PMID- 29144718
OWN - NLM
STAT- MEDLINE
DCOM- 20180702
LR  - 20180702
IS  - 1936-2692 (Electronic)
IS  - 1088-0224 (Linking)
VI  - 23
IP  - 17 Suppl
DP  - 2017 Nov
TI  - The emerging role of gammaCore(R) in the management of cluster headache: expert 
      panel recommendations.
PG  - S326-S333
AB  - A panel of 9 experts, including neurologists, other headache specialists, and 
      medical and pharmacy directors, from 4 health plans (1 integrated delivery 
      network and 3 plans with commercial, Medicare, and Medicaid lines of business), 
      convened to discuss cluster headache (CH). Topics covered included the current 
      treatment landscape, treatment challenges, economic impact of disease, and gaps 
      in care for patients with CH. One major challenge in the management of CH is that 
      it is underrecognized and frequently misdiagnosed, leading to delays in and 
      suboptimal treatment for patients who suffer from this painful and disabling 
      condition. The management of CH is challenging due to the lack of a robust 
      evidence base for preventive treatment, the adverse events (AEs) associated with 
      conventional preventive treatments, the variability of response to acute 
      treatments, and the challenging reimbursement landscape for well-accepted 
      treatments (eg, oxygen). The lack of effective prevention for many patients may 
      lead to the excessive use of acute therapies, often multiple times each day, 
      which drives the cost of illness up significantly. The goal of the panel 
      discussion was to discuss the role of gammaCore, the recently released first 
      non-invasive vagus nerve stimulation (nVNS) therapy in the acute treatment of 
      patients with episodic CH (eCH), in the management of CH. The panel reviewed 
      current practices and formulated recommendations on incorporating a newly 
      released therapy into CH management. The panel explored the role of traditional 
      management strategies as well as that of gammaCore in the acute treatment of 
      patients with eCH. Resources that may be useful in the treatment of patients with 
      CH were also discussed.
FAU - Silberstein, Stephen D
AU  - Silberstein SD
FAU - Calhoun, Anne H
AU  - Calhoun AH
FAU - Treppendahl, Christina
AU  - Treppendahl C
FAU - Dodick, David W
AU  - Dodick DW
FAU - Rapoport, Alan M
AU  - Rapoport AM
FAU - Mamidi, Avinash
AU  - Mamidi A
FAU - Vargas, Peter
AU  - Vargas P
FAU - Ebert, Thomas H
AU  - Ebert TH
FAU - Tepper, Stewart J
AU  - Tepper SJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
MH  - Cluster Headache/*therapy
MH  - Humans
MH  - Pain Management/*methods/*standards
MH  - *Practice Guidelines as Topic
MH  - United States
MH  - Vagus Nerve Stimulation/*methods/*standards
EDAT- 2017/11/17 06:00
MHDA- 2018/07/03 06:00
CRDT- 2017/11/17 06:00
PHST- 2017/11/17 06:00 [entrez]
PHST- 2017/11/17 06:00 [pubmed]
PHST- 2018/07/03 06:00 [medline]
AID - 87322 [pii]
PST - ppublish
SO  - Am J Manag Care. 2017 Nov;23(17 Suppl):S326-S333.