TY - JOUR
T1 - Efficacy of levetiracetam for migraine prophylaxis
T2 - A systematic review and meta-analysis
AU - Yen, Po Hua
AU - Kuan, Yi Chun
AU - Tam, Ka Wai
AU - Chung, Chen Chih
AU - Hong, Chien Tai
AU - Huang, Yao Hsien
N1 - Publisher Copyright:
© 2020 Formosan Medical Association
PY - 2021/1
Y1 - 2021/1
N2 - Background: Migraine is characterized by moderate to severe recurrent headache lasting for 4–72 h. Cortical hyperexcitability may play a crucial role in migraine onset. Therefore, antiepileptic drugs, such as levetiracetam, may be beneficial. Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and prospective studies that evaluated the efficacy of levetiracetam in migraine prophylaxis. Electronic databases, including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials, were searched for articles on migraine prophylaxis and levetiracetam published before May 2020. The main outcomes were number of patients with >50% headache frequency reduction, frequency of headache, and headache severity. Results: We identified 4 RCTs involving 192 patients and 4 prospective studies involving 85 patients. The overall data on number of patients with >50% headache frequency reduction, headache frequency, and headache severity were subjected to meta-analysis, which revealed significant differences between the levetiracetam and the placebo groups (risk ratio [RR] of number of patients with >50% headache frequency reduction = 0.46, 95% confidence interval [CI] = 0.35 to 0.61; weighted mean difference [WMD] of headache frequency per month = −3.78, 95% CI = −5.52 to −2.03; standard mean difference [SMD] of headache severity = −2.42, 95% CI = −4.47 to −0.37). Conclusion: Our study indicated that levetiracetam can significantly reduce headache frequency and severity in adults and children. Thus, oral levetiracetam can be a therapeutic option for migraine prophylaxis, especially concerning with the adverse effects or teratogenicity of other preventive treatments.
AB - Background: Migraine is characterized by moderate to severe recurrent headache lasting for 4–72 h. Cortical hyperexcitability may play a crucial role in migraine onset. Therefore, antiepileptic drugs, such as levetiracetam, may be beneficial. Methods: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) and prospective studies that evaluated the efficacy of levetiracetam in migraine prophylaxis. Electronic databases, including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials, were searched for articles on migraine prophylaxis and levetiracetam published before May 2020. The main outcomes were number of patients with >50% headache frequency reduction, frequency of headache, and headache severity. Results: We identified 4 RCTs involving 192 patients and 4 prospective studies involving 85 patients. The overall data on number of patients with >50% headache frequency reduction, headache frequency, and headache severity were subjected to meta-analysis, which revealed significant differences between the levetiracetam and the placebo groups (risk ratio [RR] of number of patients with >50% headache frequency reduction = 0.46, 95% confidence interval [CI] = 0.35 to 0.61; weighted mean difference [WMD] of headache frequency per month = −3.78, 95% CI = −5.52 to −2.03; standard mean difference [SMD] of headache severity = −2.42, 95% CI = −4.47 to −0.37). Conclusion: Our study indicated that levetiracetam can significantly reduce headache frequency and severity in adults and children. Thus, oral levetiracetam can be a therapeutic option for migraine prophylaxis, especially concerning with the adverse effects or teratogenicity of other preventive treatments.
KW - Antiepileptic drugs
KW - Headache disorders
KW - Levetiracetam
KW - Meta-analysis
KW - Migraine prophylaxis
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U2 - 10.1016/j.jfma.2020.08.020
DO - 10.1016/j.jfma.2020.08.020
M3 - Article
C2 - 32861551
AN - SCOPUS:85089864832
SN - 0929-6646
VL - 120
SP - 755
EP - 764
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 1
ER -