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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Octreotide ?
        
(Message started by: UN solved on Jun 25^th, 2007, 4:15pm)

Title: Octreotide ?
Post by UN solved on Jun 25^th, 2007, 4:15pm

I don't think I've seen this mentioned here. Has anyone tried the drug Octreotide in the acute treatment of CH ? Speak up !!

From the Mayo Clinic:
"Octreotide (Sandostatin, Sandostatin LAR). This drug, a synthetic version of the brain hormone somatostatin, has traditionally been used to control severe diarrhea. However, some studies have shown that the injectable form is an effective treatment for cluster headache and is safe for people with high blood pressure and ischemic heart disease"

Source:
http://www.mayoclinic.com/health/cluster-headache/DS00487/DSECTION=7

UNsolved

Title: Re: Octreotide ?
Post by Redd on Jun 25^th, 2007, 5:03pm

Anyone who can look this up and find studies regarding this please do so. I've never heard of this before.

Appears to be an abortive rather than preventive stratagy if I read correctly.

Title: Re: Octreotide ?
Post by Bob_Johnson on Jun 25^th, 2007, 9:52pm

Found a couple of abstracts in PubMed along the lines of the following but nothing after 2005. Suggests that no one is, at least yet, do follow-up studies on this approach.
---------------------
Ann Neurol. 2004 Oct;56(4):488-94.

Erratum in:
Ann Neurol. 2004 Nov;56(5):751.

Subcutaneous octreotide in cluster headache: randomized placebo-controlled double-blind crossover study.

Matharu MS, Levy MJ, Meeran K, Goadsby PJ.

Headache Group, Institute of Neurology, Queen Square, London, United Kingdom.

Current practical evidence-based acute treatments of cluster headache are limited to subcutaneous and intranasal formulations of sumatriptan, and oxygen. Two small randomized, double-blind trials suggested efficacy of somatostatin in cluster headache. We sought to determine whether octreotide, a somatostatin analog, is effective in the abortive treatment of acute cluster headache. Patients with episodic and chronic cluster headache, as defined by the International Headache Society, were recruited to a double-blind placebo-controlled crossover study. Patients were instructed to treat two attacks of at least moderate pain severity, with at least a 24-hour break, using subcutaneous octreotide microg or matching placebo. The primary end point was the headache response defined as very severe, severe, or moderate pain becomes mild or nil, at 30 minutes. The primary end point was examined using a multilevel analysis approach. A total of 57 patients were recruited of whom 46 provided efficacy data on attacks treated with octreotide and 45 with placebo. The headache response rate with subcutaneous octreotide was 52%, whereas that with placebo was 36%. Modeling the treatment outcome as a binomial where response was determined by treatment, using the patient as the level 2 variable, and considering period effect, sex, and cluster headache type as other variables of interest, we found that the effect of subcutaneous octreotide 100 microg was significantly superior to placebo (p < 0.01). Subcutaneous octreotide 100 microg is effective in the acute treatment of cluster headache when compared with placebo. Nonvasconstrictor treatment of acute cluster headache is possible.

Publication Types:
Clinical Trial
Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

PMID: 15455406 [PubMed

Title: Re: Octreotide ?
Post by Pinkfloyd on Jun 26^th, 2007, 12:46am

It looks like this might be part of the background evidence behind the work that is now being done with peptides etc. Part of why they are persuing this and having some success in that area.
Any success and clues that lead them away from the surgery routes, is good IMHO.

Good find UNsolved/BJ,
Bobw

Title: Re: Octreotide ?
Post by LeeS on Jun 26^th, 2007, 10:24am

As I recall, Goadsby first discussed octreotide at the OUCH (UK) Conference in 2003, but as BobW says, it appears that he is now pinning his hopes on CGRP antagonists in the acute treatment of CH.

Flo picked up on octreotide and it was discussed here a couple of years ago (with Ozzy I think), but I can't find the old thread. Here's Flo's take on it anyway:

http://www.med-owl.com/clusterheadaches/tiki-index.php?page=Somatostatin

-Lee

Edited to add: found it hidden away in this thread with some good old fashioned banter ;) http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi?board=medsarchive2005;action=display;num=1116260911

Title: Re: Octreotide ?
Post by UN solved on Jun 26^th, 2007, 6:39pm

It also appears that Octreotide is a very expensive drug too. The drug reference book @ my local neuro's office had these symbols by it ... $$$$$

UNsolved

Title: Re: Octreotide ?
Post by RayU on Jul 4^th, 2007, 7:42am

Hi all,
I was involved in a trial in London in December 2001 - was given two vials but did not know which was Octreotride and which was placebo.
If my memory serves me correctly one of them did provide some relief. Will try and find my notes from back then and let you know.

Cheers,
Raymond