Migrainaren tratamendu profilaktikorako farmakoen eraginkortasunaren azterketa

Abstract

Migraine is a primary headache. In general, we can differentiate between acute and chronic migraine, but there are also other non-conventional migraines. Different treatments are available for migraine prophylaxis, but their use according to the type of migraine is not well established. Therefore, the aim of this study was to investigate the efficacy of drugs used for the prophylactic treatment of migraine. To this end, a systematic review of placebo-controlled clinical trials was conducted using different databases. According to the study, CoQ10 coenzymes, active vitamins D3 and isoflabones were effective to reduce the frequency, intensity and duration of migraine attacks (primary variables) in acute migraine prevention in the few clinical trials collected. For the prevention of chronic migraine, the same substances also reduce the primary variables. In addition, the efficacy of topiramate and probiotics on the analysed variables was observed. Other drugs, such as anti-CGRP, atogepant, nadolol for certain variables or secondary variables, among others, were effective in the different types of migraines. Furthermore, both in primary care and in the specialised neurology services of some of the OSIs in Bizkaia, the absence of standardised protocols for the prevention of migraines has been detected, and each centre uses different guidelines. Many of the drugs mentioned in these guidelines (amitriptyline, topiramate, antiCGRP), but not all, are in line with the efficacy results obtained in our systematic review. According to our study, the amount of evidence collected for each drug with the systematic procedure used was very small. Therefore, more evidence on the efficacy of drugs for the prevention of migraine would be necessary and subsequently joint guidelines could be established regarding the treatment of the type of migraine in the Basque Public Health System.