科研之友
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摘要
Objective: To assess the evidence base for drugs used for prophylaxis of episodic migraine (headache on %26lt;= 14 days a month) in Canada. Methods: A detailed search strategy was employed to find relevant published clinical trials. All abstracts were reviewed for eligibility by two reviewers. Only double-blind randomized clinical trials with placebo or active drug controls were included in the analysis. Studies were graded with respect to methodological quality according to the US Preventative Services Task Force. Recommendations were graded according to the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group, using a consensus group. Results: Nineteen medications were evaluated. Seventeen were recommended for use in migraine prophylaxis. Four received a strong recommendation - high quality evidence (topiramate, propranolol, metoprolol, and amitriptyline), four received a strong recommendation - moderate quality evidence (nadolol, gabapentin, candesartan, butterbur), and three received a strong recommendation - low quality evidence (riboflavin, co-enzyme Q10, and magnesium citrate). Three medications received a weak recommendation - high quality evidence (divalproex sodium, flunarizine, and pizotifen), and three received a weak recommendation - low quality evidence (venlafaxine, verapamil, and lisinopril). A strong recommendation was made not to use two medications in patients with episodic migraine: botulinum toxin type A (high quality evidence), and feverfew (moderate quality evidence). Conclusion: Our systematic review formulated recommendations for the available medications for migraine prophylaxis according to the GRADE method. This should be helpful for practitioners who prescribe medications for migraine prophylaxis.
- 出版日期2012-3
