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Effect of prednisolone for the treatment of medication‐overuse headache: A 3‐month result from a multicenter REgistry for Load and management of mEdicAtion overuSE headache (RELEASE) study
Ist Teil von
Headache, 2024-02, Vol.64 (2), p.149-155
Ort / Verlag
United States: Wiley Subscription Services, Inc
Erscheinungsjahr
2024
Quelle
Wiley-Blackwell Journals
Beschreibungen/Notizen
Objective
To evaluate the efficacy of prednisolone in the treatment of medication‐overuse headache (MOH) using data from a multicenter prospective registry (Registry for Load and Management of Medication Overuse Headache [RELEASE]).
Background
The treatment of MOH is challenging, especially when withdrawal headache manifests during the cessation of overused medication. Although systemic corticosteroids have been empirically used to reduce withdrawal headaches, their efficacy on the long‐term outcomes of MOH has not been documented.
Methods
This was a post hoc analysis of the RELEASE study. The RELEASE is an ongoing multicenter observational cohort study in which patients with MOH have been recruited from seven hospitals in Korea since April 2020. Clinical characteristics, disease profiles, treatments, and outcomes were assessed at baseline and specific time points. We analyzed the effect of prednisolone on MOH reversal at 3 months.
Results
Among the 309 patients enrolled during the study period, prednisolone was prescribed to 59/309 (19.1%) patients at a dose ranging from 10 to 40 mg/day for 5–14 days; 228/309 patients (73.8%) completed the 3‐month follow‐up period. The MOH reversal rates at 3 months after baseline were 76% (31/41) in the prednisolone group and 57.8% (108/187) in the non‐prednisolone group (p = 0.034). The effect of steroids remained significant (adjusted odds ratio 2.78, 95% confidence interval 1.27–6.1, p = 0.010) after adjusting for the number of monthly headache days at baseline, mode of discontinuation of overused medication, use of early preventive medications, and the number of preventive medications combined.
Conclusions
Although our observational study could not draw a definitive conclusion, prednisolone may be effective in the treatment of MOH.