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RecruitingNCT05475769NUMITORUpdated Feb 28, 2024

NUMITOR Study: Nummular Headache Iberian Study on the Treatments and Outcomes in Real-World Setting

An observational study in Headache Disorders, Secondary, Headache Disorders and Central Nervous System Diseases, sponsored by Hospital Clínico Universitario de Valladolid. Recruiting at 1 site in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-02-28.

Sponsored by Hospital Clínico Universitario de Valladolid · Observational

From the registry’s dates

  • Primary completion was expected by Dec 2024, 1 year 10 months ago, but the record still lists the study as recruiting.
  • Started Mar 2022; still recruiting 4 years 8 months later.
Study type
Observational
Model
Cohort
Time perspective
Other
Enrollment
98
Ages
18 Years and older
Sex
All
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Study summary

The NUMITOR study is an analytical observational study with an multicenter ambisective (retrospective and prospective) cohort design.

Read the detailed description

This study aims to create a multicenter registry that will increase the knowledge of nummular headache and assess which treatments are more effective and better tolerated. The study population will be patients with nummular headache who, under the opinion of their responsible neurologists, have required or require preventive treatment, in any of its modalities, oral or injectable.

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Conditions studied

  • Headache Disorders, Secondary
  • Headache Disorders
  • Central Nervous System Diseases
  • Brain Diseases
  • Neurologic Manifestations
  • Nervous System Diseases
  • Pain
03

In context

Headache Disorders, Secondary

52 studies on the registry are indexed under Headache Disorders, Secondary; 13 are open to participants now.

This study's planned enrollment of 98 is below the median of 122 across 17 observational studies indexed under Headache Disorders, Secondary.

Browse Headache Disorders, Secondary studies →

Lead sponsor

Hospital Clínico Universitario de Valladolid is the lead sponsor of 21 studies on the registry; 9 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population will be made up of patients with nummular headache who, under the opinion of their responsible neurologists, have required or require preventive treatment, in any of its modalities, oral or injectable.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Nummular headache according to the criteria of the International Classification of Headache Disorders, third version (ICHD-3).
  2. Nummular headache duration of more than three months.
  3. Treatment with a medication with possible preventive drug according to the Clinical Practice Guidelines of the Spanish Society of Neurology21.
  4. Age over 18 years.
  5. signature.

Exclusion criteria

Exclusion Criteria:

  1. Diagnosis is better accounted for by any other entity included in the International Classification of Headache Disorders, 3rd version.
  2. Serious systemic or psychiatric pathology that makes it difficult to assess the patient.
  3. Secondary nummular headache
  4. Use of preventive treatment with another indication (e.g., epilepsy, other painful conditions, aesthetic).
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

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Study design

Observational model
Cohort
Time perspective
Other
Enrollment
98 participants (estimated)
Patient registry
No

Groups and cohorts

  • Nummular headache patients

    Patients that fulfill the International Classification of Headache Disorders, 3rd edition, for Nummular Headache.

    Drug: Clinical evaluation

Interventions

  • DrugClinical evaluation

    Patients will receive treatments under the criteria of the responsible physician and the response to these treatments will be prospectively collected.

    Also known as: Patients that under the criteria of the responsible physician receive oral or injectable treatment that are listed in the local Standard of Care

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What researchers measure

Primary outcomes

  1. 50% response 8-12

    To evaluate the 50% responder rate in patients with NH treated with each preventive drug between weeks 8-12, compared to the baseline situation (month prior to the treatment onset) for each different drug.

    Time frame: Weeks 8-12

Secondary outcomes

  1. 50% response 20-24

    To evaluate the 50% responder rate in the period between weeks 20-24, compared to the baseline situation (month prior to the treatment onset) for each different drug.

    Time frame: Weeks 20-24

  2. 30% response 8-12

    To evaluate the proportion of patients with "partial" response, determined by the 30% response rate, between weeks 8-12, compared to the baseline situation.

