{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:55:32Z","timestamp":1793397332427,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T00:00:00Z","timestamp":1764115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medical Scientific Fund of the Mayor of the City of Vienna","award":["Project 21009"],"award-info":[{"award-number":["Project 21009"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Headache Pain"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Effective acute headache treatment is essential for improving the quality of life in people with idiopathic intracranial hypertension (pwIIH). While current guidance recommends \u201ctreat to the phenotype\u201d, robust data on effectiveness of available options is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis used standardized symptom diaries of pwIIH from the Vienna Idiopathic Intracranial Hypertension (VIIH) database (1-JUL-2021 to 30-JUN-2023). Three classes of acute medications (nonsteroidal anti-inflammatory drugs [NSAID], acetaminophen [APAP], and triptans) were analyzed, with NSAIDs as the reference. Headache attacks were classified per ICHD-3 as migraine (MIG), tension-type (TTH), or other (OTH). We used 2-level nested logistic regression models to analyze odds ratio (OR) of treatment response for each headache type, adjusting for covariance within individual pwIIH and concurrent medication with propensity-weighting for age, sex, and headache severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analyzed 35,640 medication-outcome pairs from 23,507 headache attacks (45.3% MIG, 21.1% TTH, 33.6% OTH) in 156 patients (89.7% female, mean age 32.9 years). NSAID were most commonly used across all headache types (MIG: 60.5%, TTH: 69.8%, OTH: 70.7%), followed by APAP (MIG: 21.5%, TTH: 21.1%, OTH: 27.7%) and triptans (MIG: 18%, TTH: 10.1%, OTH: 12.8%). Triptans were the most effective across all headache types (OR for MIG: 4.8 [CI 3.9\u20136.1], TTH: 2.9 [CI 1.8\u20134.3], OTH: 3.1 [CI 2.2\u20134.3]). APAP was less effective for MIG (OR 0.81 [CI 0.74\u20130.90]) but similar to NSAIDs in TTH and OTH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Triptans are associated with better response rates than NSAID\/APAP in acute management of headaches in pwIIH, particularly \u2013 but not exclusively \u2013 for migraine-type attacks. These findings support preferential use of triptans, questioning the \u201ctreating to the phenotype\u201d approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s10194-025-02236-4","type":"journal-article","created":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T08:19:20Z","timestamp":1764145160000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Acute headache treatment in idiopathic intracranial hypertension: treating to the phenotype?"],"prefix":"10.1186","volume":"26","author":[{"given":"Gabriel","family":"Bsteh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nik","family":"Krajnc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Zaic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Marik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bertich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Stapf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Novak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Macher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold","family":"Pemp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"W\u00f6ber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,26]]},"reference":[{"key":"2236_CR1","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/s1474-4422(15)00298-7","volume":"15","author":"KA Markey","year":"2016","unstructured":"Markey KA, Mollan SP, Jensen RH, Sinclair AJ (2016) Understanding idiopathic intracranial hypertension: mechanisms, management, and future directions. 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He has received unrestricted research grants from BMS and Novartis. He serves on the Executive Committee of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the Board of Directors of the International Multiple Sclerosis Visual System Consortium (IMSVISUAL). Nik Krajnc: has participated in meetings sponsored by, received speaker honoraria or travel funding from Alexion, BMS\/Celgene, Janssen-Cilag, Merck, Neuraxpharm, Novartis, Roche and Sanofi-Genzyme and held a grant for a Multiple Sclerosis Clinical Training Fellowship Programme from the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS). Sina Zaic: declares no conflict of interest relevant to this study. Nina M\u00fcller: declares no conflict of interest relevant to this study. Wolfgang Marik: declares no conflict of interest relevant to this study. Martin Bertich: declares no conflict of interest relevant to this study. Christoph Stapf: declares no conflict of interest relevant to this study. Klaus Novak: declares no conflict of interest relevant to this study. Stefan Macher: declares no conflict of interest relevant to this study. Berthold Pemp: has received honoraria for consultancy\/speaking from Chiesi, GenSight and Novartis. Christian W\u00f6ber: has received honoraria consultancy\/speaking from Apomedica, Curelator, Eli Lilly, Gr\u00fcnenthal, Hermes, Novartis, Pfizer, Ratiopharm\/Teva, and Stada.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"292"}}