Amanda Cyntia Lima Fonseca Rodrigues (Curitiba/ BR), Bernardo Vieira Nogueira (Teresópolis/ BR), Julia Souto Faria Navarro (Cuiabá/ BR), Lucas Lopes Penido de Mendonça (Rio de Janeiro/ BR), Luise Bernardes da Silva Neves (Rio de Janeiro/ BR), Felipe Morais Pereira de Medeiros (Rio de Janeiro/ BR), Guilherme Curvelo Bernardes Silva (Vassouras/ BR), Victor Marone Barros Lopes (Rio de Janeiro/ BR), Rafael Barbosa Mokdeci Surerus (Juiz de Fora/ BR), Tatiana Nizoli de Campos (Nova Iguaçu/ BR), André Saul Crestani (Curitiba/ BR), Luiza Giuliani Schmitt (Santa Maria/ BR), Edson Vieira Nascimento (Curitiba/ BR), Maria Vitória Delgobbo Pereira (Curitiba/ BR), Maria Letícia Ribeiro Lodo (São Paulo/ BR), Renato do Couto Soares Caversan (Birigüi/ BR), Isabelle Audacio Ramos Fernandez (Marília/ BR), Mirella Zago Mazzini (Marília/ BR), Rodrigo Carlos Soares (São Paulo/ BR), Simone Gonçalves Alencar Rodrigues Furtado Rocha (São Paulo/ BR), Sophia Bazo Diniz (Araras/ BR), Mariana Lorini Rodrigues (São Paulo/ BR), Maria Paula Batista Aveaneda (Marília/ BR), Vitória Alves da Silva (São Paulo/ BR), Alexandra Magna Garib (Marília/ BR), Laura Luminati Picolo de Oliveira (Marília/ BR), Carlos Eduardo Bazo Diniz (Itaperuna/ BR), Yuri Ribeiro Basseto (Marília/ BR), Lidiely Kassburg Mello (São Paulo/ BR), Isadora Biglia Diniz (Assis/ BR), Richard Agustinho Rodrigues (Araçatuba/ BR), Lorena Correia da Cruz (Assis/ BR), Natália Mazetto Rocha (Assis/ BR), Vitor Emanuel Gomes Lomba (Assis/ BR), Samir Fortes Garib Batista (Adamantina/ BR), Bruna Amaraisa da Silva (São Paulo/ BR), Anthonny Toyokytty Yoshida (Assis/ BR), Marco Antônio de Castro Olyntho Júnior (São José do Rio Preto/ BR), Gianne Macedo Goedert (Curitiba/ BR), Luana Bandeira Rocha (Nova Iguaçu/ BR)
Abstract text (incl. figure legends and references)
Question: Cluster headache (CH) causes excruciating unilateral temporal or periorbital pain with ipsilateral autonomic symptoms. Classified as primary headache, it is characterized by daily headaches that persist for weeks to months with direct impact on quality life. Treatment with galcanezumab (GZB) is an upcoming option for preventive treatment of CH. What is the impact of this new therapy in preventing and reducing the frequency of CH? Methods: A total of 122 articles were identified in databases: Pubmed, Embase and Cochrane), by two independent researchers. Three randomized controlled trials were included in this systematic review using a PRISMA protocol. The outcome of interest was change in weekly frequency of CH attacks and mean reduction in attack frequency compared with baseline. Results: A total of 449 patients were randomized into 2 groups, the intervention group received the standard dose of 300mg of GZB versus the placebo control group. The studies primarily evaluated the reduction of CH and the mean >= 50% reduction in attack frequency compared with baseline. Goadsby et al. obtained a mean percentage reduction in the weekly frequency of CH attacks in the first 3 weeks of 52% in the intervention group and 27% in the placebo group. Kudrow et al. reported the observed reduction by approximately 43% in the intervention group over the same period. Both studies showed compatible efficacy reducing attacks >= 50% (71% (p=0.046) and 78.3%, respectively). However, Dodick et al. showed no statistically significant effect of GZB in both outcomes: the reduction in weekly attack frequency (p=0.334) and mean reduction in attacks 32.6% (p=0.170). Conclusions: The effects of GZB in reducing the number of seizures, especially in the first few weeks of treatment, are encouraging, although further studies are required to establish the efficacy of GZB in long-term use for CH prevention and treatment.