A Meta-analysis:Efficacy And Safety For Botulinum Toxin A In Prophylactic Treatment For Migraine

Objective:To evaluate the efficacy and safety about botulinum toxin A in the prophylactic treatment for migraine.Methods:Foreign databases including PubMed,EMbase and Cochrane Library and Chinese databases including CMB,CNKI and Wanfang Data were searched for relevant randomized controlled trials(RCT),and the Review Manager 5.3 software is used to perform a meta-analysis.Results:A total of 12 RCTs were included,including 4131 patients.The meta-analysis showed that there was no significant difference in average reduction monthly in the frequency of migraine attacks between the experimental group and the placebo group(MD=-0.1,95%tCI:-0.41~0.21,P = 0.53);After subgroup analysis,the results showed that compared with the placebo group,The average monthly frequency of migraine attacks in the botulinum toxin A group was lower than that in the placebo group(MD=-0.43,95%CI:-0.70~-0.17,p=0.001)for the subgroup chronic migraine group,while in the subgroup with episodic migraine,There was no significant difference in the average frequency of migraine attacks per month(MD=0.08,95%CI:-0.16~0.33,p=0.50).Compared with the placebo group,the average number of days per month for migraine attacks,average monthly frequency of medication for acute headache and the score of life quality in the botulinum toxin A group for chronic migraine were better than those in the placebo group(P < 0.05),However,the three outcome indicators for episodic migraine can not be statistically analyzed because of too few studies.Compared with placebo group,the total incidence of adverse events in botulinum toxin A group was higher than that in placebo group(OR=1.41,95%CI:1.23~1.62,P <0.00001),but no serious adverse reactions occurred.Conclusion: Botulinum toxin A can effectively reduce the monthly frequency of migraine attacks,migraine days and average monthly frequency of medication for acute headache and improve the quality of life for chronic migraine,but the effect on episodic migraine is not obvious,Both chronic migraine and episodic migraine have good safety and tolerance to BTX-A.