title: Long-term predictors of remission in patients treated for medication-overuse headache at a specialized headache center: A prospective cohort study.
abstract: Objective To evaluate long-term predictors of remission in patients with medication-overuse headache (MOH) by prospective cohort study. Background Knowledge regarding long-term predictors of MOH outcome is limited. Methods Two hundred and forty MOH patients recruited from 2000 to 2005 were included in a one-year follow-up study and then subsequently followed until 31 December 2013. The median follow-up was three years (interquartile range, three years). Predictive values of selected variables were assessed by the Cox proportional hazard regression model. Results At the end of follow-up, 102 (42.5%) patients were in remission. The most important predictors of remission were lower number of headache days per month before the one-year follow-up (HR-hazard ratio = 0.936, 95% confidence interval (CI) 0.884-0.990, p = 0.021) and efficient initial drug withdrawal (HR = 0.136, 95% CI 0.042-0.444, p = 0.001). Refractory MOH was observed in seven (2.9%) and MOH relapse in 131 patients (54.6%). Conclusions Outcome at the one-year follow-up is a reliable predictor of MOH long-term remission.
authors.affiliation: 1 Headache Centre, Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.|2 Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Jasna J
authors.initials: JJ
authors.lastname: Zidverc-Trajkovic
authors.affiliation: 2 Faculty of Medicine, University of Belgrade, Serbia.|3 Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pekmezovic
authors.affiliation: 1 Headache Centre, Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.|2 Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Zagorka
authors.initials: Z
authors.lastname: Jovanovic
authors.affiliation: 1 Headache Centre, Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.|2 Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Pavlovic
authors.affiliation: 1 Headache Centre, Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.|2 Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Milija
authors.initials: M
authors.lastname: Mijajlovic
authors.affiliation: 1 Headache Centre, Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.|2 Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Radojicic
authors.affiliation: 1 Headache Centre, Neurology Clinic, Clinical Centre of Serbia, Belgrade, Serbia.|2 Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Nadezda
authors.initials: N
authors.lastname: Sternic
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D051271:Headache Disorders, Secondary / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome
keywords: Medication-overuse headache; long-term outcome; predictors