Neues bei Kopfschmerzen 2022–2023

Die letzte Zusammenfassung zu neuen Aspekten der Epidemiologie, Klinik und Therapie von Kopfschmerzen in der Neurologie up2date erschien vor über 2 Jahren. In der Zwischenzeit gibt es viele neue wissenschaftliche Erkenntnisse zu Kopfschmerzen. Diese Übersicht stützt sich auf eine Literaturrecherche für den Zeitraum von Januar 2022 bis Juli 2023.

Kernaussagen

• Viele Patienten überschätzen die tatsächliche Bedeutung von Triggerfaktoren für das Auslösen von Migräneattacken.

• Triptane sind die Medikamente der 1. Wahl zur Behandlung akuter Migräneattacken.

• Es gibt bisher keine direkten Vergleichsstudien zwischen den Triptanen, den Ditanen und den Gepanten bezüglich der Wirksamkeit bei der Therapie akuter Migräneattacken.

• In Deutschland werden immer noch zu wenige Migränepatienten mit einem Triptan behandelt.

• Nach der Einnahme von Lasmiditan darf über einen Zeitraum von 8 h kein Kraftfahrzeug geführt werden.

• Antikörper gegen PACAP sind möglicherweise zur Prophylaxe der Migräne wirksam.

• Patienten mit chronischer Migräne und Medikamentenübergebrauch haben den höchsten Nutzen von einer Therapie mit monoklonalen Antikörpern gegen CGRP oder den CGRP-Rezeptor.

• Die monoklonalen Antikörper gegen CGRP unter den CGRP-Rezeptor weisen eine sehr gute Verträglichkeit auf.

• Amitriptylin ist die wirksamste Substanz zur Prophylaxe des chronischen Kopfschmerzes vom Spannungstyp.

• Kopfschmerzen gehören zu den häufigsten Symptomen einer akuten COVID-19-Erkrankung. Im Anschluss kann es in seltenen Fällen zu einem new daily persistent Headache kommen. Dies kann auch nach einer COVID-19-Impfung der Fall sein.

• Der monoklonale Antikörper Erenumab ist bei der idiopathischen Trigeminusneuralgie nicht wirksam.

• Eine vielversprechende neue Therapieoption bei der idiopathischen intrakraniellen Hypertension ist möglicherweise der GLP-1-Rezeptor-Agonist Exenatide.

Schlüsselwörter

Schmerztherapie - Migräne - Clusterkopfschmerz - Spannungskopfschmerz - Medikamentenübergebrauch

