TY - JOUR
T1 - Evolving options for the treatment of cluster headache
AU - Villar-Martinez, Maria Dolores
AU - Chan, Calvin
AU - Goadsby, Peter J.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - PURPOSE OF REVIEW: Cluster headache is a neurological disorder that patients consider the most severe pain they experience. Recognizing new treatments provides opportunities to advance current management. RECENT FINDINGS: In contrast to the classic treatments, new options narrow in on the therapeutic target and are better tolerated. Calcitonin gene-related peptide (CGRP) pathway blockade with monoclonal antibodies (MABs), specifically the CGRP MAB galcanezumab, represents an important advance for episodic cluster headache, reducing the number of attacks during a bout. Neuromodulation strategies aimed at anatomical structures involved in the pathophysiology of cluster headache, such as the sphenopalatine ganglion and the vagus nerve, have proved effective in reducing the pain intensity and the number of attacks, and also to be safe and well tolerated. SUMMARY: Our understanding of the pathophysiology of cluster headache and its management continues to grow. Novel treatments have appeared from research, such as neuromodulation and CGRP monoclonal antibodies. Nonetheless, chronic cluster headache and designing trials that select the correct sham in evaluating devices remain challenging.
AB - PURPOSE OF REVIEW: Cluster headache is a neurological disorder that patients consider the most severe pain they experience. Recognizing new treatments provides opportunities to advance current management. RECENT FINDINGS: In contrast to the classic treatments, new options narrow in on the therapeutic target and are better tolerated. Calcitonin gene-related peptide (CGRP) pathway blockade with monoclonal antibodies (MABs), specifically the CGRP MAB galcanezumab, represents an important advance for episodic cluster headache, reducing the number of attacks during a bout. Neuromodulation strategies aimed at anatomical structures involved in the pathophysiology of cluster headache, such as the sphenopalatine ganglion and the vagus nerve, have proved effective in reducing the pain intensity and the number of attacks, and also to be safe and well tolerated. SUMMARY: Our understanding of the pathophysiology of cluster headache and its management continues to grow. Novel treatments have appeared from research, such as neuromodulation and CGRP monoclonal antibodies. Nonetheless, chronic cluster headache and designing trials that select the correct sham in evaluating devices remain challenging.
UR - http://www.scopus.com/inward/record.url?scp=85084272300&partnerID=8YFLogxK
U2 - 10.1097/WCO.0000000000000808
DO - 10.1097/WCO.0000000000000808
M3 - Article
C2 - 32209808
AN - SCOPUS:85084272300
SN - 1350-7540
VL - 33
SP - 323
EP - 328
JO - Current Opinion in Neurology
JF - Current Opinion in Neurology
IS - 3
ER -