Eur J Neurol. 2021 Sep 14. doi: 10.1111/ene.15103. Online ahead of print.
ABSTRACT
AIM: Many migraine patients rely on over-the-counter (OTC) analgesics for the treatment of migraine attacks. Fixed-dose combinations of aspirin, paracetamol and caffeine (APC) are used for treating migraine in many countries for a long time. We performed a meta-analysis for the comparison of APC vs placebo, which has not been done so far.
METHODS: Randomised, blinded, placebo-controlled, parallel-group studies using APC to treat a migraine attack were included in a meta-analysis. We calculated relative rates (RR) for APC compared with placebo.
RESULTS: Seven studies were included, with 3,306 participants (2,147 with APC and 1,159 with placebo). For the primary efficacy outcome pain-free at 2 h, APC was superior to placebo (19.6% vs. 9.0%, and RR = 2.2; 95%-confidence interval (CI): 1.4-3.3). For the co-primary efficacy outcome pain relief at 2 h, APC was superior to placebo (54.3% vs. 31.2%, and RR = 1.7; 95% CI: 1.6-1.9). Adverse event (AE) rates were more frequent for APC than for placebo (10.9% vs. 7.8%, and RR = 1.7, 95%-CI: 1.3-2.2).
CONCLUSIONS: APC is superior to placebo in the treatment of acute migraine attacks. The efficacy for a pain-free response and for pain relief at 2 h is clinically relevant.
PMID:34519136 | DOI:10.1111/ene.15103