Publication History

Article published online:
08 December 2023

• Literatur

• 1 Ruscheweyh R, Klonowski T, Gossrau G. et al. The headache registry of the German Migraine and Headache Society (DMKG): baseline data of the first 1,351 patients. J Headache Pain 2022; 23: 74 DOI: 10.1186/s10194-022-01447-3. (PMID: 35773650)
• 2 Müller B, Gaul C, Reis O. et al. Headache impact and socioeconomic status: findings from a study of the German Migraine and Headache Society (DMKG). J Headache Pain 2023; 24: 37 DOI: 10.1186/s10194-023-01564-7.
• 3 Casanova A, Vives-Mestres M, Donoghue S. et al. The role of avoiding known triggers, embracing protectors, and adhering to healthy lifestyle recommendations in migraine prophylaxis: insights from a prospective cohort of 1125 people with episodic migraine. Headache 2023; 63: 51-61 DOI: 10.1111/head.14451.
• 4 Casanova A, Vives-Mestres M, Donoghue S. et al. An observational study of self-reported migraine triggers and prospective evaluation of the relationships with occurrence of attacks enabled by a smartphone application (App). Headache 2022; 62: 1406-1415 DOI: 10.1111/head.1432814451.
• 5 Klan T, Gaul C, Liesering-Latta E. et al. Efficacy of cognitive-behavioral therapy for the prophylaxis of migraine in adults: a three-armed randomized controlled trial. Front Neurol 2022; 13: 852616 DOI: 10.3389/fneur.2022.852616. (PMID: 35572937)
• 6 VanderPluym JH, Mangipudi K, Mbonde AA. et al. Incidence of status migrainosus in Olmsted County, Minnesota, United States: characterization and predictors of recurrence. Neurology 2023; 100: e255-e263 DOI: 10.1212/wnl.0000000000201382. (PMID: 36175145)
• 7 Kurth T, Slomke MA, Kase CS. et al. Migraine, headache, and the risk of stroke in women: a prospective study. Neurology 2005; 64: 1020-1026 DOI: 10.1212/01.WNL.0000154528.21485.3A. (PMID: 15781820)
• 8 Batur P, Yao M, Bucklan J. et al. Use of combined hormonal contraception and stroke: a case-control study of the impact of migraine type and estrogen dose on ischemic stroke risk. Headache 2023; 63: 813-821 DOI: 10.1111/head.14473.. (PMID: 36752588)
• 9 Purdue-Smithe AC, Stuart JJ, Farland LV. et al. Prepregnancy migraine, migraine phenotype, and risk of adverse pregnancy outcomes. Neurology 2023; 100: e1464-e73 DOI: 10.1212/WNL.0000000000206831. (PMID: 36657989)
• 10 Diener HC, Förderreuther S, Kropp P. et al. Therapie der Migräneattacke und Prophylaxe der Migräne, S1-Leitlinie, 2022, DGN und DMKG. In: Deutsche Gesellschaft für Neurologie (Hrsg.), Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. Accessed August 24, 2023 at: https://www.dgn.org/leitlinien
• 11 Diener HC. The risks or lack thereof of migraine treatments in vascular disease. Headache 2020; 60: 649-653 DOI: 10.1111/head.13749. (PMID: 31967337)
• 12 Ghanshani S, Chen C, Lin B. et al. Risk of acute myocardial infarction, heart failure, and death in migraine patients treated with triptans. Headache 2020; 60: 2166-2175 DOI: 10.1111/head.13959.
• 13 Gaul C, Förderreuther S. Sumatriptan 3mg subkutan: Klinische Relevanz in der Akuttherapie der Migräne trotz Dosisreduktion. Nervenarzt 2022; 93: 612-617 DOI: 10.1007/s00115-021-01189-8.
• 14 Goadsby PJ, Wietecha LA, Dennehy EB. et al. Phase 3 randomized, placebo-controlled, double-blind study of lasmiditan for acute treatment of migraine. Brain 2019; 142: 1894-1904 DOI: 10.1093/brain/awz134. (PMID: 31132795)
• 15 Farkkila M, Diener HC, Geraud G. et al. Efficacy and tolerability of lasmiditan, an oral 5-HT(1F) receptor agonist, for the acute treatment of migraine: a phase 2 randomised, placebo-controlled, parallel-group, dose-ranging study. Lancet Neurol 2012; 11: 405-413 DOI: 10.1016/S1474-4422(12)70047-9. (PMID: 22459549)