    Time frame: Weeks 8-12

  3. 30% response 20-24

    To evaluate the proportion of patients with "partial" response, determined by the 30% response rate, between weeks 20-24, compared to the baseline situation.

    Time frame: Weeks 20-24

  4. 75% response 8-12

    To evaluate the proportion of patients with an "optimal" response, determined by the 75% responder rate, between weeks 8-12, compared to the baseline situation.

    Time frame: Weeks 8-12

  5. 75% response 20-24

    To evaluate the proportion of patients with an "optimal" response, determined by the 75% response rate, between weeks 20-24, compared to the baseline situation.

    Time frame: Weeks 20-24

  6. Adverse events

    To evaluate the frequency and type of treatment-related adverse effects

    Time frame: Weeks 0-24

  7. Adverse events discontinuation

    To evaluate the proportion of patients who discontinue each treatment due to adverse effects.

    Time frame: Weeks 0-24

  8. Response predictors weeks 8-12

    To calculate which demographic or clinical variables present an odds ratio higher or lower than 1, including the 95% confidence interval, in a logistic regression analysis where the dependent variable is the presence of a 50% responder rate between weeks 8-12.

    Time frame: Weeks 0-12

  9. 50% response 8-12 in women

    To evaluate the 50% responder rate in women with NH treated with each preventive drug between weeks 8-12, compared to the baseline situation (month prior to the treatment onset) for each different drug.

    Time frame: Weeks 0-12

  10. Adverse events in women

    To evaluate the frequency and type of treatment-related adverse effects in women

    Time frame: Weeks 0-24

  11. 50% response 8-12 in patients older than 65

    To evaluate the 50% responder rate in patients older than 65 with NH treated with each preventive drug between weeks 8-12, compared to the baseline situation (month prior to the treatment onset) for each different drug.

    Time frame: Weeks 0-12

  12. Adverse events in patients older than 65

    To evaluate the frequency and type of treatment-related adverse effects in patients older than 65

    Time frame: Weeks 0-24

  13. 50% response 8-12 in patients older than 80

    To evaluate the 50% responder rate in patients older than 80 with NH treated with each preventive drug between weeks 8-12, compared to the baseline situation (month prior to the treatment onset) for each different drug.

    Time frame: Weeks 0-12

  14. Adverse events in patients older than 80

    To evaluate the frequency and type of treatment-related adverse effects in patients older than 80

