Abstract
BackgroundMigraine is a neurological disorder resulting in large socioeconomic burden. This network meta-analysis (NMA) is designed to compare the relative efficacy and tolerability of non-steroidal anti-inflammatory agents (NSAIDs) and triptans.MethodsWe conducted systematic searches in database PubMed and Embase. Treatment effectiveness was compared by synthesizing direct and indirect evidences using NMA. The surface under curve ranking area (SUCRA) was created to rank those interventions.ResultsEletriptan and rizatriptan are superior to sumatriptan, zolmitriptan, almotriptan, ibuprofen and aspirin with respect to pain-relief. When analyzing 2 h-nausea-absence, rizatriptan has a better efficacy than sumatriptan, while other treatments indicate no distinctive difference compared with placebo. Furthermore, sumatriptan demonstrates a higher incidence of all-adverse-event compared with diclofenac-potassium, ibuprofen and almotriptan.ConclusionThis study suggests that eletriptan may be the most suitable therapy for migraine from a comprehensive point of view. In the meantime ibuprofen may also be a good choice for its excellent tolerability. Multi-component medication also attracts attention and may be a promising avenue for the next generation of migraine treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s10194-016-0703-0) contains supplementary material, which is available to authorized users.
Highlights
Migraine is a neurological disorder resulting in large socioeconomic burden affecting approximately 18% of females and 6% of males in the United States [1]
A large number of treatments have been developed for migraine over the past decades, several disputes have been encountered by clinicians such as misclassification of migraine, inappropriate selection of treatment and medication overuse
The selection of acute treatments has been differentiated into two pathways: non-specific medications which include analgesics and non-steroidal anti-inflammatory drugs (NSAIDs); and specific medications which include ergot derivatives and triptans [5]
Summary
Migraine is a neurological disorder resulting in large socioeconomic burden. This network metaanalysis (NMA) is designed to compare the relative efficacy and tolerability of non-steroidal anti-inflammatory agents (NSAIDs) and triptans. Migraine is a neurological disorder resulting in large socioeconomic burden affecting approximately 18% of females and 6% of males in the United States [1]. Two types of migraine therapies have been developed: preventive therapies which are used to reduce attack frequency or severity and acute therapies which are used for the sake of aborting attacks. The selection of acute treatments has been differentiated into two pathways: non-specific medications which include analgesics and non-steroidal anti-inflammatory drugs (NSAIDs); and specific medications which include ergot derivatives and triptans [5]. As suggested by the European Federation of Neurological Societies (EFNS), both oral NSAIDs and
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