• 16 Lipton RB, Croop R, Stock EG. et al. Rimegepant, an oral calcitonin gene-related peptide receptor antagonist, for migraine. N Engl J Med 2019; 381: 142-149 DOI: 10.1056/NEJMoa1811090. (PMID: 31291516)
• 17 Croop R, Goadsby PJ, Stock DA. et al. Efficacy, safety, and tolerability of rimegepant orally disintegrating tablet for the acute treatment of migraine: a randomised, phase 3, double-blind, placebo-controlled trial. Lancet 2019; 394: 737-745 DOI: 10.1016/S0140-6736(19)31606-X. (PMID: 31311674)
• 18 Dodick DW, Lipton RB, Ailani J. et al. Ubrogepant for the treatment of migraine. N Engl J Med 2019; 381: 2230-2241 DOI: 10.1056/NEJMoa1813049. (PMID: 31800988)
• 19 Puledda F, Younis S, Huessler E-M. et al. Efficacy, safety and indirect comparisons of lasmiditan, rimegepant, and ubrogepant for the acute treatment of migraine: a systematic review and network meta-analysis of the literature. Cephalalgia 2023; 43 DOI: 10.1177/03331024231151419. (PMID: 36786357)
• 20 Begasse de Dhaem O, Takizawa T, Dodick DW. Long-term open-label and real-world studies of lasmiditan, ubrogepant, and rimegepant for the acute treatment of migraine attacks. Cephalalgia 2023; 43: 3331024221137092 DOI: 10.1177/03331024221137092. (PMID: 36739505)
• 21 de I Boer, Verhagen IE, Souza MNP. et al. Place of next generation acute migraine specific treatments among triptans, non-responders and contraindications to triptans and possible combination therapies. Cephalalgia 2023; 43: 3331024221143773 DOI: 10.1177/03331024221143773.
• 22 Dodick DW. Triptan nonresponder studies: implications for clinical practice. Headache 2005; 45: 156-162 DOI: 10.1111/j.1526-4610.2005.05031.x. (PMID: 15705122)
• 23 Diener HC, Gaul C, Kropp P. et al. Kopfschmerz bei Übergebrauch von Schmerz- oder Migränemitteln (Medication Overuse Headache=MOH), S1 Leitline, 2022. In: Deutsche Gesellschaft für Neurologie, Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. Accessed August 24, 2023 at: https://www.dgn.org/leitlinien
• 24 Rau JC, Navratilova E, Oyarzo J. et al. Evaluation of LY573144 (lasmiditan) in a preclinical model of medication overuse headache. Cephalalgia 2020; 40: 903-912 DOI: 10.1177/0333102420920006. (PMID: 32580575)
• 25 Navratilova E, Behravesh S, Oyarzo J. et al. Ubrogepant does not induce latent sensitization in a preclinical model of medication overuse headache. Cephalalgia 2020; 40: 892-902 DOI: 10.1177/0333102420938652.
• 26 Croop R, Madonia J, Stock DA. et al. Zavegepant nasal spray for the acute treatment of migraine: a phase 2/3 double-blind, randomized, placebo-controlled, dose-ranging trial. Headache 2022; 62: 1153-1163 DOI: 10.1111/head.14389.. (PMID: 36239038)
• 27 Lipton RB, Croop R, Stock DA. et al. Safety, tolerability, and efficacy of zavegepant 10 mg nasal spray for the acute treatment of migraine in the USA: a phase 3, double-blind, randomised, placebo-controlled multicentre trial. Lancet Neurol 2023; 22: 209-217 DOI: 10.1016/S1474-4422(22)00517-8.
• 28 Chou DE, Shnayderman Yugrakh M, Winegarner D. et al. Acute migraine therapy with external trigeminal neurostimulation (ACME): a randomized controlled trial. Cephalalgia 2019; 39: 3-14 DOI: 10.1177/0333102418811573.
• 29 Magis D, Sava S, d'Elia TS. et al. Safety and patients' satisfaction of transcutaneous supraorbital neurostimulation (tSNS) with the Cefaly(R) device in headache treatment: a survey of 2,313 headache sufferers in the general population. J Headache Pain 2013; 14: 95 DOI: 10.1186/1129-2377-14-95.
• 30 Kuruvilla DE, Mann JI, Tepper SJ. et al. Phase 3 randomized, double-blind, sham-controlled trial of e-TNS for the acute treatment of migraine (TEAM). Sci Rep 2022; 12: 5110 DOI: 10.1038/s41598-022-09071-6. (PMID: 35332216)
