Abstract Details

Title Acute and preventive treatment patterns in episodic cluster headache: findings from the United States, United Kingdom and Germany

Topic Headache

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-015

Objective To describe regional treatment patterns for episodic cluster headache.

Background Patients with episodic cluster headache (ECH) can experience multiple, excruciatingly painful, unilateral headache attacks a day. Treatment options for CH have limited supportive data and the standard of care may differ by region.

Design/Methods Data were drawn from the Adelphi 2017 CH Disease Specific Programme, a cross sectional survey including physicians and their CH patients from Germany, UK and US. Physicians reported on the full acute and preventive treatment history for their next 10 consulting CH patients. Data was analyzed descriptively.

Results The majority of ECH patients in Germany (N=309), the UK (N=328) and US (N=375) received acute therapy only (53%, 48%, 43% respectively), a combination of acute and preventive therapy (34%; 37%; 42%), or preventive therapy only (10%, 8%, 12%). Most frequently prescribed acute treatments were sumatriptan, oxygen and zolmitriptan. Oxygen was prescribed more often in Germany (45%) and UK (33%) vs. US (19%). Verapamil was the most commonly prescribed preventive therapy (34%, 29% and 25% of patients in Germany, US and UK respectively) followed by topiramate and lithium. Fewer UK patients reported taking their preventive therapy as advised vs. Germany and US (32% vs. 60% and 80% respectively). Key reasons for non-compliance across geographies: forgetfulness, not feeling like a dose was needed and side effects experienced. Over half of patients in the UK (60%) and US (54%) reported the need to take an extra dose of their acute medication to relieve pain symptoms, compared with 30% in Germany, and 13% in the US indicated they did this ‘all the time’ or ‘nearly all the time’ (vs. 2% in Germany and 7% in UK).

Conclusions The treatment of ECH is marked by high use of acute medications and lower use of preventive treatments, despite recommendations, suggesting the need for additional preventive options.

Authors/Disclosures
Russell Nichols PRESENTER	Russell Nichols has received personal compensation for serving as an employee of Eli Lilly and Company. Russell Nichols has received stock or an ownership interest from Eli Lilly and Company.
J S. Andrews	J Scott Andrews has received personal compensation for serving as an employee of Eli Lilly & Company. J Scott Andrews has received stock or an ownership interest from Eli Lilly & Company.
James Jackson (Adelphi Real World)	James Jackson has nothing to disclose.
Sarah Cotton	Sarah Cotton has nothing to disclose.
Antje Tockhorn-Heidenreich	Antje Tockhorn-Heidenreich has received personal compensation for serving as an employee of Eli Lilly and Company. An immediate family member of Antje Tockhorn-Heidenreich has received personal compensation for serving as an employee of Evidera. Antje Tockhorn-Heidenreich has received stock or an ownership interest from Eli Lilly and Company . An immediate family member of Antje Tockhorn-Heidenreich has received stock or an ownership interest from PPD.
	No disclosure on file
	No disclosure on file
James Martinez	No disclosure on file

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