    Time frame: Weeks 0-24

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • Pareja JA, Caminero AB, Serra J, Barriga FJ, Baron M, Dobato JL, Vela L, Sanchez del Rio M. Numular headache: a coin-shaped cephalgia. Neurology. 2002 Jun 11;58(11):1678-9. doi: 10.1212/wnl.58.11.1678. PubMed 12058099 ↗
  • Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. doi: 10.1177/0333102417738202. No abstract available. PubMed 29368949 ↗
  • Pareja JA, Pareja J, Barriga FJ, Baron M, Dobato JL, Pardo J, Sanchez C, Vela L. Nummular headache: a prospective series of 14 new cases. Headache. 2004 Jun;44(6):611-4. doi: 10.1111/j.1526-4610.2004.446011.x. PubMed 15186307 ↗
  • Guerrero AL, Martin-Polo J, Gutierrez F, Iglesias F. [Representation of the nummular healdache in general consultation in neurology]. Neurologia. 2008 Sep;23(7):474. No abstract available. Spanish. PubMed 18726731 ↗
  • Alvaro LC, Garcia JM, Areitio E. Nummular headache: a series with symptomatic and primary cases. Cephalalgia. 2009 Mar;29(3):379-83. doi: 10.1111/j.1468-2982.2008.01722.x. PubMed 19220316 ↗
  • Porta-Etessam J, Lapena T, Cuadrado ML, Guerrero A, Parejo B. Multifocal nummular headache with trophic changes. Headache. 2010 Nov;50(10):1612-3. doi: 10.1111/j.1526-4610.2010.01773.x. Epub 2010 Oct 12. No abstract available. PubMed 21198563 ↗
  • Cortijo E, Guerrero-Peral AL, Herrero-Velazquez S, Penas-Martinez ML, Rojo-Martinez E, Mulero P, Fernandez R. [Nummular headache: clinical features and therapeutic experience in a series of 30 new cases]. Rev Neurol. 2011 Jan 16;52(2):72-80. Spanish. PubMed 21271546 ↗
  • Cortijo E, Guerrero-Peral AL, Herrero-Velazquez S, Penas-Martinez ML, Rojo-Martinez E, Mulero P, Fernandez R. [Nummular headache: shedding light on some concepts. Reply]. Rev Neurol. 2011 Dec 16;53(12):768. No abstract available. Spanish. PubMed 22127666 ↗
  • Guerrero AL, Cuadrado ML, Garcia-Garcia ME, Cortijo E, Herrero-Velazquez S, Rodriguez O, Mulero P, Porta-Etessam J. Bifocal nummular headache: a series of 6 new cases. Headache. 2011 Jul-Aug;51(7):1161-6. doi: 10.1111/j.1526-4610.2011.01940.x. Epub 2011 Jun 15. PubMed 21675970 ↗
  • Guerrero AL, Cortijo E, Herrero-Velazquez S, Mulero P, Miranda S, Penas ML, Pedraza MI, Fernandez R. Nummular headache with and without exacerbations: comparative characteristics in a series of 72 patients. Cephalalgia. 2012 Jun;32(8):649-53. doi: 10.1177/0333102412447537. PubMed 22711962 ↗
  • Mulero P, Matarazzo M, Pedraza MI, Llamas S, Herrero S, Domingo-Santos A, Martinez-Salio A, Guerrero AL. Nummular headache related to exercise or Valsalva maneuver. Clinical characteristics of 3 cases. Headache. 2013 Jul-Aug;53(7):1167-8. doi: 10.1111/head.12133. No abstract available. PubMed 23865918 ↗
  • Irimia P, Palma JA, Idoate MA, Espana A, Riverol M, Martinez-Vila E. Cephalalgia alopecia or nummular headache with trophic changes? A new case with prolonged follow-up. Headache. 2013 Jun;53(6):994-7. doi: 10.1111/head.12072. Epub 2013 Mar 7. PubMed 23469985 ↗
  • Herrero-Velazquez S, Guerrero AL, Pedraza MI, Mulero P, Ayllon B, Ruiz-Pinero M, Rojo E, Marco J, Fernandez-Buey N, Cuadrado ML. Nummular headache and epicrania fugax: possible association of epicranias in eight patients. Pain Med. 2013 Mar;14(3):358-61. doi: 10.1111/pme.12022. Epub 2012 Dec 28. PubMed 23279627 ↗
  • Rodriguez C, Herrero-Velazquez S, Ruiz M, Baron J, Carreres A, Rodriguez-Valencia E, Guerrero AL, Madeleine P, Cuadrado ML, Fernandez-de-Las-Penas C. Pressure pain sensitivity map of multifocal nummular headache: a case report. J Headache Pain. 2015;16:523. doi: 10.1186/s10194-015-0523-7. Epub 2015 Apr 30. PubMed 25929432 ↗
