Guidelines concerning pharmacological intervention for migraine in adults: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

WEI Jingjing ^1,2,3 , LIANG Xiao ³ , FU Guojing ¹ , JIA Min ³ , CHEN Qian ¹ , LEI Lin ¹ , LU Yan ³ , GUO Rongjuan ⁴ ,  LIAO Xing ² ,  ZHANG Yunling ³

1. Graduate School of Beijing University of Chinese Medicine, Beijing 100029, P.R.China;
2. Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, P.R.China;
3. Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R.China;
4. Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, P.R.China;

Corresponding?author：

LIAO Xing, Email: okfrom2008@hotmail.com; ZHANG Yunling, Email: yunlingzhang2004@126.com

Keywords：

Migraine; Pharmacological intervention; Guideline; Quality assessment; AGREE Ⅱ

DOI：

10.7507/1672-2531.202007055

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objectives To evaluate the methodological quality of guidelines for pharmacological intervention of migraine in adults, to compare and analyze the differences in first-line drug recommendations in different regions and quality levels, so as to explore the evidence of drug recommendations, and provide a basis for clinical decision-making.Methods PubMed, The Cochrane Library, EMbase, SinoMed, CNKI, VIP, and WanFang Data databases, Up To Date, as well as the related books, Yimaitong, Guideline Central, Guidelines International Network (GIN) and National Institute for Health and Clinical Excellence (NICE) were systematically searched to collect pharmacological intervention guidelines of migraine in adults from inception to January 12^th, 2020. The methodological quality of the guidelines was evaluated by Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ).Results A total of 25 guidelines were included (including 22 evidence-based guidelines), covering 10 countries on 4 continents and World Health Organization (WHO) with a time span of 1997 to 2019. According to AGREE Ⅱ, 5 were A-level guidelines, 18 were B-level guidelines, and 2 were C-level guidelines. Scope and purpose, rigour of development, clarity of presentations and editorial independence obtained high average scores (more than 60%) among all 25 guidelines. The average scores of guidelines in different domains of AGREE Ⅱ varied with regions and countries. Triptans and NSAIDs were the most frequently recommended as first-line drugs for the acute management; beta-blockers and antiepileptic drugs were recommended for the first-line prevention drugs of migraine in adults. There were 2 guidelines that recommended complementary treatments, one recommended traditional Chinese medicine and another recommended herbal butterbur.Conclusions The methodological quality of the pharmacological intervention guidelines of migraine in adults is suboptimal among different regions or countries. The quality of evidence-based guidelines is superior to that established by consensus. The consistency of first-line drug recommendations is strong, but there are still regional differences. The therapeutic effect of traditional Chinese medicine requires further verification.

Citation： WEI Jingjing, LIANG Xiao, FU Guojing, JIA Min, CHEN Qian, LEI Lin, LU Yan, GUO Rongjuan, LIAO Xing, ZHANG Yunling. Guidelines concerning pharmacological intervention for migraine in adults: a systematic review. Chinese Journal of Evidence-Based Medicine, 2020, 20(11): 1316-1325. doi: 10.7507/1672-2531.202007055 Copy