• 31 Guo S, Jansen-Olesen I, Olesen J. et al. Role of PACAP in migraine: an alternative to CGRP?. Neurobiol Dis 2023; 176: 105946 DOI: 10.1016/j.nbd.2022.105946. (PMID: 36481434)
• 32 Uddman R, Goadsby PJ, Jansen I. et al. PACAP, a VIP-like peptide: immunohistochemical localization and effect upon cat pial arteries and cerebral blood flow. J Cereb Blood Flow Metab 1993; 13: 291-297 DOI: 10.1038/jcbfm.1993.36.
• 33 Ashina H, Guo S, Vollesen ALH. et al. PACAP38 in human models of primary headaches. J Headache Pain 2017; 18: 110 DOI: 10.1186/s10194-017-0821-3. (PMID: 29453754)
• 34 Haghdoost F, Puledda F, Garcia-Azorin D. et al. Evaluating the efficacy of CGRP mAbs and gepants for the preventive treatment of migraine: a systematic review and network meta-analysis of phase 3 randomised controlled trials. Cephalalgia 2023; 43 DOI: 10.1177/03331024231159366. (PMID: 36855951)
• 35 Messina R, Huessler E-M, Puledda F. et al. Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: a systematic review and network meta-analysis. Cephalalgia 2023; 43 DOI: 10.1177/03331024231152169. (PMID: 36786548)
• 36 Raffaelli B, De Icco R, Corrado M. et al. Open-label trials for CGRP-targeted drugs in migraine prevention: a narrative review. Cephalalgia 2023; 43 DOI: 10.1177/03331024221137091. (PMID: 36718044)
• 37 Asawavichienjinda T, Sathitratanacheewin S, Chokesuwattanaskul R. "Wearing-off" efficacy of CGRP monoclonal antibodies for migraine prevention: a meta-analysis of randomized controlled trials. Cephalalgia 2023; 43 DOI: 10.1177/03331024231161261. (PMID: 36924253)
• 38 Wang X, Wen D, He Q. et al. Efficacy and safety of monoclonal antibody against calcitonin gene-related peptide or its receptor for migraine patients with prior preventive treatment failure: a network meta-analysis. J Headache Pain 2022; 23: 105 DOI: 10.1186/s10194-022-01472-2. (PMID: 36071388)
• 39 Briceño-Casado MDP, Gil-Sierra MD, De-La-Calle-Riaguas B. Switching of monoclonal antibodies against calcitonin gene-related peptide in chronic migraine in clinical practice: a case series. Eur J Hosp Pharm 2021; 30: e19 DOI: 10.1136/ejhpharm-2021-002946. (PMID: 34521726)
• 40 Overeem LH, Peikert A, Hofacker MD. et al. Effect of antibody switch in non-responders to a CGRP receptor antibody treatment in migraine: a multi-center retrospective cohort study. Cephalalgia 2022; 42: 291-301 DOI: 10.1177/03331024211048765. (PMID: 34644203)
• 41 Vernieri F, Brunelli N, Messina R. et al. Discontinuing monoclonal antibodies targeting CGRP pathway after one-year treatment: an observational longitudinal cohort study. J Headache Pain 2021; 22: 154 DOI: 10.1186/s10194-021-01363-y. (PMID: 34922444)
• 42 Holzer P, Holzer-Petsche U. Constipation caused by anti-calcitonin gene-related peptide migraine therapeutics explained by antagonism of calcitonin gene-related peptide's motor-stimulating and prosecretory function in the intestine. Front Physiol 2021; 12 DOI: 10.3389/fphys.2021.820006. (PMID: 35087426)
• 43 Ailani J, Kaiser EA, Mathew PG. et al. Role of calcitonin gene-related peptide on the gastrointestinal symptoms of migraine-clinical considerations: a narrative review. Neurology 2022; 99: 841-853 DOI: 10.1212/wnl.0000000000201332. (PMID: 36127137)
• 44 Kudrow D, Nguyen L, Semler J. et al. A phase IV clinical trial of gastrointestinal motility in adult patients with migraine before and after initiation of a calcitonin gene-related peptide ligand (galcanezumab) or receptor (erenumab) antagonist. Headache 2022; 62: 1164-1176 DOI: 10.1111/head.14390. (PMID: 35690723)
• 45 de Vries Lentsch S, Heleen van der Arend BW, Maassen van den Brink A. et al. Blood pressure in migraine patients treated with monoclonal anti-CGRP (receptor) antibodies: a prospective follow-up study. Neurology 2022; 99: e1897-e1904 DOI: 10.1212/wnl.0000000000201008.
