Evidence map›Paper›PMID 40301763›Full record

ArticleThe journal of headache and pain2025

Tolerability of repetitive dihydroergotamine infusions paired with an adjustment in preventive treatment strategy in chronic headache disorders in children and youth.

Sara Pavitt, Cynthia Morris, Lauren Shin, Andrew Jones, Beata Vayngortin, Natalia Zorrilla, Chengshi Jin, Isabel Allen, Amy A Gelfand

Abstract read
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In one paragraph

Article in The journal of headache and pain, 2025. 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
–field-weighted citation impact
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.

  1. Article
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  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

9 authors.

Sara PavittDepartment of Neurology, University of Texas at Austin Dell Medical School, 4910 Mueller Blvd, Suite 300 Austin TX, Austin, TX, 78723, USA.
Cynthia MorrisDepartment of Neurology, Saint Louis University, 1225 S Grand, Blvd. St Louis, Saint Louis, MO, USA.
Lauren ShinChild & Adolescent Headache Program, University of California San Francisco, 1825 4 th Street, 5 th floor 5 A San Francisco, San Francisco, CA, 94143, USA.
Andrew JonesDepartment of Neurology, Saint Louis University, 1225 S Grand, Blvd. St Louis, Saint Louis, MO, USA.
Beata VayngortinDepartment of Internal Medicine, Kaiser Permanente San Francisco, 2425 Geary Blvd. San Francisco, San Francisco, CA, 94115, USA.
Natalia ZorrillaChild & Adolescent Headache Program, University of California San Francisco, 1825 4 th Street, 5 th floor 5 A San Francisco, San Francisco, CA, 94143, USA.
Chengshi JinDepartment of Epidemiology and Biostatistics, University of California San Francisco, 1825 4 th Street, 5 th floor 5 A San Francisco, San Francisco, CA, 94143, USA.
Isabel AllenDepartment of Epidemiology and Biostatistics, University of California San Francisco, 1825 4 th Street, 5 th floor 5 A San Francisco, San Francisco, CA, 94143, USA.
Amy A GelfandChild & Adolescent Headache Program, University of California San Francisco, 1825 4 th Street, 5 th floor 5 A San Francisco, San Francisco, CA, 94143, USA. amy.gelfand@ucsf.edu.

Funding

Engaging University of California Stakeholders for Biorespository ResearchUL1TR000004 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI GRANDIS, JENNIFER RUBIN · 2012 to 2015
$78.0M
NCATS NIH HHS UL1 TR000004
6 · The paper itself

Abstract

backgroundIn adults, intravenous (IV) dihydroergotamine (DHE) has been shown to be effective at improving medium term outcomes in patients with chronic headache disorders. The IV formulation is utilized given its superior bioavailability. We aim to assess the safety and effectiveness of repetitive IV DHE infusions paired with an adjustment of a preventive treatment strategy within children and youth with chronic headache disorders.

methodsA retrospective chart review was conducted of children and youth diagnosed with a chronic headache disorder who were admitted for DHE from January 2014 - October 2020. Patients completed a 5-day, standardized protocol. A new preventive was started one week after discharge. Data were collected from pre- and post-admission clinic notes. Safety and tolerability were assessed. Results were evaluated using descriptive statistics and compared with paired t-tests.

resultsOne hundred and eighty-seven patients were included for review. Sixty-eight percent (127) had chronic migraine (CM), 20% (37) new daily persistent headache (NDPH) and 12% (23) persistent headache attributed to head trauma (PHHT). The median (range) age was 16 years (7-21), and median (range) number of previous preventive trials was 4 (0-21). At follow-up, patients with CM had a significant decrease in headache days per month from 28.6 to 26.3 days (95% CI -4.1 to -1.3) p < 0.001, baseline headache intensity decreased from 5.9/10 to 5.3/10 (95% CI -1.3 to -0.1) p = 0.006, number of severe headache days per month decreased from 11.5 to 7.9 days (95% CI -6.5 to -2.3), p < 0.001, and monthly days of acute medication use from 12.1 to 9.8 days (95% CI -4.5 to -0.7) p = 0.002. In patients with NDPH there were significant decreases in baseline headache intensity from 6.4/10 to 5.3/10 (95% CI -1.7 to -0.3) p = 0.005 and monthly days of acute medication usage from 9.2 days to 5.9 days (95% CI -7.8 to -0.1) p = 0.043. Patients with PHHT had a significant decrease in headache days per month from 29 to 24 days (95% CI -9.4 to -0.7) p = 0.031. The most common side effects were nausea (85%) and mild leg cramping (60%).

conclusionRepetitive DHE infusions followed by preventive treatment adjustment was well tolerated and significantly reduced headache frequency, baseline intensity, number of severe days and/or acute medication usage in children and youth with refractory headache disorders.

Indexed as

Analgesics, Non-NarcoticDihydroergotamineHeadache DisordersAdolescentAdultChildFemaleHumansInfusions, IntravenousMaleMigraine DisordersRetrospective StudiesYoung AdultAnalgesics, Non-NarcoticDihydroergotamineChronic migraineDihydroergotaminePediatric headache

Identifiers

PMID40301763
PMCPMC12042534

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LicenceCC BY
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Registered trials

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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.