1.	GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol, 2019, 18(5): 459-480.
2.	偏頭痛診斷與防治專家共識組. 偏頭痛診斷與防治專家共識. 中華內科雜志, 2006, 45(8): 694-696.
3.	頭面痛學組. 中國偏頭痛診斷治療指南. 中國疼痛醫學雜志, 2011, 17(2): 65-86.
4.	中國中醫科學院, 中國針灸學會組. 中醫循證臨床實踐指南. 北京: 中國中醫藥出版社, 2011.
5.	韋當, 王聰堯, 肖曉娟, 等. 指南研究與評價(AGREE Ⅱ)工具實例解讀. 中國循證兒科雜志, 2013, 8(4): 316-319.
6.	Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-842.
7.	陳尹, 胡世蓮, 李幼平, 等. 全球藥物干預治療單純性高血壓指南的系統評價. 中國循證醫學雜志, 2012, 12(10): 1180-1194.
8.	Steiner TJ, Jensen R, Katsarava Z, et al. Aids to management of headache disorders in primary care (2nd edition). J Headache Pain, 2019, 20(1): 57.
9.	Hsu YC, Lin KC, Taiwan Headache Society TGSOTHS. Medical treatment guidelines for acute migraine attacks. Acta Neurol Taiwan, 2017, 26(2): 78-96.
10.	Orr SL, Friedman BW, Christie S, et al. Management of adults with acute migraine in the emergency department: the American Headache Society evidence assessment of parenteral pharmacotherapies. Headache, 2016, 56(6): 911-940.
11.	Orr SL, Aubé M, Becker WJ, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia, 2015, 35(3): 271-284.
12.	Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society guideline: acute drug therapy for migraine headache. Can J Neurol Sci, 2013, 40(5 Suppl 3): S1-S80.
13.	Ducharme J. Canadian Association of Emergency Physicians guidelines for the acute management of migraine headache. J Emerg Med, 1999, 17(1): 137-144.
14.	Kowacs F, Roesler CAP, Piovesan éJ, et al. Consensus of the Brazilian Headache Society on the treatment of chronic migraine. Arq Neuropsiquiatr, 2019, 77(7): 509-520.
15.	Sacco S, Bendtsen L, Ashina M, et al. European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain, 2019, 20(1): 58.
16.	Huang TC, Lai TH, Taiwan Headache Society TGSOTHS. Medical treatment guidelines for preventive treatment of migraine. Acta Neurol Taiwan, 2017, 26(1): 33-53.
17.	Giacomozzi AR, Vindas AP, Silva AA, et al. Latin American consensus on guidelines for chronic migraine treatment. Arq Neuropsiquiatr, 2013, 71(7): 478-486.
18.	Pringsheim T, Davenport W, Mackie G, et al. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci, 2012, 39(2 Suppl 2): S1-S59.
19.	Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 2012, 78(17): 1346-1353.
20.	Silberstein SD, Holland S, Freitag F, et al. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 2012, 78(17): 1337-1345.
21.	Araki N, Takeshima T, Ando N, et al. Clinical practice guideline for chronic headache 2013. Neurology Clin Neurosci, 2019, 7(5): 1-284.
22.	Kouremenos E, Arvaniti C, Constantinidis TS, et al. Consensus of the Hellenic Headache Society on the diagnosis and treatment of migraine. J Headache Pain, 2019, 20(1): 113.
23.	American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache, 2019, 59(1): 1-18.
24.	Scottish Intercollegiate Guidelines Network (SIGN). Pharmacological management of migraine. 2018. Available from: http://www.sign.ac.uk.
25.	中華醫學會疼痛學分會頭面痛學組, 中國醫師協會神經內科醫師分會疼痛和感覺障礙專委會. 中國偏頭痛防治指南. 中國疼痛醫學雜志, 2016, 22(10): 721-727.
26.	Becker WJ, Findlay T, Moga C, et al. Guideline for primary care management of headache in adults. Can Fam Physician, 2015, 61(8): 670-679.
27.	National Institute for Health and Care Excellence (NICE). Diagnosis and management of headaches in young people and adults: evidence update October 2014. Available from: https://www.evidence.nhs.uk/search?q=Diagnosis+and+management+of+headaches+in+young+people+and+adults.
28.	Haag G, Diener HC, May A, et al. Self-medication of migraine and tension-type headache: summary of the evidence-based recommendations of the Deutsche Migr?ne und Kopfschmerzgesellschaft (DMKG), the Deutsche Gesellschaft für Neurologie (DGN), the ?sterreichische Kopfschmerzgesellschaft (?KSG) and the Schweizerische Kopfwehgesellschaft (SKG). J Headache Pain, 2011, 12(2): 201-217.
29.	Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force. Eur J Neurol, 2009, 16(9): 968-981.
30.	Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2000, 55(6): 754-762.
31.	Pryse-Phillips WE, Dodick DW, Edmeads JG, et al. Guidelines for the diagnosis and management of migraine in clinical practice. Canadian Headache Society. CMAJ, 1997, 156(9): 1273-1287.
32.	趙國楨, 馮碩, 張霄瀟, 等. 中醫藥臨床實踐指南: 現狀和思考. 中國循證醫學雜志, 2018, 18(12): 1386-1390.
33.	張莉, 欒勇, 孫成春. 曲坦類藥物治療偏頭痛的臨床應用進展. 解放軍藥學學報, 2012, 28(6): 551-553, 557.
34.	Xu H, Han W, Wang J, et al. Network meta-analysis of migraine disorder treatment by NSAIDs and triptans. J Headache Pain, 2016, 17(1): 1-18.
35.	郭莉, 孫茂蒼. 用托吡酯治療偏頭疼的效果觀察. 當代醫藥論叢, 2019, 17(13): 144-145.
36.	徐曉琳, 解麗麗. 探討托吡酯治療偏頭痛的臨床療效及對患者腦血管病變與神經元放電指標的影響. 中國醫藥指南, 2020, 18(5): 127-128.
37.	鮑麗. 托吡酯治療偏頭痛的臨床療效及其對腦血管病變和神經元放電的影響研究. 系統醫學, 2019, 4(7): 73-75.
38.	屈文英, 師媛, 解建國, 等. 氟桂利嗪分別聯合普萘洛爾與托吡酯治療偏頭痛的臨床價值分析. 腦與神經疾病雜志, 2019, 27(3): 182-186.
39.	National Institute for Health and Care Excellence. Botulinum toxin type A for the prevention of headaches in adults with chronic migraine. Available from: https://www.nice.org.uk/guidance/ta260.
40.	孫鑫, 譚婧, 唐立, 等. 重新認識真實世界研究. 中國循證醫學雜志, 2017, 17(2): 126-130.

1. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol, 2019, 18(5): 459-480.
2. 偏頭痛診斷與防治專家共識組. 偏頭痛診斷與防治專家共識. 中華內科雜志, 2006, 45(8): 694-696.
3. 頭面痛學組. 中國偏頭痛診斷治療指南. 中國疼痛醫學雜志, 2011, 17(2): 65-86.
4. 中國中醫科學院, 中國針灸學會組. 中醫循證臨床實踐指南. 北京: 中國中醫藥出版社, 2011.
5. 韋當, 王聰堯, 肖曉娟, 等. 指南研究與評價(AGREE Ⅱ)工具實例解讀. 中國循證兒科雜志, 2013, 8(4): 316-319.
6. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-842.
7. 陳尹, 胡世蓮, 李幼平, 等. 全球藥物干預治療單純性高血壓指南的系統評價. 中國循證醫學雜志, 2012, 12(10): 1180-1194.
8. Steiner TJ, Jensen R, Katsarava Z, et al. Aids to management of headache disorders in primary care (2nd edition). J Headache Pain, 2019, 20(1): 57.
9. Hsu YC, Lin KC, Taiwan Headache Society TGSOTHS. Medical treatment guidelines for acute migraine attacks. Acta Neurol Taiwan, 2017, 26(2): 78-96.
10. Orr SL, Friedman BW, Christie S, et al. Management of adults with acute migraine in the emergency department: the American Headache Society evidence assessment of parenteral pharmacotherapies. Headache, 2016, 56(6): 911-940.
11. Orr SL, Aubé M, Becker WJ, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia, 2015, 35(3): 271-284.
12. Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society guideline: acute drug therapy for migraine headache. Can J Neurol Sci, 2013, 40(5 Suppl 3): S1-S80.
13. Ducharme J. Canadian Association of Emergency Physicians guidelines for the acute management of migraine headache. J Emerg Med, 1999, 17(1): 137-144.
14. Kowacs F, Roesler CAP, Piovesan éJ, et al. Consensus of the Brazilian Headache Society on the treatment of chronic migraine. Arq Neuropsiquiatr, 2019, 77(7): 509-520.
15. Sacco S, Bendtsen L, Ashina M, et al. European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain, 2019, 20(1): 58.
16. Huang TC, Lai TH, Taiwan Headache Society TGSOTHS. Medical treatment guidelines for preventive treatment of migraine. Acta Neurol Taiwan, 2017, 26(1): 33-53.
17. Giacomozzi AR, Vindas AP, Silva AA, et al. Latin American consensus on guidelines for chronic migraine treatment. Arq Neuropsiquiatr, 2013, 71(7): 478-486.
18. Pringsheim T, Davenport W, Mackie G, et al. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci, 2012, 39(2 Suppl 2): S1-S59.
19. Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 2012, 78(17): 1346-1353.
20. Silberstein SD, Holland S, Freitag F, et al. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 2012, 78(17): 1337-1345.
21. Araki N, Takeshima T, Ando N, et al. Clinical practice guideline for chronic headache 2013. Neurology Clin Neurosci, 2019, 7(5): 1-284.
22. Kouremenos E, Arvaniti C, Constantinidis TS, et al. Consensus of the Hellenic Headache Society on the diagnosis and treatment of migraine. J Headache Pain, 2019, 20(1): 113.
