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Based on the success of treatment, various medications are prescribed to prevent pediatric migraines.
The problem of a migraine is considered among the ten
most disabling disorders that may arise in any age group. Various medications
are available for the prevention and treatment of a migraine in pediatric
patients. This study enlightens the efficacy of an approved anticonvulsant drug
topiramate among adolescents generating mixed results.
Based on the success of treatment, various medications
are prescribed to prevent pediatric migraines. Topiramate, the drug approved
for migraine prevention in children as young as 12 years of age. This
meta-analysis was aimed to assess the published data supporting the efficacy of
topiramate for the prevention of a migraine in patients less than 18 years of
age.
Various online journals PubMed/Medline, Embase and the
Cochrane Library (from inception to April 2017) were searched for randomized
controlled trials (RCTs) published in English. Data was extracted by two
independant investigators and quality
was evaluated by using the Cochrane Collaboration’s tool. The extracted data
was then analyzed by the Review Manager 5.3 software.
A total of four Randomised Clinical Trials with matched
inclusion criteria were included in this review. With an aggregate of 465
patients, only 329 were included in the topiramate group, and 136 were included
in the placebo group. The meta-analysis revealed that in comparison with
placebo, topiramate failed to decrease the number of patients experiencing a ≥
50% relative reduction in headache frequency (n = 465, RR = 1.26, 95% CI =
[0.94,1.67], Z = 1.55, P = 0.12) or the number of headache days (n = 465, MD =
−0.77, 95% CI = [−2.31,0.76], Z = 0.99, P = 0.32) but did reduce PedMIDAS
scores (n = 205, MD = −9.02, 95% CI = [−17.34, −0.70], Z = 2.13, P = 0.03). A
higher rates of side effects and adverse events were observed in the topiramate
group than in the placebo group.
Topiramate may not be an effective in the prevention of
migraines in patients less than 18 years of age, and topiramate may lead to
more side effects or adverse events in the included patients.
The Journal of Headache and Pain
Is topiramate effective for migraine prevention in patients less than 18 years of age? A meta-analysis of randomized controlled trials
Kai Le et al.
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