detected in 27.1% of the whole populations. Regarding our primary aim, MOH was diagnosed in 29% of non-responder patients and 22% of responders (p > 0.05). All patients received preventative treatment. After 3 months of preventive pharmacological therapy, 65.4% of patients who did not respond to acute medications achieved a response, while 34.6% of patients who were non-responder remain non-responder (p < 0.05). Prophylactic therapy was also effective in 69% of patients who responded to acute medication (p < 0.05). Psychiatric comorbidities were detected in 68.6% of patients, with no difference between responders and non-responders (72.2% vs. 67.3%; p = 0.05).
CONCLUSIONS
CONCLUSIONS
Despite the high prevalence of unresponsiveness to acute therapies in pediatric CM, it does not act as a protective factor for MOH. Moreover, responsiveness to acute drugs is improved by pharmacological preventive treatment and it is not affected by concomitant psychiatric comorbidities.
Identifiants
pubmed: 38649822
doi: 10.1186/s10194-024-01766-7
pii: 10.1186/s10194-024-01766-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
61Subventions
Organisme : Ministero della Salute
ID : Current Research
Organisme : Ministero della Salute
ID : GR-2019-12369766
Informations de copyright
© 2024. The Author(s).
Références
Abu-Arafeh I, Razak S, Sivaraman B, Graham C (2010) Prevalence of headache and migraine in children and adolescents: a systematic review of population‐based studies. Develop Med Child Neuro Dicembre 52(12):1088–1097
doi: 10.1111/j.1469-8749.2010.03793.x
Serrano D, Lipton RB, Scher AI, Reed ML, Stewart WF, Adams AM et al (2017) Fluctuations in episodic and chronic migraine status over the course of 1 year: implications for diagnosis, treatment and clinical trial design. J Headache Pain Dicembre 18(1):101
doi: 10.1186/s10194-017-0787-1
Bigal ME, Lipton RB (2008) Clinical course in migraine: conceptualizing migraine transformation. Neurol 9 Settembre 71(11):848–855
Bigal ME, Lipton RB (2008) Concepts and mechanisms of Migraine Chronification. Headache Gennaio 48(1):7–15
doi: 10.1111/j.1526-4610.2007.00969.x
Bigal ME, Lipton RB (2006) When migraine progresses: transformed or chronic migraine. Expert Rev Neurother Marzo 6(3):297–306
doi: 10.1586/14737175.6.3.297
Lipton RB, Buse DC, Nahas SJ, Tietjen GE, Martin VT, Löf E et al (2023) Risk factors for migraine disease progression: a narrative review for a patient-centered approach. J Neurol Dicembre 270(12):5692–5710
doi: 10.1007/s00415-023-11880-2
Zwart JA, Dyb G, Holmen T, Stovner L, Sand T (2004) The prevalence of migraine and tension-type headaches among adolescents in Norway. The Nord-Trøndelag Health Study (Head-Hunt-Youth), a large Population-based epidemiological study. Cephalalgia Maggio 24(5):373–379
doi: 10.1111/j.1468-2982.2004.00680.x
Kernick D, Campbell J (2009) Measuring the impact of Headache in children: a critical review of the literature. Cephalalgia Gennaio 29(1):3–16
doi: 10.1111/j.1468-2982.2008.01693.x
Arruda MA, Guidetti V, Galli F, Albuquerque RCAP, Bigal ME (2010) Frequent headaches in the preadolescent pediatric population: a population-based study. Neurol 16 Marzo 74(11):903–908
Headache Classification Committee of the International Headache Society (IHS) (2018);38(1):1–211
Lipton RB, Manack A, Ricci JA, Chee E, Turkel CC, Winner P (2011) Prevalence and burden of chronic migraine in adolescents: results of the Chronic Daily Headache in adolescents Study (C-dAS). Headache Maggio 51(5):693–706
doi: 10.1111/j.1526-4610.2011.01885.x
De Felice M, Ossipov MH, Porreca F (2011) Persistent medication-induced neural adaptations, descending facilitation, and medication overuse headache. Curr Opin Neurol Giugno 24(3):193–196
doi: 10.1097/WCO.0b013e328346af25
De Felice M, Ossipov MH, Wang R, Lai J, Chichorro J, Meng I et al (2010) Triptan-induced latent sensitization: a possible basis for medication overuse headache. Annals Neurol Marzo 67(3):325–337
doi: 10.1002/ana.21897
Felice MD, Porreca F (2009) Opiate-Induced Persistent Pronociceptive Trigeminal neural adaptations: potential relevance to Opiate-Induced Medication Overuse Headache. Cephalalgia Dicembre 29(12):1277–1284
doi: 10.1111/j.1468-2982.2009.01873.x
Bigal ME, Lipton RB (2008) Excessive acute migraine medication use and migraine progression. Neurol 25 Novembre 71(22):1821–1828
Katsarava Z, Schneeweiss S, Kurth T, Kroener U, Fritsche G, Eikermann A et al (2004) Incidence and predictors for chronicity of headache in patients with episodic migraine. Neurol 9 Marzo 62(5):788–790