• 46 Ruiz M, Cocores A, Tosti A. et al. Alopecia as an emerging adverse event to CGRP monoclonal antibodies: Cases Series, evaluation of FAERS, and literature review. Cephalalgia 2023; 43: 3331024221143538 DOI: 10.1177/03331024221143538. (PMID: 36739513)
• 47 Alpuente A, Torres-Ferrus M, Terwindt GM. Preventive CGRP-targeted therapies for chronic migraine with and without medication-overuse headache. Cephalalgia 2023; 43 DOI: 10.1177/03331024221150235.
• 48 Giri S, Tronvik E, Linde M. et al. Randomized controlled studies evaluating topiramate, botulinum toxin type A, and mABs targeting CGRP in patients with chronic migraine and medication overuse headache: a systematic review and meta-analysis. Cephalalgia 2023; 43 DOI: 10.1177/03331024231156922.
• 49 Pensato U, Baraldi C, Favoni V. et al. Detoxification vs non-detoxification before starting an anti-CGRP monoclonal antibody in medication overuse headache. Cephalalgia 2022; 42: 645-653 DOI: 10.1177/03331024211067791.
• 50 Underwood M, Achana F, Carnes D. et al. Supportive self-management program for people with chronic headaches and migraine. a randomized controlled trial and economic evaluation 2023; 100: e1339-e1352 DOI: 10.1212/wnl.0000000000201518.
• 51 Pijpers JA, Kies DA, van Zwet EW. et al. Behavioural intervention in medication overuse headache: a concealed double-blind randomized controlled trial. Eur J Neurol 2022; 29: 1496-1504 DOI: 10.1111/ene.15256.
• 52 Schwedt T, Hentz J, Sahai-Srivastava S. et al. Patient-centered treatment of chronic migraine with medication overuse: a prospective, randomized, pragmatic clinical trial. Neurology 2022; 98: e1409-e1421 DOI: 10.1212/WNL.0000000000200117.
• 53 Ashina S, Mitsikostas DD, Lee MJ. et al. Tension-type headache. Nat Rev Dis Primers 2021; 7: 24 DOI: 10.1038/s41572-021-00257-2. (PMID: 33767185)
• 54 Ferreira GE, Abdel-Shaheed C, Underwood M. et al. Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ 2023; 380: e072415 DOI: 10.1136/bmj-2022-072415. (PMID: 36725015)
• 55 Tao QF, Wang XY, Feng SJ. et al. Efficacy of acupuncture for tension-type headache prophylaxis: systematic review and meta-analysis with trial sequential analysis. J Neurol 2023; 270: 3402-3412 DOI: 10.1007/s00415-023-11695-1.
• 56 Schiller J, Niederer D, Kellner T. et al. Effects of acupuncture and medical training therapy on depression, anxiety, and quality of life in patients with frequent tension-type headache: a randomized controlled study. Cephalalgia 2023; 43 DOI: 10.1177/03331024221132800.
• 57 Schiller J, Karst M, Kellner T. et al. Combination of acupuncture and medical training therapy on tension type headache: results of a randomised controlled pilot study. Cephalalgia 2021; 41: 879-893 DOI: 10.1177/0333102421989620. (PMID: 33563049)
• 58 Diener HC, Tassorelli C, Dodick DW. Management of trigeminal autonomic cephalalgias including chronic cluster: a review. JAMA Neurol 2023; DOI: 10.1001/jamaneurol.2022.4804. (PMID: 36648786)
• 59 Diener HC, May A. Drug treatment of cluster headache. Drugs 2022; 82: 33-42 DOI: 10.1007/s40265-021-01658-z. (PMID: 34919214)
• 60 Petersen AS, Pedersen AS, Barloese MCJ. et al. Intranasal ketamine for acute cluster headache attacks—results from a proof-of-concept open-label trial. Headache 2022; 62: 26-35 DOI: 10.1111/head.14220.
• 61 Chen ST, Wu JW. CGRP-targeted therapy for episodic and chronic cluster headache. Curr Pain Headache Rep 2022; 26: 667-675 DOI: 10.1007/s11916-022-01070-6. (PMID: 35881279)
• 62 Dodick DW, Goadsby PJ, Lucas C. et al. Phase 3 randomized, placebo-controlled study of galcanezumab in patients with chronic cluster headache: results from 3-month double-blind treatment. Cephalalgia 2020; 40: 935-948 DOI: 10.1177/0333102420905321.
