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. 2010 May 16;11(5):373–377. doi: 10.1007/s10194-010-0221-4

Medication overuse headache: a critical review of end points in recent follow-up studies

Knut Hagen 1,2,✉, Rigmor Jensen 3, Magne Geir Bøe 4, Lars Jacob Stovner 1,2
PMCID: PMC3452270  PMID: 20473701

Abstract

No guidelines for performing and presenting the results of studies on patients with medication overuse headache (MOH) exist. The aim of this study was to review long-term outcome measures in follow-up studies published in 2006 or later. We included MOH studies with >6 months duration presenting a minimum of one predefined end point. In total, nine studies were identified. The 1,589 MOH patients (22% men) had an overall mean frequency of 25.3 headache days/month at baseline. Headache days/month at the end of follow-up was reported in six studies (mean 13.8 days/month). The decrease was more pronounced for studies including patients with migraine only (−14.6 days/month) compared to studies with the original diagnoses of migraine and tension-type headache (−9.2 days/month). Six studies reported relapse rate (mean of 26%) and/or responder rate (mean of 28%). Medication days/month and change in headache index at the end of follow-up were reported in only one and two of nine studies, respectively. The present review demonstrated a lack of uniform end points used in recently published follow-up studies. Guidelines for presenting follow-up data on MOH are needed and we propose end points such as headache days/month, medication days/month, relapse rate and responder rate defined as ≥50% reduction of headache frequency and/or headache index from baseline.

Keywords: Medication overuse headache, Follow-up, Outcome parameters, Relapse rate, Responders

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Conflict of interest

None.

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