Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials
Abstract Background Mainly based on evidence of success in adults, various medications are commonly used to prevent pediatric migraines. Topiramate has been approved for migraine prevention in children as young as 12 years of age. In this meta-analysis, we aimed to assess the currently published dat...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | The Journal of Headache and Pain |
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| Online Access: | http://link.springer.com/article/10.1186/s10194-017-0776-4 |
| _version_ | 1818231837875503104 |
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| author | Kai Le Dafan Yu Jiamin Wang Abdoulaye Idriss Ali Yijing Guo |
| author_facet | Kai Le Dafan Yu Jiamin Wang Abdoulaye Idriss Ali Yijing Guo |
| author_sort | Kai Le |
| collection | DOAJ |
| description | Abstract Background Mainly based on evidence of success in adults, various medications are commonly used to prevent pediatric migraines. Topiramate has been approved for migraine prevention in children as young as 12 years of age. In this meta-analysis, we aimed to assess the currently published data pertaining to the efficacy of topiramate for migraine prevention in patients less than 18 years of age. Methods We searched PubMed/Medline, Embase and the Cochrane Library (from inception to April 2017) for randomized controlled trials (RCTs) published in English. Two independent investigators performed data extraction and quality evaluation using the Cochrane Collaboration’s tool. The data extracted were analyzed by Review Manager 5.3 software. Results A total of four RCTs matching the inclusion criteria were included, with an aggregate of 465 patients. Of these patients, 329 were included in the topiramate group, and 136 were included in the placebo group. This meta-analysis revealed that compared with placebo, topiramate failed to decrease the number of patients experiencing a ≥ 50% relative reduction in headache frequency (n = 465, RR = 1.26, 95% CI = [0.94,1.67], Z = 1.55, P = 0.12) or the number of headache days (n = 465, MD = −0.77, 95% CI = [−2.31,0.76], Z = 0.99, P = 0.32) but did reduce PedMIDAS scores (n = 205, MD = −9.02, 95% CI = [−17.34, −0.70], Z = 2.13, P = 0.03). Higher rates of side effects and adverse events in the topiramate group than in the placebo group were observed in the included trials. Conclusions Topiramate may not achieve a more effective clinical trial endpoint than placebo in the prevention of migraines in patients less than 18 years of age, and topiramate may lead to more side effects or adverse events in the included patients. |
| first_indexed | 2024-12-12T10:56:45Z |
| format | Article |
| id | doaj.art-34185e98923f4845bdc7241ba5c8b27c |
| institution | Directory Open Access Journal |
| issn | 1129-2369 1129-2377 |
| language | English |
| last_indexed | 2024-12-12T10:56:45Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | The Journal of Headache and Pain |
| spelling | doaj.art-34185e98923f4845bdc7241ba5c8b27c2022-12-22T00:26:38ZengBMCThe Journal of Headache and Pain1129-23691129-23772017-07-0118111010.1186/s10194-017-0776-4Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trialsKai Le0Dafan Yu1Jiamin Wang2Abdoulaye Idriss Ali3Yijing Guo4Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityDepartment of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityDepartment of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityDepartment of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityDepartment of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast UniversityAbstract Background Mainly based on evidence of success in adults, various medications are commonly used to prevent pediatric migraines. Topiramate has been approved for migraine prevention in children as young as 12 years of age. In this meta-analysis, we aimed to assess the currently published data pertaining to the efficacy of topiramate for migraine prevention in patients less than 18 years of age. Methods We searched PubMed/Medline, Embase and the Cochrane Library (from inception to April 2017) for randomized controlled trials (RCTs) published in English. Two independent investigators performed data extraction and quality evaluation using the Cochrane Collaboration’s tool. The data extracted were analyzed by Review Manager 5.3 software. Results A total of four RCTs matching the inclusion criteria were included, with an aggregate of 465 patients. Of these patients, 329 were included in the topiramate group, and 136 were included in the placebo group. This meta-analysis revealed that compared with placebo, topiramate failed to decrease the number of patients experiencing a ≥ 50% relative reduction in headache frequency (n = 465, RR = 1.26, 95% CI = [0.94,1.67], Z = 1.55, P = 0.12) or the number of headache days (n = 465, MD = −0.77, 95% CI = [−2.31,0.76], Z = 0.99, P = 0.32) but did reduce PedMIDAS scores (n = 205, MD = −9.02, 95% CI = [−17.34, −0.70], Z = 2.13, P = 0.03). Higher rates of side effects and adverse events in the topiramate group than in the placebo group were observed in the included trials. Conclusions Topiramate may not achieve a more effective clinical trial endpoint than placebo in the prevention of migraines in patients less than 18 years of age, and topiramate may lead to more side effects or adverse events in the included patients.http://link.springer.com/article/10.1186/s10194-017-0776-4TopiramatePediatricAdolescentChildrenMigrainePrevention |
| spellingShingle | Kai Le Dafan Yu Jiamin Wang Abdoulaye Idriss Ali Yijing Guo Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials The Journal of Headache and Pain Topiramate Pediatric Adolescent Children Migraine Prevention |
| title | Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials |
| title_full | Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials |
| title_fullStr | Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials |
| title_full_unstemmed | Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials |
| title_short | Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials |
| title_sort | is topiramate effective for migraine prevention in patients less than 18 years of age a meta analysis of randomized controlled trials |
| topic | Topiramate Pediatric Adolescent Children Migraine Prevention |
| url | http://link.springer.com/article/10.1186/s10194-017-0776-4 |
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