Oral preventive medications for migraine in adults aged 18-65: a network meta-analysis
Abstract
Background: Migraine is a highly prevalent neurological disorder that significantly impairs quality of life. Understanding the comparative effectiveness and safety of oral preventive medications is essential to guide treatment decisions in adult patients. This study aims to evaluate and compare the efficacy and safety of oral pharmacological therapies for migraine prevention in adults using Network Meta-Analysis.
Methods: A comprehensive search was conducted across The Cochrane Library, PubMed, SCOPUS, and Embase databases until 15 December 2024 to find relevant studies on preventing migraine among adult populations. Clinical trials involving adult individuals with migraine who received oral pharmacological interventions were included. Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, data extraction was independently conducted by five researchers in duplicate. Model choice was based on heterogeneity with random-effects used for I2 ≥ 50% and fixed-effects for I2 < 50%. The main endpoint was the monthly frequency of migraine attacks. Secondary endpoints encompassed the response rate of ≥50%, migraine duration, pain intensity, and quality of life (QoL). Adverse events were assessed.
Results: From the 17,443 identified citations, we included 44 trials (4,612 participants) in our analysis. Topiramate, valproate, and propranolol demonstrated significant efficacy in the prevention of migraines. Memantine, melatonin, and vitamin D3 also…
How strong is the evidence?
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. Reported size: 4,612 participants or records.
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