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Recent Trends in the Pharmacological Treatment of Chronic Migraine: A Systematic Review of Randomized Controlled Trials

Jitender Sharma, Rahul Soni, S. Singh

Cureus, 2025

2,436 participants · 1 citation

Abstract

Chronic migraine is one of the debilitating neurological conditions affecting the lives of several patients. This systematic review aimed to explore the recent trends in the pharmacological treatment of chronic migraine. We conducted this systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The literature search encompassed extensive databases such as PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials. The analysis included studies published from 2014 to 2024, and the quality of the included studies was evaluated using the appropriate tools according to the study design. The synthesis and data analysis included a summary of study characteristics, interventions, outcomes measured, and main study results/conclusions. Sample sizes in the included studies ranged from 1,072 to 2,436 participants. The most common pharmacological treatments used for chronic migraine were eptinezumab, onabotulinumtoxinA, and galcanezumab, which emerged from 14 quality randomized controlled trials. Studies observed significant improvements across various metrics, including headache frequency, severity, quality of life measures, and patient-reported outcomes. The Headache Impact Test-6 score, monthly migraine headache days, Migraine-Specific Quality-of-Life score, and Migraine Disability Assessment score were particularly useful in quantifying the treatment’s effectiveness. This systematic review concludes the…

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Evidence Hub reads this as a systematic review, 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: 2,436 participants or records.

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