Treatment of Primary Nummular Headache: A Series of 183 Patients from the NUMITOR Study

Cristina García-Iglesias; Francesca Puledda; Ana Echavarría-Íñiguez; Yesica González-Osorio; Álvaro Sierra-Mencía; Andrea Recio-García; Ana González-Celestino; Gonzalo Valle-Peñacoba; Pablo Irimia; Ángel Luis Guerrero-Peral; David García-Azorín

doi:10.3390/jcm12010122

Treatment of Primary Nummular Headache: A Series of 183 Patients from the NUMITOR Study

Cristina García-Iglesias, Francesca Puledda, Ana Echavarría-Íñiguez^*, Yesica González-Osorio, Álvaro Sierra-Mencía, Andrea Recio-García, Ana González-Celestino, Gonzalo Valle-Peñacoba, Pablo Irimia, Ángel Luis Guerrero-Peral, David García-Azorín

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Nummular headache (NH) is a primary headache characterized by superficial coin-shaped pain. NUMITOR (NCT 05475769) is an observational study evaluating the responder rate of preventive drugs in NH patients. The treatment response was assessed between weeks 8 and 12 compared with the baseline. Patients were included between February 2002 and October 2022. Demographic and clinical variables were assessed; treatment response was estimated by 50%, 30%, and 75% responder rates and treatment discontinuation due to inadequate tolerability. A total of 183 out of 282 patients fulfilled eligibility criteria and completed the study. Patients were aged 49.5 (standard deviation (SD): 16.8) years, and 60.7% were female. NH phenotype was a parietal circular pain of four centimeters’ diameter, moderate intensity, and oppressive quality. At baseline, patients had 25 (interquartile range) pain days per month. Preventive treatment was used by 114 (62.3%) patients. The highest 50% and 75% responder rates corresponded to onabotulinumtoxinA (62.5%, 47.5%), followed by gabapentin (43.7%, 35.2%). Oral preventive drugs were not tolerated by 12.9–25%. The present study provides class IV evidence of the effectiveness of oral preventive drugs and onabotulinumtoxinA in the treatment of primary NH. OnabotulinumtoxinA was the most effective and best-tolerated drug, positioning it as first-line treatment of NH.

Original language	English
Article number	122
Journal	Journal of Clinical Medicine
Volume	12
Issue number	1
DOIs	https://doi.org/10.3390/jcm12010122
Publication status	Published - Jan 2023

Keywords

epicranial headache
headache disorders
nummular headache

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10.3390/jcm12010122

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García-Iglesias, C., Puledda, F., Echavarría-Íñiguez, A., González-Osorio, Y., Sierra-Mencía, Á., Recio-García, A., González-Celestino, A., Valle-Peñacoba, G., Irimia, P., Guerrero-Peral, Á. L., & García-Azorín, D. (2023). Treatment of Primary Nummular Headache: A Series of 183 Patients from the NUMITOR Study. Journal of Clinical Medicine, 12(1), Article 122. https://doi.org/10.3390/jcm12010122

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title = "Treatment of Primary Nummular Headache: A Series of 183 Patients from the NUMITOR Study",

abstract = "Nummular headache (NH) is a primary headache characterized by superficial coin-shaped pain. NUMITOR (NCT 05475769) is an observational study evaluating the responder rate of preventive drugs in NH patients. The treatment response was assessed between weeks 8 and 12 compared with the baseline. Patients were included between February 2002 and October 2022. Demographic and clinical variables were assessed; treatment response was estimated by 50%, 30%, and 75% responder rates and treatment discontinuation due to inadequate tolerability. A total of 183 out of 282 patients fulfilled eligibility criteria and completed the study. Patients were aged 49.5 (standard deviation (SD): 16.8) years, and 60.7% were female. NH phenotype was a parietal circular pain of four centimeters{\textquoteright} diameter, moderate intensity, and oppressive quality. At baseline, patients had 25 (interquartile range) pain days per month. Preventive treatment was used by 114 (62.3%) patients. The highest 50% and 75% responder rates corresponded to onabotulinumtoxinA (62.5%, 47.5%), followed by gabapentin (43.7%, 35.2%). Oral preventive drugs were not tolerated by 12.9–25%. The present study provides class IV evidence of the effectiveness of oral preventive drugs and onabotulinumtoxinA in the treatment of primary NH. OnabotulinumtoxinA was the most effective and best-tolerated drug, positioning it as first-line treatment of NH.",

keywords = "epicranial headache, headache disorders, nummular headache",

author = "Cristina Garc{\'i}a-Iglesias and Francesca Puledda and Ana Echavarr{\'i}a-{\'I}{\~n}iguez and Yesica Gonz{\'a}lez-Osorio and {\'A}lvaro Sierra-Menc{\'i}a and Andrea Recio-Garc{\'i}a and Ana Gonz{\'a}lez-Celestino and Gonzalo Valle-Pe{\~n}acoba and Pablo Irimia and Guerrero-Peral, {{\'A}ngel Luis} and David Garc{\'i}a-Azor{\'i}n",

