Botulinum Toxin A for Prophylactic Treatment of Migraine and Tension Headaches in Adults: A Meta-analysis Full Text
JAMA,  Evidence Based Medicine  Clinical Article

Jackson JL et al. – Botulinum toxin A compared with placebo was associated with a small to modest benefit for chronic daily headaches and chronic migraines but was not associated with fewer episodic migraine or chronic tension–type headaches per month.

Methods
  • A search of MEDLINE, EMBASE, bibliographies of published systematic reviews, and the Cochrane trial registries between 1966 and March 15, 2012.
  • Inclusion and exclusion criteria of each study were reviewed.
  • Headaches were categorized as episodic (<15 headaches per month) or chronic (≥15 headaches per month) migraine and episodic or chronic daily or tension headaches.
  • Randomized controlled trials comparing botulinum toxin A with placebo or other interventions for headaches among adults.
  • Data were ed and quality assessed independently by 2 reviewers.
  • Outcomes were pooled using a random–effects model.

Results
  • Pooled analyses suggested that botulinum toxin A was associated with fewer headaches per month among patients with chronic daily headaches (1115 patients, –2.06 headaches per month; 95% CI, –3.56 to –0.56; 3 studies) and among patients with chronic migraine headaches (n = 1508, –2.30 headaches per month; 95% CI, –3.66 to –0.94; 5 studies).
  • There was no significant association between use of botulinum toxin A and reduction in the number of episodic migraine (n = 1838, 0.05 headaches per month; 95% CI, –0.26 to 0.36; 9 studies) or chronic tension–type headaches (n = 675, –1.43 headaches per month; 95% CI, –3.13 to 0.27; 7 studies).
  • In single trials, botulinum toxin A was not associated with fewer migraine headaches per month vs valproate (standardized mean difference [SMD], –0.20; 95% CI, –0.91 to 0.31), topiramate (SMD, 0.20; 95% CI, –0.36 to 0.76), or amitriptyline (SMD, 0.29; 95% CI, –0.17 to 0.76).
  • Botulinum toxin A was associated with fewer chronic tension–type headaches per month vs methylprednisolone injections (SMD, –2.5; 95% CI, –3.5 to –1.5).
  • Compared with placebo, botulinum toxin A was associated with a greater frequency of blepharoptosis, skin tightness, paresthesias, neck stiffness, muscle weakness, and neck pain.

Please login or register to follow this author.
► Click here to access Full Text, PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Medical Student

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Medical Student Articles

1 Midlife dietary vitamin D intake and subsequent performance in different cognitive domains Annals of Nutrition and Metabolism, September 16, 2014    Clinical Article

2 Regular fish consumption and age-related brain gray matter loss American Journal of Preventive Medicine, August 15, 2014    Clinical Article

3 Habitual intake of fruit juice predicts central blood pressure Appetite, October 24, 2014    Clinical Article

4 Oral bisphosphonate use and total knee/hip implant survival: Validation of results in an external population-based cohort Arthritis & Rheumatism, August 13, 2014    Clinical Article

5 Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: Results from the EPIC cohort study International Journal of Cancer, October 3, 2014    Clinical Article

6 Effects of tea intake on blood pressure: A meta-analysis of 21 randomized controlled trials JACC - Journal of the American College of Cardiology, October 22, 2014    Clinical Article

7 Effect of ginger (Zingiber officinale) on heavy menstrual bleeding: a placebo-controlled, randomized clinical trial Phytotherapy Research, October 13, 2014    Clinical Article

8 Chocolate consumption and risk of heart failure in the Physicians Health Study European Journal of Heart Failure, October 17, 2014    Clinical Article

9 Intake of fruit and vegetables and risk of bladder cancer: A dose-response meta-analysis of observational studies Cancer Causes and Control, October 10, 2014    Clinical Article

10 Fish consumption and risk of rheumatoid arthritis: A dose-response meta-analysis Arthritis Research & Therapy, October 7, 2014    Evidence Based Medicine    Review Article

11 Trazodone improves sleep parameters in Alzheimer's disease patients: A randomized, double-blind, and placebo-controlled study The American Journal of Geriatric Psychiatry, October 15, 2014    Clinical Article

12 Serum 25-hydroxyvitamin D levels and metabolic health status in extremely obese individuals Obesity, October 10, 2014    Review Article

13 Effects of decontamination of the oropharynx and intestinal tract on antibiotic resistance in ICUs: a randomized clinical trial JAMA, October 10, 2014    Evidence Based Medicine    Clinical Article

14 Diet and inflammatory bowel disease: review of patient-targeted recommendations Clinical Gastroenterology and Hepatology , October 10, 2014    Review Article

15 Vitamin B12 and folate deficiency in chronic heart failure Heart, October 24, 2014    Clinical Article

16 Nutrition for the prevention and treatment of chronic kidney disease in diabetes Canadian Journal of Diabetes, September 26, 2014    Review Article

17 Effect of pentoxifylline on renal function and urinary albumin excretion in patients with diabetic kidney disease: The PREDIAN trial Journal of the American Society of Nephrology, June 30, 2014    Clinical Article

18 Vancomycin-resistant enterococci colonization among dialysis patients: A meta-analysis of prevalence, risk factors, and significance American Journal of Kidney Diseases, July 18, 2014    Review Article

19 Vitamin D analogue therapy, cardiovascular risk and kidney function in people with Type 1 diabetes mellitus and diabetic nephropathy: a randomized trial Diabetic Medicine, October 13, 2014    Clinical Article

20 Age-related cataract in men in the selenium and vitamin E cancer prevention trial eye endpoints study: A randomized clinical trial JAMA Ophthalmology, October 3, 2014    Evidence Based Medicine    Clinical Article

Indexed Journals in Medical Student: Academic Medicine, BMC Medical Education, Medical Teachermore