Evidence map›Paper›PMID 36437611›Full record

ReviewHeadache2022

Is prednisone still a reasonable option in the treatment of withdrawal headache in patients with chronic migraine and medication overuse headache in the age of CGRP antibodies? A narrative review.

Katharina Kaltseis, Till Hamann, Charly Gaul, Gregor Broessner

Open access · hybridAbstract readReview
In one paragraph

Review in Headache, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Katharina KaltseisDepartment of Neurology, Headache Outpatient Clinic, Innsbruck Medical University, Innsbruck, Austria.
Till HamannDepartment of Neurology, Headache Center North-East, University Medical Center Rostock, Rostock, Germany.
Charly GaulHeadache Center Frankfurt, Frankfurt, Germany.ORCID 0000-0002-9362-3711
Gregor BroessnerDepartment of Neurology, Headache Outpatient Clinic, Innsbruck Medical University, Innsbruck, Austria.
Innsbruck Medical University · ATCardiovascular Center Frankfurt · DEUniversity of Rostock · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAlong with the development of novel migraine therapies as the monoclonal antibodies against calcitonin gene-related peptide (CGRP) and its receptor, the question arises if the treatment of chronic migraine (CM) and medication overuse headache (MOH) must be reconsidered. Have previous therapeutic approaches, including glucocorticoids, lost their role in the management of this debilitating disorder? In this narrative review, we present an overview of the available treatment options in CM and MOH in light of CGRP antibodies as well as an evaluation of the role of glucocorticoids in withdrawal therapy.

backgroundChronic migraine and medication overuse continues to be a difficult to treat condition. To date, potent treatment options are scarce and algorithms for advising patients with MOH are often still based on expert consensus rather than evidence-based medicine. For years and probably due to lack of effective alternatives, glucocorticoids have been used in MOH, especially to alleviate withdrawal symptoms caused by detoxification. Small case series report positive effects of steroids in this respective patient group; however, randomized controlled trials did not show a consistent benefit, although this may be due to methodological limitations. Because of these discrepancies, their role in MOH has been under debate ever since.

methodsWe searched the electronic database PubMed for articles up to June 1, 2022 on the use of glucocorticoids in CM and MOH.

conclusionDespite popular use in clinical practice, there is currently still no scientific evidence for the efficacy of glucocorticoids in patients with CM and MOH. Treatment with monoclonal antibodies achieved high transition rates from medication overuse to non-overuse. However, further research is needed to evaluate the additional benefit of these new agents.

Indexed as

GlucocorticoidsHeadache Disorders, SecondaryMigraine DisordersPrednisoneAntibodies, MonoclonalCalcitonin Gene-Related PeptideHumansAntibodies, MonoclonalCalcitonin Gene-Related PeptideGlucocorticoidsPrednisonecalcitonin gene-related peptide antibodieschronic migraineglucocorticoidsmedication overuseprednisone

Identifiers

PMID36437611
PMCPMC10100419
OpenAlexW4310248767

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.