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European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention-part 1: amitriptyline

dc.contributor.authorLampl, Christian
dc.contributor.authorVersijpt, Jan
dc.contributor.authorAmin, Faisal Mohammad
dc.contributor.authorDeligianni, Christina I.
dc.contributor.authorGil-Gouveia, Raquel
dc.contributor.authorJassal, Tanvir
dc.contributor.authorMaassenVanDenBrink, Antoinette
dc.contributor.authorOrnello, Raffaele
dc.contributor.authorPaungarttner, Jakob
dc.contributor.authorSanchez-Del-Rio, Margarita
dc.contributor.authorReuter, Uwe
dc.contributor.authorUluduz, Derya
dc.contributor.authorde Vries, Tessa
dc.contributor.authorZeraatkar, Dena
dc.contributor.authorSacco, Simona
dc.date.accessioned2023-04-19T13:30:03Z
dc.date.available2023-04-19T13:30:03Z
dc.date.issued2023-04-11
dc.description.abstractOBJECTIVE: The aim of this paper is to critically re-appraise the published trials assessing amitriptyline for migraine prophylaxis. METHODS: We report our methods and results following the Preferred Reporting Items for Systematic Reviews (PRISMA), by searching MEDLINE, EMBASE, Cochrane CENTRAL, and ClinicalTrials.gov for randomized trials of pharmacologic treatments for migraine prophylaxis. We included randomized trials that compared amitriptyline with placebo for migraine prophylaxis in adults. Our outcomes of interest were informed by the Outcome Set for preventive intervention trials in chronic and episodic migraine (COSMIG) and include the proportion of patients who experience a 50% or more reduction in migraine days per month, migraine days per month, and adverse events leading to discontinuation. We assessed risk of bias by using a modified Cochrane RoB 2.0 tool and the certainty of evidence by using the GRADE approach. RESULTS: Our search yielded 10.826 unique records, of which three trials (n = 622) were eligible for data synthesis and analysis. We found moderate certainty evidence that amitriptyline increases the proportion of patients who experience a 50% or more reduction in monthly migraine days, compared to placebo (relative risk: 1.60 (95% CI 1.17 to 2.19); absolute risk difference: 165 more per 1,000 (95% CI 47 more to 327 more). We found moderate certainty evidence that amitriptyline increases the proportion of patients who discontinue due to adverse events compared to placebo (risk difference: 0.05 (95% CI 0.01 to 0.10); absolute risk difference: 50 more per 1,000 (95% CI 10 more to 100 more). CONCLUSIONS: Our meta-analysis showed that amitriptyline may have a prophylactic role in migraine patients, however these results are far from robust. This warrants further large-scale research to evaluate the role of amitriptyline in migraine prevention.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.1186/s10194-023-01573-6pt_PT
dc.identifier.eid85152109444
dc.identifier.issn1129-2369
dc.identifier.pmcPMC10088191
dc.identifier.pmid37038134
dc.identifier.urihttp://hdl.handle.net/10400.14/40886
dc.identifier.wos000968950200001
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectAmitriptylinept_PT
dc.subjectMeta-analysispt_PT
dc.subjectMigrainept_PT
dc.subjectProphylactic treatmentpt_PT
dc.titleEuropean Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention-part 1: amitriptylinept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.titleThe journal of headache and painpt_PT
oaire.citation.volume24pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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