Review compares drug interventions for the treatment of acute migraine

MONDAY, Sept. 23, 2024 (HealthDay News) — All active interventions demonstrate better efficacy than placebo for pain relief and most also for sustained pain relief in the acute treatment of migraine in adults, according to a study published online Sept. 18 in The BMJ.

William K. Karlsson from the Danish Headache Center at Rigshospitalet University Hospital in Copenhagen and colleagues conducted a systematic review and network meta-analysis to compare all approved drug interventions as oral monotherapy for the acute treatment of migraine episodes in adults. Data from 137 randomized controlled trials with 89,445 participants assigned to one of 17 active interventions or placebo were included.

The researchers found that all active interventions showed better efficacy compared with placebo for pain relief at two hours (odds ratios ranging from 1.73 for naratriptan to 5.19 for eletriptan), and most also showed better efficacy for sustained pain relief up to 24 hours (odds ratios ranging from 1.71 for celecoxib to 7.58 for ibuprofen). Eletriptan was the most effective drug in direct comparison for pain relief at two hours (odds ratios ranging from 1.46 to 3.01), followed by rizatriptan, sumatriptan, and zolmitriptan (odds ratios ranging from 1.59 to 2.44, 1.35 to 2.04, and 1.47 to 1.96, respectively). The most effective interventions for sustained pain relief were eletriptan and ibuprofen (odds ratios ranging from 1.41 to 4.82).

“The results of this systematic review and network meta-analysis provide the best available evidence for the choice of acute oral drug interventions for migraine attacks,” the authors write. “Our results are consistent with current observational data.”

Several authors revealed connections to the biopharmaceutical industry.

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