Comparative Efficacy of Acupuncture, Pharmacological Interventions, Sham Acupuncture, and Placebo for Migraine Prevention: A Bayesian Network Meta-Analysis
Abstract
Objective: This study aimed to compare the preventive effects of acupuncture (ACU), pharmacological interventions (PIs), sham ACU, and placebo for migraine through a Bayesian network meta-analysis and to evaluate the relative efficacy of different treatment approaches.
Methods: By reviewing PubMed, Embase, MEDLINE, and Web of Science databases, 32 randomized controlled trials (RCTs) were included in this study. Bayesian network analyses were performed using Stata and R software to compare the effects of ACU, PI, sham ACU, and placebo on reducing headache frequency, reducing monthly migraine days, alleviating headache intensity, and decreasing the use of analgesics. Treatment effects were estimated using the Markov Chain Monte Carlo method, and model convergence and heterogeneity were evaluated. The results were presented as pairwise comparisons and forest plots.
Results: A total of 32 RCTs were included. Network meta-analysis evaluated four intervention categories: ACU, PI, sham ACU, and placebo. For monthly migraine attack frequency, ACU was significantly more effective than placebo (MD = -2.30, 95% CrI: -3.70 to -1.00), and PI also showed superiority over placebo (MD = -1.70, 95% CrI: -2.50 to -0.82), while no significant differences were observed between ACU and PI or sham ACU. For monthly migraine days, both ACU (MD = -1.78, 95% CrI: -2.89 to -0.70) and PI (MD = -1.72, 95% CrI: -2.29 to -1.16) were superior to placebo, with no significant difference between ACU and PI…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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