Rates and Predictors of Relapse in Medication Overuse Headache: A Clinic-Based Study from China

Abstract

Objective: This study aims to further assess the rates and risk factors for relapse in medication overuse headache (MOH) patients in China. Methods: The patients were admitted to neurology outpatient clinics at Chinese PLA General Hospital (primarily for headache) and diagnosed with MOH. They responded well to 2 months of preventive treatment and completed a 1-year consultation. General information was collected, including demographic characteristics (age, height, weight, and education level), the clinical features of the headache and the use of pain relievers (type, frequency and duration). Differences in each factor between the group with relapse and the group without relapse were analyzed by the chi-square test or Wilcoxon test. Variables with a p < 0.05 were included as independent variables in nonconditional logistic regression analysis. Results: In total, 129 patients were recruited for this retrospective study. The relapse rate of the MOH patients at the 1-year follow-up was 24.8%. The relapse rate was significantly higher in the patients with migraine (29/97, 29.9%) than in the patients with tension-type headache (3/32, 9.4%) and in the patients with low education levels (middle school or lower; 24/77, 31.6%) than in those with high education levels (high school or higher; 8/52, 15.4%). Nonconditional logistic regression analysis showed that the type of primary headache was an independent risk factor for MOH relapse (OR 3.719, p = 0.044). Conclusions: The relapse rate of MOH patients at the 1-year follow-up was 24.8% in China. The type of primary headache is an independent risk factor for MOH relapse, and patients with migraine as the primary headache are more prone to relapse.