Louter MA, Bosker JE, Van Oosterhout WPJ, Van Zwet EW, Zitman FG, Ferrari MD et al (2013) Cutaneous allodynia as a predictor of migraine chronification. Brain Novembre 136(11):3489–3496
doi: 10.1093/brain/awt251
Wang SJ, Fuh JL, Lu SR, Juang KD (2007) Outcomes and predictors of chronic daily headache in adolescents: a 2-year longitudinal study. Neurol 20 Febbraio 68(8):591–596
Sacco S, Lampl C, Amin FM, Braschinsky M, Deligianni C, Uludüz D et al (2022) European Headache Federation (EHF) consensus on the definition of effective treatment of a migraine attack and of triptan failure. J Headache Pain Dicembre 23(1):133
doi: 10.1186/s10194-022-01502-z
Ferrari M, Goadsby P, Roon K, Lipton R (2002) Triptans (serotonin, 5-HT
doi: 10.1046/j.1468-2982.2002.00404.x
Ferrari MD, Roon KI, Lipton RB, Goadsby PJ (2001) Oral triptans (serotonin 5-HT1B/1D agonists) in acute migraine treatment: a meta-analysis of 53 trials. Lancet Novembre 358(9294):1668–1675
doi: 10.1016/S0140-6736(01)06711-3
Cady RK, Wendt JK, Kirchner JR (1991) Treatment of acute migraine with subcutaneous suma- triptan. JAMA.;(265):2831–2835
Lipton RB, Munjal S, Buse DC, Fanning KM, Bennett A, Reed ML (2016) Predicting inadequate response to Acute Migraine Medication: results from the A merican migraine prevalence and Prevention (AMPP) Study. Headache Novembre 56(10):1635–1648
doi: 10.1111/head.12941
Saracco MG, Allais G, Tullo V, Zava D, Pezzola D, Reggiardo G et al (2014) Efficacy of frovatriptan and other triptans in the treatment of acute migraine of normal weight and obese subjects: a review of randomized studies. Neurol Sci Maggio 35(S1):115–119
doi: 10.1007/s10072-014-1752-2
Papetti L, Salfa I, Battan B, Moavero R, Termine C, Bartoli B et al (2019) Features of primary chronic headache in children and adolescents and Validity of Ichd 3 Criteria. Front Neurol 15 Febbraio 10:92
doi: 10.3389/fneur.2019.00092
Moavero R, Stornelli M, Papetti L, Ursitti F, Ferilli MAN, Balestri M et al (2020) Medication overuse withdrawal in children and adolescents does not always improve headache: a cross-sectional study. Front Neurol 19 Agosto 11:823
doi: 10.3389/fneur.2020.00823
Stevens J, Hayes J, Pakalnis A (2014) A randomized trial of telephone-based motivational interviewing for adolescent chronic headache with medication overuse. Cephalalgia Maggio 34(6):446–454
doi: 10.1177/0333102413515336
Langdon R, DiSabella MT (2017) Pediatric Headache: an overview. Curr Probl Pediatr Adolesc Health Care Marzo 47(3):44–65
doi: 10.1016/j.cppeds.2017.01.002
Heyer GL, Idris SA (2014) Does Analgesic Overuse Contribute to Chronic Post-traumatic Headaches in Adolescent Concussion Patients? Pediatric Neurology. maggio.;50(5):464–8
Bahra A, Walsh M, Menon S, Goadsby PJ (2003) Does Chronic Daily Headache Arise De Novo in Association With Regular Use of Analgesics? Headache. marzo.;43(3):179–90
Wilkinson SM, Becker WJ, Heine JA (2001) Opiate Use to Control Bowel Motility May Induce Chronic Daily Headache in Patients With Migraine. Headache. 30 marzo.;41(3):303–9
Consortium COMOESTAS, Find NL, Terlizzi R, Munksgaard SB, Bendtsen L, Tassorelli C et al (2016) Medication overuse headache in Europe and Latin America: general demographic and clinical characteristics, referral pathways and national distribution of painkillers in a descriptive, multinational, multicenter study. J Headache Pain Dicembre 17(1):20
doi: 10.1186/s10194-016-0612-2
Papetti L, Ursitti F, Moavero R, Ferilli MAN, Sforza G, Tarantino S et al (2019) Prophylactic Treatment of Pediatric Migraine: Is There Anything New in the Last Decade? Front Neurol. 16 luglio.;10:771
Kristoffersen ES, Lundqvist C (2014) Medication-overuse headache: epidemiology, diagnosis and treatment. Therapeutic Adv Drug Saf Aprile 5(2):87–99
doi: 10.1177/2042098614522683
Cevoli S, Sancisi E, Grimaldi D, Pierangeli G, Zanigni S, Nicodemo M et al (2009) Family History for Chronic Headache and Drug Overuse as a risk factor for Headache Chronification. Headache Marzo 49(3):412–418
doi: 10.1111/j.1526-4610.2008.01257.x
Cupini LM, De Murtas M, Costa C, Mancini M, Eusebi P, Sarchielli P et al (2009) Obsessive-compulsive disorder and migraine with medication‐overuse headache. Headache Luglio 49(7):1005–1013
doi: 10.1111/j.1526-4610.2009.01457.x
Odegard MN, Ceasar RC, Hijaz D, Obinelo A, Rosales A, Bhanvadia S et al Adolescent and parent perceptions of postoperative opioid use: a qualitative, thematic analysis. Journal of Pediatric Surgery. dicembre 2023;S002234682300756X.
