Copeptin for Risk Stratification in Non-traumatic Headache in the Emergency Setting - The CoHead Study - Full Text View

Purpose

Headache is a common symptom, and patients often seek medical attention at emergency departments due to headaches.

The aim of the CoHead Study is to find out if it is possible by measuring copeptin, a marker of stress in the blood, to find out which patients have simple headaches and which patients have dangerous headaches that are the symptom of an underlying disease and need further investigation and treatment.

Copeptin is a marker for physical stress and has been tested in patients with stroke, heart attack and pneumonia. In all these illnesses, the patients with the most serious forms had the highest levels of copeptin, while the ones with only mild presentation or no affection at all had the lowest levels of copeptin.

The investigators expect to show the same in patients with headaches.

Condition
Head Pain

Study Type:	Observational
Study Design:	Observational Model: Cohort Time Perspective: Prospective
Official Title:	Copeptin for Risk Stratification in Non-traumatic Headache in the Emergency Setting - The CoHead Study

Resource links provided by NLM:

MedlinePlus related topics: Headache

U.S. FDA Resources

Further study details as provided by University Hospital, Basel, Switzerland:

Primary Outcome Measures:

Differentiation between serious secondary non-traumatic headache as opposed to benign, self-limiting non-traumatic headache by copeptin level measurement [ Time Frame: At study entry, assessment of baseline characteristics, questionnaire, further investigations done by attending physician, and blood collection for copeptin measurement. telephone interview after 3 months. ] [ Designated as safety issue: No ]
Assessment of the prognostic value of copeptin to predict the primary endpoint (serious secondary NTH).

Non-traumatic headache (NTH) will be assessed and defined according to the ICHD-II-Criteria. Serious secondary NTH will be defined as a composite endpoint including different secondary NTH causes and entities as listed in the ICHD-II-Criteria.

Secondary Outcome Measures:

clinical outcome of patients [ Time Frame: study entry and 3-month-interview ] [ Designated as safety issue: No ]
- all-cause mortality within the 3-month follow-up period
- morbidity measured by the MIDAS-questionnaire which is performed at study entry and at the 3-month-interview
Additive benefit on sensitivity if copeptin and a diagnostic algorithm are combined [ Time Frame: study entry and 3-month-interview ] [ Designated as safety issue: No ]
A validated, diagnostic algorithm consisting of four clinical scenarios (published by Grimaldi et al.) will be used by the study team upon entry into the study. We will evaluate the additive benefit of copeptin to this algorithm with means of multivariate logistic regression analysis and calculation of reclassification tables.
Comparison of copeptin with other potential biomarkers in non-traumatic headache [ Time Frame: study entry and 3-month-interview ] [ Designated as safety issue: No ]
We will compare the diagnostic and prognostic accuracy of copeptin with other potential biomarkers which have been reported to be of diagnostic value in migraine or cerebrovascular events, both being potential clinical scenarios of non-traumatic headache.

Biospecimen Retention: Samples Without DNA

7.5 ml of EDTA blood, 7.5 ml of serum, 4.3 ml of citrate blood

Estimated Enrollment:	600
Study Start Date:	October 2010
Estimated Study Completion Date:	August 2013
Estimated Primary Completion Date:	August 2013 (Final data collection date for primary outcome measure)

Show Detailed Description

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No
Sampling Method:	Probability Sample

Study Population

Patients presenting to emergency department or walk-in clinic

Criteria

Inclusion Criteria:

headache at the time of screening
Patients must be able to give informed consent

Exclusion Criteria:

less than 18 years of age
preceding (head) trauma

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01174901

Locations

Switzerland
Kantonsspital Aarau AG
Aarau, AG, Switzerland, 5001
University Hospital of Basel
Basel, BS, Switzerland, 4031

Sponsors and Collaborators

University Hospital, Basel, Switzerland

Investigators

Principal Investigator:

Mirjam Christ-Crain, MD, PhD

Department of Endocrinology, University Hospital of Basel, Switzerland

More Information

Publications:

Katan M, Fluri F, Morgenthaler NG, Schuetz P, Zweifel C, Bingisser R, Müller K, Meckel S, Gass A, Kappos L, Steck AJ, Engelter ST, Müller B, Christ-Crain M. Copeptin: a novel, independent prognostic marker in patients with ischemic stroke. Ann Neurol. 2009 Dec;66(6):799-808. Erratum in: Ann Neurol. 2010 Feb;67(2):277-81.

Katan M, Müller B, Christ-Crain M. Copeptin: a new and promising diagnostic and prognostic marker. Crit Care. 2008;12(2):117. Epub 2008 Mar 6.

Reichlin T, Hochholzer W, Stelzig C, Laule K, Freidank H, Morgenthaler NG, Bergmann A, Potocki M, Noveanu M, Breidthardt T, Christ A, Boldanova T, Merki R, Schaub N, Bingisser R, Christ M, Mueller C. Incremental value of copeptin for rapid rule out of acute myocardial infarction. J Am Coll Cardiol. 2009 Jun 30;54(1):60-8.

Friedman BW, Hochberg ML, Esses D, Grosberg B, Corbo J, Toosi B, Meyer RH, Bijur PE, Lipton RB, Gallagher EJ. Applying the International Classification of Headache Disorders to the emergency department: an assessment of reproducibility and the frequency with which a unique diagnosis can be assigned to every acute headache presentation. Ann Emerg Med. 2007 Apr;49(4):409-19, 419.e1-9. Epub 2007 Jan 8.

1. Error occurred: cannot get document summary PMID: 192211851

Grimaldi D, Cevoli S, Cortelli P. Headache in the emergency department. How to handle the problem? Neurol Sci. 2008 May;29 Suppl 1:S103-6. Review.

Responsible Party:	University Hospital, Basel, Switzerland
ClinicalTrials.gov Identifier:	NCT01174901 History of Changes
Other Study ID Numbers:	CoHead
Study First Received:	August 2, 2010
Last Updated:	April 25, 2013
Health Authority:	Switzerland: Ethikkommission Switzerland: Federal Office of Public Health Switzerland: Laws and standards

Keywords provided by University Hospital, Basel, Switzerland:

cephalalgia
copeptins
biomarkers

headache
C-terminal provasopression
physiological stress response

Additional relevant MeSH terms:

Emergencies
Headache
Disease Attributes
Pathologic Processes

Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms

ClinicalTrials.gov processed this record on June 18, 2013