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year = "2023",

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doi = "10.3390/jcm12010122",

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volume = "12",

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García-Iglesias, C, Puledda, F, Echavarría-Íñiguez, A, González-Osorio, Y, Sierra-Mencía, Á, Recio-García, A, González-Celestino, A, Valle-Peñacoba, G, Irimia, P, Guerrero-Peral, ÁL & García-Azorín, D 2023, 'Treatment of Primary Nummular Headache: A Series of 183 Patients from the NUMITOR Study', Journal of Clinical Medicine, vol. 12, no. 1, 122. https://doi.org/10.3390/jcm12010122

TY - JOUR

T1 - Treatment of Primary Nummular Headache

T2 - A Series of 183 Patients from the NUMITOR Study

AU - García-Iglesias, Cristina

AU - Puledda, Francesca

AU - Echavarría-Íñiguez, Ana

AU - González-Osorio, Yesica

AU - Sierra-Mencía, Álvaro

AU - Recio-García, Andrea

AU - González-Celestino, Ana

AU - Valle-Peñacoba, Gonzalo

AU - Irimia, Pablo

AU - Guerrero-Peral, Ángel Luis

AU - García-Azorín, David

PY - 2023/1

Y1 - 2023/1

N2 - Nummular headache (NH) is a primary headache characterized by superficial coin-shaped pain. NUMITOR (NCT 05475769) is an observational study evaluating the responder rate of preventive drugs in NH patients. The treatment response was assessed between weeks 8 and 12 compared with the baseline. Patients were included between February 2002 and October 2022. Demographic and clinical variables were assessed; treatment response was estimated by 50%, 30%, and 75% responder rates and treatment discontinuation due to inadequate tolerability. A total of 183 out of 282 patients fulfilled eligibility criteria and completed the study. Patients were aged 49.5 (standard deviation (SD): 16.8) years, and 60.7% were female. NH phenotype was a parietal circular pain of four centimeters’ diameter, moderate intensity, and oppressive quality. At baseline, patients had 25 (interquartile range) pain days per month. Preventive treatment was used by 114 (62.3%) patients. The highest 50% and 75% responder rates corresponded to onabotulinumtoxinA (62.5%, 47.5%), followed by gabapentin (43.7%, 35.2%). Oral preventive drugs were not tolerated by 12.9–25%. The present study provides class IV evidence of the effectiveness of oral preventive drugs and onabotulinumtoxinA in the treatment of primary NH. OnabotulinumtoxinA was the most effective and best-tolerated drug, positioning it as first-line treatment of NH.

AB - Nummular headache (NH) is a primary headache characterized by superficial coin-shaped pain. NUMITOR (NCT 05475769) is an observational study evaluating the responder rate of preventive drugs in NH patients. The treatment response was assessed between weeks 8 and 12 compared with the baseline. Patients were included between February 2002 and October 2022. Demographic and clinical variables were assessed; treatment response was estimated by 50%, 30%, and 75% responder rates and treatment discontinuation due to inadequate tolerability. A total of 183 out of 282 patients fulfilled eligibility criteria and completed the study. Patients were aged 49.5 (standard deviation (SD): 16.8) years, and 60.7% were female. NH phenotype was a parietal circular pain of four centimeters’ diameter, moderate intensity, and oppressive quality. At baseline, patients had 25 (interquartile range) pain days per month. Preventive treatment was used by 114 (62.3%) patients. The highest 50% and 75% responder rates corresponded to onabotulinumtoxinA (62.5%, 47.5%), followed by gabapentin (43.7%, 35.2%). Oral preventive drugs were not tolerated by 12.9–25%. The present study provides class IV evidence of the effectiveness of oral preventive drugs and onabotulinumtoxinA in the treatment of primary NH. OnabotulinumtoxinA was the most effective and best-tolerated drug, positioning it as first-line treatment of NH.

KW - epicranial headache

KW - headache disorders

KW - nummular headache

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U2 - 10.3390/jcm12010122

DO - 10.3390/jcm12010122

M3 - Article

AN - SCOPUS:85145948434

SN - 2077-0383

VL - 12

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 1

M1 - 122

ER -

Treatment of Primary Nummular Headache: A Series of 183 Patients from the NUMITOR Study

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