Therapeutic efficacy of nimodipine and topiramate on migraine and vestibular migraine; A prospective multicenter open-label study
Abstract
Background: Although new preventive treatments for migraine have emerged, it remains essential to validate the efficacy of established drugs to ensure broader therapeutic options for migraine and, in particular, for vestibular migraine where clinical evidence is more limited. This study aimed to assess the therapeutic effectiveness of nimodipine, an L-type calcium channel blocker, in patients with migraine and vestibular migraine, with reference to outcomes observed with topiramate.
Methods: Using a prospective open-label study involving nine referral-based university hospitals in South Korea, we recruited 850 patients (81% women, mean age ± SD = 41 ± 12) with migraine, including 255 with vestibular migraine. The primary outcome was the change in headache days over three months. The secondary outcomes included changes in pain rating scale, Migraine Disability Assessment Scale (MIDAS) and Headache Impact Test-6 (HIT-6). The outcomes of vestibular migraine included dizziness days and intensity, Dizziness Handicap Inventory, and UCLA-Dizziness Questionnaire.
Results: Of the 850 patients, 465 (55%) completed three months of evaluation (205 in the nimodipine group, 160 in the topiramate group, and 100 in the combination group). All groups showed a significant reduction in the headache days (1.2-2 days/week, p < 0.001) without inter-group differences (p = 0.865). The topiramate group showed greater improvements in MIDAS and HIT-6 scores than the nimodipine (p = 0.004) and…
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 850 participants or records.
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