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Meta-analysis of efficacy of topiramate in migraine prophylaxis.

Guo Y, Han X, Yu T, Yao G - Neural Regen Res (2012)

Bottom Line: Adverse events were recorded as the number of subjects exhibiting at least one adverse event.The total incidence rate of adverse events for topiramate was higher than in the placebo group (P < 0.01), but most adverse events were mild to moderate.Overall, topiramate obtained good outcomes and safety in migraine prophylaxis.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Second Hospital, Jilin University, Changchun 130041, Jilin Province, China ; Department of Neonatology, First Hospital, Jilin University, Changchun 130021, Jilin Province, China.

ABSTRACT

Objective: To evaluate the treatment effects and safety of topiramate in migraine prophylaxis.

Data retrieval: We searched the Medline database, EMbase, Cochrane Library and China National Knowledge Infrastructure database for articles published between January 1995 and May 2011, using the key words "migraine", "topiramate", and "prophylaxis".

Selection criteria: We selected randomized controlled trials of migraine patients, in which the experimental group was orally administered topiramate, and the control group was given placebo. Odds ratios (ORs) and mean differences (MDs) were calculated using a fixed effects model/random effects model. Quality evaluation and data extraction were performed independently by two researchers utilizing RevMan 5.0 software.

Main outcome measures: Efficacy was recorded as the responder rate (response defined as at least a 50% reduction in average monthly migraine frequency) and change in mean monthly number of migraine days. Adverse events were recorded as the number of subjects exhibiting at least one adverse event.

Results: Eight randomized controlled trials were found to be appropriate, and had available data. The meta-analysis results revealed that topiramate (100 or 200 mg/d) was more effective than placebo in responder rate (OR = 2.97, 95% confidence interval (CI): 2.17-4.08, P < 0.01; OR = 2.35, 95%CI: 1.77-3.12, P < 0.01). Topiramate (100 mg/d) was more effective than placebo in terms of the change in mean monthly migraine days (MD: -1.14, 95%CI: -1.69 to -0.59, P < 0.01). The total incidence rate of adverse events for topiramate was higher than in the placebo group (P < 0.01), but most adverse events were mild to moderate.

Conclusion: Overall, topiramate obtained good outcomes and safety in migraine prophylaxis.

No MeSH data available.


Related in: MedlinePlus

Funnel plot of topiramate 200 mg/d vs. placebo for responder rate.X-axis: Log odds ratios (ORs); Y-axis: 1/standard error (log ORs).
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Figure 6: Funnel plot of topiramate 200 mg/d vs. placebo for responder rate.X-axis: Log odds ratios (ORs); Y-axis: 1/standard error (log ORs).

Mentions: We assessed the possibility of publication bias by evaluating a funnel plot, in the comparison of topiramate 200 mg/d with placebo for responder rate; no evidence of publication bias was found (Figure 6). Regarding the comparisons of topiramate 100 mg/d with placebo for responder rate, change of mean monthly migraine days and adverse events, there were less than five studies included in each comparison; it was not possible to conduct bias analysis by evaluating funnel plot.


Meta-analysis of efficacy of topiramate in migraine prophylaxis.

Guo Y, Han X, Yu T, Yao G - Neural Regen Res (2012)

Funnel plot of topiramate 200 mg/d vs. placebo for responder rate.X-axis: Log odds ratios (ORs); Y-axis: 1/standard error (log ORs).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4302531&req=5

Figure 6: Funnel plot of topiramate 200 mg/d vs. placebo for responder rate.X-axis: Log odds ratios (ORs); Y-axis: 1/standard error (log ORs).
Mentions: We assessed the possibility of publication bias by evaluating a funnel plot, in the comparison of topiramate 200 mg/d with placebo for responder rate; no evidence of publication bias was found (Figure 6). Regarding the comparisons of topiramate 100 mg/d with placebo for responder rate, change of mean monthly migraine days and adverse events, there were less than five studies included in each comparison; it was not possible to conduct bias analysis by evaluating funnel plot.

Bottom Line: Adverse events were recorded as the number of subjects exhibiting at least one adverse event.The total incidence rate of adverse events for topiramate was higher than in the placebo group (P < 0.01), but most adverse events were mild to moderate.Overall, topiramate obtained good outcomes and safety in migraine prophylaxis.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Second Hospital, Jilin University, Changchun 130041, Jilin Province, China ; Department of Neonatology, First Hospital, Jilin University, Changchun 130021, Jilin Province, China.

ABSTRACT

Objective: To evaluate the treatment effects and safety of topiramate in migraine prophylaxis.

Data retrieval: We searched the Medline database, EMbase, Cochrane Library and China National Knowledge Infrastructure database for articles published between January 1995 and May 2011, using the key words "migraine", "topiramate", and "prophylaxis".

Selection criteria: We selected randomized controlled trials of migraine patients, in which the experimental group was orally administered topiramate, and the control group was given placebo. Odds ratios (ORs) and mean differences (MDs) were calculated using a fixed effects model/random effects model. Quality evaluation and data extraction were performed independently by two researchers utilizing RevMan 5.0 software.

Main outcome measures: Efficacy was recorded as the responder rate (response defined as at least a 50% reduction in average monthly migraine frequency) and change in mean monthly number of migraine days. Adverse events were recorded as the number of subjects exhibiting at least one adverse event.

Results: Eight randomized controlled trials were found to be appropriate, and had available data. The meta-analysis results revealed that topiramate (100 or 200 mg/d) was more effective than placebo in responder rate (OR = 2.97, 95% confidence interval (CI): 2.17-4.08, P < 0.01; OR = 2.35, 95%CI: 1.77-3.12, P < 0.01). Topiramate (100 mg/d) was more effective than placebo in terms of the change in mean monthly migraine days (MD: -1.14, 95%CI: -1.69 to -0.59, P < 0.01). The total incidence rate of adverse events for topiramate was higher than in the placebo group (P < 0.01), but most adverse events were mild to moderate.

Conclusion: Overall, topiramate obtained good outcomes and safety in migraine prophylaxis.

No MeSH data available.


Related in: MedlinePlus