The Efficacy And Safety In Chronic Migraine Prophylaxis: A Meta-Analysis

OBJECTIVE To evaluate the efficacy and safety of topiramate (TPM)and Botulinum toxin type A (BotxA) versus placebo (PLB) respectively for chronic migraine prophylaxis.METHODS Such databases as CBM, CNKI, VIP Database, PUBMED, EMNASEand Cochrane (since the self-built library～2015.2) were searched, randomized controlled trials (RCT)were identified, and Meta-analysis were conducted by using RevMan5.2 software.RESULTS A total of 6 RCTs involving 1815 patients were included. The heterogeneity inspection analysis of TPM is obvious (12= 87%, P<0.1), but BotxA has no statistical heterogeneity (I2= 37%, P= 0.21). Meta analysis using random effects model,The results of meta-analyses were statistically significant,showed that the change from baseline in frequency of migraine days of TPM is higher than placebo[MD=-3.52,95%CI(-6.27,-0.76); P=0.01],and also BotxA [MD=-1.96,95%CI (-2.66,-1.26); P<0.00001].CONCLUSION As current evidence shows, the efficacy of TPM or BotxA for chronic migraine prophylaxis is better than placebo, as good as the safety and tolerability.However, the results should be interpreted with caution because of the quantity and sample size of the included trials. More large, multicenter, double-blind, randomized controlled trials are needed to further prove the results.