23. American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache, 2019, 59(1): 1-18.
24. Scottish Intercollegiate Guidelines Network (SIGN). Pharmacological management of migraine. 2018. Available from: http://www.sign.ac.uk.
25. 中華醫學會疼痛學分會頭面痛學組, 中國醫師協會神經內科醫師分會疼痛和感覺障礙專委會. 中國偏頭痛防治指南. 中國疼痛醫學雜志, 2016, 22(10): 721-727.
26. Becker WJ, Findlay T, Moga C, et al. Guideline for primary care management of headache in adults. Can Fam Physician, 2015, 61(8): 670-679.
27. National Institute for Health and Care Excellence (NICE). Diagnosis and management of headaches in young people and adults: evidence update October 2014. Available from: https://www.evidence.nhs.uk/search?q=Diagnosis+and+management+of+headaches+in+young+people+and+adults.
28. Haag G, Diener HC, May A, et al. Self-medication of migraine and tension-type headache: summary of the evidence-based recommendations of the Deutsche Migr?ne und Kopfschmerzgesellschaft (DMKG), the Deutsche Gesellschaft für Neurologie (DGN), the ?sterreichische Kopfschmerzgesellschaft (?KSG) and the Schweizerische Kopfwehgesellschaft (SKG). J Headache Pain, 2011, 12(2): 201-217.
29. Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force. Eur J Neurol, 2009, 16(9): 968-981.
30. Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2000, 55(6): 754-762.
31. Pryse-Phillips WE, Dodick DW, Edmeads JG, et al. Guidelines for the diagnosis and management of migraine in clinical practice. Canadian Headache Society. CMAJ, 1997, 156(9): 1273-1287.
32. 趙國楨, 馮碩, 張霄瀟, 等. 中醫藥臨床實踐指南: 現狀和思考. 中國循證醫學雜志, 2018, 18(12): 1386-1390.
33. 張莉, 欒勇, 孫成春. 曲坦類藥物治療偏頭痛的臨床應用進展. 解放軍藥學學報, 2012, 28(6): 551-553, 557.
34. Xu H, Han W, Wang J, et al. Network meta-analysis of migraine disorder treatment by NSAIDs and triptans. J Headache Pain, 2016, 17(1): 1-18.
35. 郭莉, 孫茂蒼. 用托吡酯治療偏頭疼的效果觀察. 當代醫藥論叢, 2019, 17(13): 144-145.
36. 徐曉琳, 解麗麗. 探討托吡酯治療偏頭痛的臨床療效及對患者腦血管病變與神經元放電指標的影響. 中國醫藥指南, 2020, 18(5): 127-128.
37. 鮑麗. 托吡酯治療偏頭痛的臨床療效及其對腦血管病變和神經元放電的影響研究. 系統醫學, 2019, 4(7): 73-75.
38. 屈文英, 師媛, 解建國, 等. 氟桂利嗪分別聯合普萘洛爾與托吡酯治療偏頭痛的臨床價值分析. 腦與神經疾病雜志, 2019, 27(3): 182-186.
39. National Institute for Health and Care Excellence. Botulinum toxin type A for the prevention of headaches in adults with chronic migraine. Available from: https://www.nice.org.uk/guidance/ta260.
40. 孫鑫, 譚婧, 唐立, 等. 重新認識真實世界研究. 中國循證醫學雜志, 2017, 17(2): 126-130.

Previous Article
Analysis of hotspots and frontiers of frailty research: a visualization analysis based on CiteSpace
Next Article
Chinese herb injections for viral pneumonia: an overview of systematic reviews

Chinese Journal of Evidence-Based Medicine

Guidelines concerning pharmacological intervention for migraine in adults: a systematic review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content