Cluster headache: an overview of established and emerging treatments

Abstract

Cluster headache is a rare but disabling neurological disorder, characterised, according to the International Classification of Headache Disorders-3 (ICHD-3), by unilateral severe headache with associated autonomic features and agitation. Despite proven abortive and preventive treatments, many cases remain refractory, leading to adverse psychosocial and employment outcomes. Understanding the efficacy of current and emerging therapies may help to improve clinical management of such cases. \n \nThis month’s journal club reviews three papers relating to treatment of cluster headache. The first explores the effectiveness and adverse effects of a range of acute treatments for cluster headache, based on a large international sample. The second is a pooled analysis of two previous trials evaluating non-invasive vagus nerve stimulation (nVNS) as an acute treatment for cluster headache. The third paper describes a double-blind, randomised, placebo-controlled study assessing the monoclonal antibody galcanezumab as a preventive agent for cluster headache.