• 63 Goadsby PJ, Dodick DW, Leone M. et al. Trial of galcanezumab in prevention of episodic cluster headache. N Engl J Med 2019; 381: 132-141 DOI: 10.1056/NEJMoa1813440. (PMID: 31291515)
• 64 Riesenberg R, Gaul C, Stroud CE. et al. Long-term open-label safety study of galcanezumab in patients with episodic or chronic cluster headache. Cephalalgia 2022; 42: 1225-1235 DOI: 10.1177/03331024221103509. (PMID: 34919214)
• 65 Medrea I, Christie S, Tepper SJ. et al. Effects of acute and preventive therapies for episodic and chronic cluster headache: a scoping review of the literature. Headache 2022; 62: 329-362 DOI: 10.1111/head.14284. (PMID: 35315067)
• 66 Evans RW, Turner DP. Clinical features of new daily persistent headache: a retrospective chart review of 328 cases. Headache 2021; 61: 1529-1538 DOI: 10.1111/head.14207. (PMID: 34710236)
• 67 Lobo R, Wang M, Lobo S. et al. Time to retire 'New daily persistent headache': mode of onset of chronic migraine and tension-type headache. Cephalalgia 2022; 42: 385-395 DOI: 10.1177/03331024211044440. (PMID: 34579562)
• 68 Pomeroy JL, Marmura MJ, Nahas SJ. et al. Ketamine infusions for treatment refractory headache. Headache 2017; 57: 276-282 DOI: 10.1111/head.13013. (PMID: 28025837)
• 69 Nierenburg H, Newman LC. Update on new daily persistent headache. Curr Treat Options Neurol 2016; 18: 25 DOI: 10.1007/s11940-016-0408-3. (PMID: 27080086)
• 70 Caronna E, van den Hoek TC, Bolay H. et al. Headache attributed to SARS-CoV-2 infection, vaccination and the impact on primary headache disorders of the COVID-19 pandemic: a comprehensive review. Cephalalgia 2023; DOI: 10.1177/03331024221131337. (PMID: 36606562)
• 71 Sampaio Rocha-Filho PA. Headache associated with COVID-19: epidemiology, characteristics, pathophysiology, and management. Headache 2022; 62: 650-656 DOI: 10.1111/head.14319. (PMID: 35545780)
• 72 Sampaio Rocha-Filho PA, Voss L. Persistent headache and persistent anosmia associated with COVID-19. Headache 2020; 60: 1797-1799 DOI: 10.1111/head.13941. (PMID: 32790179)
• 73 Schott Andersen AS, Maarbjerg S, Noory N. et al. Safety and efficacy of erenumab in patients with trigeminal neuralgia in Denmark: a double-blind, randomised, placebo-controlled, proof-of-concept study. Lancet Neurol 2022; 21: 994-1003 DOI: 10.1016/S1474-4422(22)00294-0.
• 74 Muñoz-Vendrell A, Teixidor S, Sala-Padró J. et al. Intravenous lacosamide and phenytoin for the treatment of acute exacerbations of trigeminal neuralgia: retrospective analysis of 144 cases. Cephalalgia 2022; 42: 1031-1038 DOI: 10.1177/03331024221092435. (PMID: 35469475)
• 75 Kupersmith MJ, Gamell L, Turbin R. et al. Effects of weight loss on the course of idiopathic intracranial hypertension in women. Neurology 1998; 50: 1094-1098 DOI: 10.1212/wnl.50.4.1094. (PMID: 9566400)
• 76 Zheng SL, Roddick AJ, Aghar-Jaffar R. et al. Association between use of sodium-glucose cotransporter 2 inhibitors, glucagon-like peptide 1 agonists, and dipeptidyl peptidase 4 inhibitors with all-cause mortality in patients with type 2 diabetes: a systematic review and meta-analysis. JAMA 2018; 319: 1580-1591 DOI: 10.1001/jama.2018.3024.
• 77 Pedrosa MR, Franco DR, Gieremek HW. et al. GLP-1 agonist to treat obesity and prevent cardiovascular disease: what have we achieved so far?. Curr Atheroscler Rep 2022; 24: 867-884 DOI: 10.1007/s11883-022-01062-2.
• 78 Botfield HF, Uldall MS, Westgate CSJ. et al. A glucagon-like peptide-1 receptor agonist reduces intracranial pressure in a rat model of hydrocephalus. Sci Transl Med 2017; 9: eaan0972 DOI: 10.1126/scitranslmed.aan0972.
• 79 Mitchell JL, Lyons HS, Walker JK. et al. The effect of GLP-1RA exenatide on idiopathic intracranial hypertension: a randomized clinical trial. Brain 2023; 146: 1821-1830