Headache Clinical Trial
Official title:
Randomized Placebo Controlled Trial With Etoricoxib That is Taken to Prevent the Yom Kippur Headache
Headache during fasting is a known entity in the scientific literature. The prevalence of
such a headache is high and in a study conducted in Israel was found in 60% of people with a
previous predilection for headache. A prior study showed a significant decrease in the
incidence of fasting headache using rofecoxib, but the drug has been taken off the market.
The goal of this project is to evaluate the efficacy of etoricoxib as treatment taken before
the fast- a COX-2 inhibitor with a relatively long half life to prevent fasting induced
headache. The study will be a prospective double blind placebo controlled trial using adult
volunteers with a history of a fasting headache who will be abstaining from food and drink
on Yom Kippur.
The study hypothesis is that treatment with etoricoxib prior to a 25 hour fast will decrease
the incidence of fasting headache.
Fasting is a known trigger for headache. More specifically, headache associated with ritual
fasting in compliance with religious edict has been documented and described in the
literature. These have been described in Jewish and Muslim ritual fasts, and have been
dubbed 'Yom Kippur headache,' and 'First of Ramadan headache' respectively. The incidence of
fasting associated headache during the 25 hour fast of Yom Kippur (YK) wherein no food or
drink is ingested, has been documented in approximately 40% of participants, but as high as
66% of those prone to headache. (1) A recent study was published in which the authors were
able to show a marked reduction in YK headache using rofecoxib 50mg, a Cox 2 specific
nonsteroidal anti-inflammatory medication with a relatively long (17 hour) half life. In a
placebo controlled double blind randomized trial, in a population with a history of fasting
headache, the drug was ingested just prior to the start of the fast. The placebo group had
an incidence of headache 65% of the time whereas the treatment group had an incidence of
19%. Headache in the treatment set was also on average milder than in the controls. These
results were all significant statistically. (3)
Unfortunately for sufferers of fasting headache, rofecoxib (Vioxx), has been removed from
the market and is no longer available.
We therefore propose to conduct a second study using etoricoxib (Arcoxia) - a Cox 2 specific
antiinflammatory medication with a longer half life than rofecoxib.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
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