Timing of cluster headache preventives in episodic cluster headache: Protocol for an observational prospective cohort pilot study

Abstract

Purpose: In cluster headache, patients often describe a ramp up period with initially milder headache and then build up to a persistent and severe pattern. It is possible that within the early ramp up, patients may be more treatment responsive. We propose to study if response to therapy for prevention of cluster headache is dependent on timing from onset of cluster cycle. Methods: We will conduct a prospective observational cohort study, where we examine the relationship between timing of start of preventive medication and likelihood of response to treatment. We will look at individuals exposed within 10 days of onset of cluster cycle, versus those exposed after 10 days, to preventive medication. Results: We plan to enroll patients into the study and present data on completion. Conclusion: We aim to study the relationship between cluster headache onset and response to therapy. We propose that there is some data to suggest that earlier in cycle cluster headache may be more easily prevented, and we aim to study this relationship systematically. This is an important question that can influence treatment decisions in clinical practice, as well as clinical trial design.