Oxygen Therapy Provides Benefits for Treatment of Cluster Headache: Presented at ANA

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Title: Oxygen Therapy Provides Benefits for Treatment of Cluster Headache: Presented at ANA
URL: http://www.pslgroup.com/dg/22D5DE.htm
Doctor's Guide
September 24, 2008

By Andrew N. Wilner, MD, FACP, FAAN

SALT LAKE CITY, Utah -- September 24, 2008 -- Inhaled oxygen therapy is effective for the treatment of acute cluster headache and should be considered a first-line treatment, according to research presented at the American Neurological Association (ANA) 133rd Annual Meeting.

Peter Goadsby, MD, Headache Center, University of San Francisco, San Francisco, California, presented the study findings here on September 22.

Cluster headache occurs in 0.1% of the population and is the worse kind of pain that people can experience, Dr. Goadsby said. Patients typically experience 1 to 8 headaches a day for 2 to 3 months and then are headache-free for the rest of the year.

Although oxygen therapy has long been touted for the treatment of acute cluster headache, there is only 1 controlled trial in the literature comprising a mere 19 patients to substantiate this claim, Dr. Goadsby observed. Obtaining reimbursement for oxygen therapy for acute cluster headache has been difficult owing to lack of its documented effectiveness, he said.

Dr. Goadsby and colleagues evaluated the efficacy of oxygen therapy in 109 adults who met the criteria of the International Headache Society for cluster headache. Recruitment was performed in conjunction with a cluster headache support group.

During each attack of cluster headache, patients were randomised to treatment using an identical-appearing gas cylinder containing either 100% oxygen or air for 4 separate cluster headaches occurring on different days.

The study was performed between March 2003 and April 2007. Patients who had previously received oxygen treatment were excluded.

A total of 150 headaches were tested with oxygen and 148 with placebo. When assessed after 15 minutes, 78% of the patients treated with 100% oxygen had complete resolution of their headaches, compared with 20% of those treated with air (P < .001). Patients tolerated the oxygen therapy well, Dr. Goadsby said.

He observed that oxygen treatment does not alter the frequency of cluster attacks but is used for the treatment of acute attacks.

Other therapies available include sumatriptan by injection and nasal sprays containing sumatriptan or zolmitriptan.

Dr. Goadsby acknowledged that the mechanism of action of oxygen in treating cluster headache remains unknown.

Now that oxygen therapy has been proven effective, Dr. Goadsby plans to do dose-ranging studies to find the minimal effective dose of oxygen that will be effective to treat acute cluster headache.

[Presentation title: A Randomized Placebo-Controlled Crossover Study of Oxygen in Acute Cluster Headache. Abstract M-93]

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