Jerusalem's Shaare Zedek Medical Center have invited healthy Muslims aged 18 to
65 who suffer from migraine headaches during the month-long dawn-to-dusk fast of
Ramadan to participate in a clinical trial for prevention of the pain.
estimated 90 million of the world’s 1.57 billion Muslims are likely to suffer
from migraine headaches during Ramadan – which begins on Wednesday, at the
height of summer heat. After Jewish researchers in Israel and the US and found
that the COX-2 inhibitor etoricoxib (commercial name Arcoxia) reduces the rate
of migraines during the 25-hour Jewish fast of Yom Kippur, a Shaare Zedek team
headed by Dr. Michael J. Drescher and Dr. Zev Wimpfheimer are testing Muslims
who want to volunteer for the clinical trial.
Writing in the journal
Headache, Drescher and colleagues noted that they had previously recommended a
different Cox-2 inhibitor, Vioxx, but it was taken off the market because it
caused a higher risk of cardiovascular complications in some people taking it
for 18 months or longer. Thus they studied a “cousin” of Vioxx that is regarded
as safer and is still prescribed.
Before Yom Kippur, they enrolled 211
Jewish patients, some of whom received the drug, with the rest getting a
placebo. They found that those who received etoricoxib had a much easier fast
compared to previous fasts. As the drug has a half-life of 22 hours and the team
suggested it could be suitable for preventing or alleviating the headaches
associated with short fasts.
The clinical trial for Muslims is
double-blinded, with neither the doctors nor the participants knowing who is
taking the etoricoxib half of the month and a harmless placebo the rest of the
month. Anyone who wants to participate in the free trial should call (052)
337-4676 or go into the Web site www.ramadanheadache.com.
unlikely that short term (or single-dose) use of etoricoxib in the context of
preventing fasting headache would pose” a risk to the cardiovascular system,
Meanwhile, Dr. Ibrahim Abu-Salameh, Israel’s only Beduin
neurologist – who works at Soroka University Medical Center in Beersheba –
headed a team that found migraine attacks are three times more common during the
Muslim fast than in the rest of the year.
Working with colleagues Dr.
Igal Plecht and Dr. Gal Ifergan of the Beersheba hospital, Abu-Salameh studied
32 Beduin who suffered from migraine attacks during the Ramadan fast last year
and compared the statistics to an ordinary month without the fast as a
Migraines were much more common in women than men;
three-quarters of the women complained of migraine while fasting, compared to a
much lower figure among the men. The Soroka study was published recently in the
Journal of Headache and Pain.
Because the Muslim calendar is a lunar one
(with no leap years, as in the Jewish calendar), the month of Ramadan moves
gradually backward through the seasons. When it occurs in the summer, the fasts
are longer, due to the many hours of sunlight, and harder because of the hot
Abu-Salameh said that he has gotten migraine headaches during
Ramadan, and has treated Beduin who came to his clinic complaining about severe
headaches. He noted that the medical literature has almost ignored the
phenomenon until now.