Topiramate, acupuncture, and BoNT‐A for chronic migraine: a network meta‐analysis
2021; Wiley; Volume: 143; Issue: 5 Linguagem: Inglês
10.1111/ane.13391
ISSN1600-0404
AutoresHui Zheng, Shi‐Le Huang, Yaoyao Chen, Tai‐Chun Tang, Di Qin, Min Chen,
Tópico(s)Trigeminal Neuralgia and Treatments
ResumoActa Neurologica ScandinavicaVolume 143, Issue 5 p. 558-568 ORIGINAL ARTICLE Topiramate, acupuncture, and BoNT-A for chronic migraine: a network meta-analysis Hui Zheng, Corresponding Author Hui Zheng zhenghui@cdutcm.edu.cn orcid.org/0000-0002-0494-1217 The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China Correspondence Hui Zheng, The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu, China, 610000. Email: zhenghui@cdutcm.edu.cn Min Chen, Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, 39 Shi-er-qiao Road, Chengdu, Sichuan, China, 610000. Email: cm@cdutcm.edu.cnSearch for more papers by this authorShi-Le Huang, Shi-Le Huang Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSearch for more papers by this authorYao-Yao Chen, Yao-Yao Chen The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSearch for more papers by this authorTai-Chun Tang, Tai-Chun Tang Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSearch for more papers by this authorDi Qin, Di Qin The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSearch for more papers by this authorMin Chen, Corresponding Author Min Chen cm@cdutcm.edu.cn Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China Correspondence Hui Zheng, The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu, China, 610000. Email: zhenghui@cdutcm.edu.cn Min Chen, Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, 39 Shi-er-qiao Road, Chengdu, Sichuan, China, 610000. Email: cm@cdutcm.edu.cnSearch for more papers by this author Hui Zheng, Corresponding Author Hui Zheng zhenghui@cdutcm.edu.cn orcid.org/0000-0002-0494-1217 The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China Correspondence Hui Zheng, The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu, China, 610000. Email: zhenghui@cdutcm.edu.cn Min Chen, Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, 39 Shi-er-qiao Road, Chengdu, Sichuan, China, 610000. Email: cm@cdutcm.edu.cnSearch for more papers by this authorShi-Le Huang, Shi-Le Huang Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSearch for more papers by this authorYao-Yao Chen, Yao-Yao Chen The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSearch for more papers by this authorTai-Chun Tang, Tai-Chun Tang Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSearch for more papers by this authorDi Qin, Di Qin The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, ChinaSearch for more papers by this authorMin Chen, Corresponding Author Min Chen cm@cdutcm.edu.cn Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China Correspondence Hui Zheng, The Third Hospital/Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Avenue, Wenjiang District, Chengdu, China, 610000. Email: zhenghui@cdutcm.edu.cn Min Chen, Clinical Medicinal School, Hospital of Chengdu University of Traditional Chinese Medicine, 39 Shi-er-qiao Road, Chengdu, Sichuan, China, 610000. Email: cm@cdutcm.edu.cnSearch for more papers by this author First published: 03 January 2021 https://doi.org/10.1111/ane.13391 Funding information: Min Chen received grants (no. 81774321) from the National Natural Science Foundation of China. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Background Botulinum neurotoxin A (BoNT-A) was the primary choice for preventive treatment of chronic migraine. Topiramate and acupuncture showed promising effect for chronic migraine, but their effectiveness relative to BoNT-A was rarely studied. We aimed to perform a network meta-analysis to compare the effectiveness and acceptability between topiramate, acupuncture, and BoNT-A. Methods We searched OVID Medline, Embase, the Cochrane register of controlled trials (CENTRAL), the Chinese Clinical Trial Register, and clinicaltrials.gov for randomized controlled trials (RCTs) that compared topiramate, acupuncture, and BoNT-A with any of them or placebo in the preventive treatment of chronic migraine. A network meta-analysis was performed by using a frequentist approach and a random-effects model. The primary outcomes were reduction in monthly headache days and monthly migraine days at week 12. Acceptability was defined as the number of dropouts owing to adverse events. Results We included 15 RCTs (n = 2545). Eleven RCTs were at low risk of bias. The network meta-analyses (n = 2061) showed that acupuncture (2061 participants; standardized mean difference [SMD] −1.61, 95% CI: −2.35 to −0.87) and topiramate (582 participants; SMD −0.4, 95% CI: −0.75 to −0.04) ranked the most effective in the reduction of monthly headache days and migraine days, respectively; but they were not significantly superior over BoNT-A. Topiramate caused the most treatment-related adverse events and the highest rate of dropouts owing to adverse events. Conclusions Topiramate and acupuncture were not superior over BoNT-A; BoNT-A was still the primary preventive treatment of chronic migraine. Large-scale RCTs with direct comparison of these three treatments are warranted to verified the findings. Open Research DATA AVAILABILITY STATEMENT All data generated or analyzed data in study are included in this article. Supporting Information Filename Description ane13391-sup-0001-Appendix.docxWord document, 1.5 MB Supplementary Material Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. Volume143, Issue5May 2021Pages 558-568 RelatedInformation
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