Sarchielli P, Corbelli I, Messina P, Cupini LM, Bernardi G, Bono G et al (2016) Psychopathological comorbidities in medication-overuse headache: a multicentre clinical study. Euro J Neurol Gennaio 23(1):85–91
doi: 10.1111/ene.12794
Winner P, Pearlman EM, Linder SL, Jordan DM, Fisher AC, Hulihan J et al (2005) Topiramate for Migraine Prevention in children: a Randomized, Double-Blind, Placebo‐Controlled Trial. Headache Novembre 45(10):1304–1312
doi: 10.1111/j.1526-4610.2005.00262.x
FDA approves Topamax for migraine prevention in adolescents (2014) J Pain Palliat Care Pharmacother Giugno 28(2):191
Powers SW, Coffey CS, Chamberlin LA, Ecklund DJ, Klingner EA, Yankey JW et al (2017) Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine. N Engl J Med. 12 gennaio.;376(2):115–24
Ludvigsson J, PROPRANOLOL, USED IN PROPHYLAXIS OF MIGRAINE IN CHILDREN (2009) Acta Neurol Scand 29 Gennaio 50(1):109–115
doi: 10.1111/j.1600-0404.1974.tb01350.x
Sorge F, Simone RD, Marano E, Nolano M, Orefice G, Carrieri P (1988) Flunarizine in Prophylaxis of Childhood Migraine: a Double-Blind, Placebo-Controlled, crossover study. Cephalalgia Marzo 8(1):1–6
doi: 10.1046/j.1468-2982.1988.0801001.x
Ashrafi MR, Salehi S, Malamiri RA, Heidari M, Hosseini SA, Samiei M et al (2014) Efficacy and safety of Cinnarizine in the Prophylaxis of Migraine in children: a double-blind placebo-controlled Randomized Trial. Pediatr Neurol Ottobre 51(4):503–508
doi: 10.1016/j.pediatrneurol.2014.05.031
Battistella PA, Ruffilli R, Moro R, Fabiani M, Bertoli S, Antolini A et al (1990) A placebo-controlled crossover trial of Nimodipine in Pediatric Migraine. Headache Aprile 30(5):264–268
doi: 10.1111/j.1526-4610.1990.hed3005264.x
Gesztelyi G (2004) [Primary headache and depression]. Orv Hetil 28 Novembre 145(48):2419–2424
Tarantino S, Papetti L, Di Stefano A, Messina V, Ursitti F, Ferilli MAN et al (2020) Anxiety, Depression, and Body Weight in Children and adolescents with Migraine. Front Psychol 28 Ottobre 11:530911
doi: 10.3389/fpsyg.2020.530911
Guidetti V, Galli F, Fabrizi P, Giannantoni A, Napoli L, Bruni O et al (1998) Headache and psychiatric comorbidity: clinical aspects and outcome in an 8-year follow-up study. Cephalalgia Settembre 18(7):455–462
doi: 10.1046/j.1468-2982.1998.1807455.x
Lantéri-Minet M, Radat F, Chautard MH, Lucas C (2005) Anxiety and depression associated with migraine: influence on migraine subjects’ disability and quality of life, and acute migraine management. Pain Dicembre 118(3):319–326
doi: 10.1016/j.pain.2005.09.010
Lewandowski AS, Palermo TM, Peterson CC (2006) Age-Dependent relationships among Pain, depressive symptoms, and functional disability in Youth with recurrent headaches. Headache Aprile 46(4):656–662
doi: 10.1111/j.1526-4610.2006.00363.x