Original Research Articles
Vol. 34 No. 1 (2024)
Intravenous methylprednisolone in patients with episodic cluster headache non-responders to oral steroids: results from an observational, interventional, single-center study
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 15 January 2024
Accepted: 19 May 2024
Accepted: 19 May 2024
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Background: Verapamil is the drug of choice in the prophylaxis of episodic cluster headache (ECH), and oral corticosteroids are frequently prescribed as concurrent bridging therapy. Approximately 25% of the patients do not respond to oral treatment. The aim of this study was to assess safety and efficacy of high dose intravenous methylprednisolone (MPD) in ECH patients who had not responded to combined oral therapy with prednisone and verapamil.
Methods: Forty-four ECH patients – non responders to oral therapy – were treated with intravenous MPD (500 mg/day for 5 days) and verapamil during cluster headache active periods. No serious adverse event was reported.
Results: After 5 days of intravenous therapy, the 24-hour frequency of cluster headache attacks significantly decreased. Sixty-eight percent of patients became headache-free, and 25% experienced a reduction of more than 50% in daily attacks. No clinical benefit was reported in the remaining three patients.
Conclusions: Our study shows that intravenous MPD is a safe, effective, and reproducible treatment for ECH patients not responding to oral therapy.
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Intravenous methylprednisolone in patients with episodic cluster headache non-responders to oral steroids: results from an observational, interventional, single-center study. Confinia Cephalal [Internet]. 2024 Jun. 18 [cited 2025 Oct. 29];34(1). Available from: https://www.confiniacephalalgica.com/site/article/view/15618
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