title: Randomised trial on episodic cluster headache with an angiotensin II receptor blocker.
abstract: OBJECTIVE
  The aim of this study was to evaluate the angiotensin II receptor antagonist candesartan as prophylactic medication in patients with episodic cluster headache.
  
  
  METHODS
  This study comprised a prospective, placebo-controlled, double-blind, parallel-designed trial performed in seven centres in Scandinavia. Forty (40) patients with episodic cluster headache (ICHD-2) were recruited and randomised over a five-year period to placebo or 16 mg candesartan in the first week, and placebo or 32 mg candesartan in the second and third week.
  
  
  RESULTS
  The number of cluster headache attacks (primary efficacy variable) during the three-week treatment period was reduced from 14.3 ± 9.2 attacks in week 1 to 5.6 ± 7.0 attacks in week 3 (-61%) in the candesartan group and from 16.8 ± 14.1 attacks in week 1 to 10.5 ± 11.3 attacks in week 3 (-38%) in the placebo group. The difference between the candesartan and placebo group was not significant with the pre-planned non-parametric ranking test, but a post-hoc exact Poisson test, which takes into account the temporal properties of the data, revealed a significant result ( P  < 0.0001).
  
  
  CONCLUSIONS
  This was a negative trial. Post-hoc statistics suitable to describe the temporal changes in cluster headache indicate that conduction of future larger studies may be justified.
authors.affiliation: Norwegian National Headache Centre, Trondheim University Hospital, Norway. erling.tronvik@ntnu.no
authors.forename: Erling
authors.initials: E
authors.lastname: Tronvik
authors.forename: Troels
authors.initials: T
authors.lastname: Wienecke
authors.forename: Inge
authors.initials: I
authors.lastname: Monstad
authors.forename: Carl
authors.initials: C
authors.lastname: Dahløf
authors.forename: Magne Geir
authors.initials: MG
authors.lastname: Bøe
authors.forename: Anne Bolette
authors.initials: AB
authors.lastname: Tjensvoll
authors.forename: Rolf
authors.initials: R
authors.lastname: Salvesen
authors.forename: John Anker
authors.initials: JA
authors.lastname: Zwart
authors.forename: Sven-Olof
authors.initials: SO
authors.lastname: Jansson
authors.forename: Lars Jacob
authors.initials: LJ
authors.lastname: Stovner
mesh_terms: D000328:Adult; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D003027:Cluster Headache / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D012537:Scandinavian and Nordic Countries; D013777:Tetrazoles / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C081643:candesartan
keywords: Randomised controlled trial; angiotensin; candesartan; cluster headache; headache