  • Baron J, Rodriguez C, Ruiz M, Pedraza MI, Guerrero AL, Madeleine P, Cuadrado ML, Fernandez-de-Las-Penas C. Atypical nummular headache or circumscribed migraine: the utility of pressure algometry. Pain Res Manag. 2015 Mar-Apr;20(2):60-2. doi: 10.1155/2015/567072. Epub 2015 Feb 3. PubMed 25647287 ↗
  • Cuadrado ML, Lopez-Ruiz P, Guerrero AL. Nummular headache: an update and future prospects. Expert Rev Neurother. 2018 Jan;18(1):9-19. doi: 10.1080/14737175.2018.1401925. Epub 2017 Nov 9. PubMed 29103335 ↗
  • Trigo J, Garcia-Azorin D, Martinez Pias E, Sierra A, Chavarria A, Guerrero AL. Clinical characteristics of nummular headache and differentiation between spontaneous and posttraumatic variant: an observational study. J Headache Pain. 2019 Apr 8;20(1):34. doi: 10.1186/s10194-019-0981-4. PubMed 30961529 ↗
  • Garcia-Azorin D, Trigo-Lopez J, Sierra A, Blanco-Garcia L, Martinez-Pias E, Martinez B, Talavera B, Guerrero AL. Observational, open-label, non-randomized study on the efficacy of onabotulinumtoxinA in the treatment of nummular headache: The pre-numabot study. Cephalalgia. 2019 Dec;39(14):1818-1826. doi: 10.1177/0333102419863023. Epub 2019 Jul 4. PubMed 31272194 ↗
  • Clar-de-Alba B, Barriga FJ, Rodriguez-Caravaca G. [Clinical and pathophysiological description of nummular headaches: a case series]. Rev Neurol. 2020 Mar 1;70(5):171-178. doi: 10.33588/rn.7005.2019152. Spanish. PubMed 32100277 ↗
  • Patel UK, Saleem S, Anwar A, Malik P, Chauhan B, Kapoor A, Arumaithurai K, Kavi T. Characteristics and treatment effectiveness of the nummular headache: a systematic review and analysis of 110 cases. BMJ Neurol Open. 2020 Mar 12;2(1):e000049. doi: 10.1136/bmjno-2020-000049. eCollection 2020. PubMed 33681785 ↗
  • Tassorelli C, Diener HC, Dodick DW, Silberstein SD, Lipton RB, Ashina M, Becker WJ, Ferrari MD, Goadsby PJ, Pozo-Rosich P, Wang SJ; International Headache Society Clinical Trials Standing Committee. Guidelines of the International Headache Society for controlled trials of preventive treatment of chronic migraine in adults. Cephalalgia. 2018 Apr;38(5):815-832. doi: 10.1177/0333102418758283. Epub 2018 Mar 4. PubMed 29504482 ↗
  • GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):459-480. doi: 10.1016/S1474-4422(18)30499-X. Epub 2019 Mar 14. PubMed 30879893 ↗
  • Chavarria-Miranda A, Guerrero AL, Talavera B, Martinez-Pias E, Trigo-Lopez J, Sierra A, Garcia-Azorin D. Linear Headache: A Novel Entity or a Variant of Nummular Headache? Clinical Characteristics and Treatment Response in a Series of 16 Patients. Pain Med. 2021 May 21;22(5):1158-1166. doi: 10.1093/pm/pnaa436. PubMed 33723599 ↗
  • Garcia-Iglesias C, Martinez-Badillo C, Garcia-Azorin D, Trigo-Lopez J, Martinez-Pias E, Guerrero-Peral AL. Secondary Nummular Headache: A New Case Series and Review of the Literature. Pain Med. 2021 Nov 26;22(11):2718-2727. doi: 10.1093/pm/pnab174. PubMed 34022054 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Undecided — Anonymized data may be shared upon reasonable request to the principal investigator.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 28, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05475769
Lead sponsor
Hospital Clínico Universitario de Valladolid
Responsible party
David García Azorín (Principal Investigator, Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid) — Principal investigator
First posted
Jul 27, 2022
Start date
Mar 1, 2022
Primary completion
Dec 31, 2024 (estimated)
Completion
Dec 31, 2024 (estimated)
Last update
Feb 28, 2024

Study contacts

David Garcia Azorín, MD, PhD
Contact
davilink@hotmail.com
+34 665872228
Yesica González Osorio, MD
Contact
ygoinvestigacion@outlook.com
+34 634330426
David García-Azorín, MD, PhD
principal investigator · Hospital Clínico Universitario de Valladolid

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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