Guidelines concerning pharmacological intervention for migraine in adults: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

WEI Jingjing ^1,2,3 , LIANG Xiao ³ , FU Guojing ¹ , JIA Min ³ , CHEN Qian ¹ , LEI Lin ¹ , LU Yan ³ , GUO Rongjuan ⁴ ,  LIAO Xing ² ,  ZHANG Yunling ³

1. Graduate School of Beijing University of Chinese Medicine, Beijing 100029, P.R.China;
2. Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, P.R.China;
3. Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P.R.China;
4. Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, P.R.China;

Corresponding author：

LIAO Xing, Email: okfrom2008@hotmail.com; ZHANG Yunling, Email: yunlingzhang2004@126.com

Keywords：

Migraine; Pharmacological intervention; Guideline; Quality assessment; AGREE Ⅱ

DOI：

10.7507/1672-2531.202007055

Video：

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Objectives To evaluate the methodological quality of guidelines for pharmacological intervention of migraine in adults, to compare and analyze the differences in first-line drug recommendations in different regions and quality levels, so as to explore the evidence of drug recommendations, and provide a basis for clinical decision-making.Methods PubMed, The Cochrane Library, EMbase, SinoMed, CNKI, VIP, and WanFang Data databases, Up To Date, as well as the related books, Yimaitong, Guideline Central, Guidelines International Network (GIN) and National Institute for Health and Clinical Excellence (NICE) were systematically searched to collect pharmacological intervention guidelines of migraine in adults from inception to January 12^th, 2020. The methodological quality of the guidelines was evaluated by Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ).Results A total of 25 guidelines were included (including 22 evidence-based guidelines), covering 10 countries on 4 continents and World Health Organization (WHO) with a time span of 1997 to 2019. According to AGREE Ⅱ, 5 were A-level guidelines, 18 were B-level guidelines, and 2 were C-level guidelines. Scope and purpose, rigour of development, clarity of presentations and editorial independence obtained high average scores (more than 60%) among all 25 guidelines. The average scores of guidelines in different domains of AGREE Ⅱ varied with regions and countries. Triptans and NSAIDs were the most frequently recommended as first-line drugs for the acute management; beta-blockers and antiepileptic drugs were recommended for the first-line prevention drugs of migraine in adults. There were 2 guidelines that recommended complementary treatments, one recommended traditional Chinese medicine and another recommended herbal butterbur.Conclusions The methodological quality of the pharmacological intervention guidelines of migraine in adults is suboptimal among different regions or countries. The quality of evidence-based guidelines is superior to that established by consensus. The consistency of first-line drug recommendations is strong, but there are still regional differences. The therapeutic effect of traditional Chinese medicine requires further verification.

Citation： WEI Jingjing, LIANG Xiao, FU Guojing, JIA Min, CHEN Qian, LEI Lin, LU Yan, GUO Rongjuan, LIAO Xing, ZHANG Yunling. Guidelines concerning pharmacological intervention for migraine in adults: a systematic review. Chinese Journal of Evidence-Based Medicine, 2020, 20(11): 1316-1325. doi: 10.7507/1672-2531.202007055 Copy

1.	GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol, 2019, 18(5): 459-480.
2.	偏头痛诊断与防治专家共识组. 偏头痛诊断与防治专家共识. 中华内科杂志, 2006, 45(8): 694-696.
3.	头面痛学组. 中国偏头痛诊断治疗指南. 中国疼痛医学杂志, 2011, 17(2): 65-86.
4.	中国中医科学院, 中国针灸学会组. 中医循证临床实践指南. 北京: 中国中医药出版社, 2011.
5.	韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREE Ⅱ)工具实例解读. 中国循证儿科杂志, 2013, 8(4): 316-319.
6.	Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-842.
7.	陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10): 1180-1194.
8.	Steiner TJ, Jensen R, Katsarava Z, et al. Aids to management of headache disorders in primary care (2nd edition). J Headache Pain, 2019, 20(1): 57.
9.	Hsu YC, Lin KC, Taiwan Headache Society TGSOTHS. Medical treatment guidelines for acute migraine attacks. Acta Neurol Taiwan, 2017, 26(2): 78-96.
10.	Orr SL, Friedman BW, Christie S, et al. Management of adults with acute migraine in the emergency department: the American Headache Society evidence assessment of parenteral pharmacotherapies. Headache, 2016, 56(6): 911-940.
11.	Orr SL, Aubé M, Becker WJ, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia, 2015, 35(3): 271-284.
12.	Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society guideline: acute drug therapy for migraine headache. Can J Neurol Sci, 2013, 40(5 Suppl 3): S1-S80.
13.	Ducharme J. Canadian Association of Emergency Physicians guidelines for the acute management of migraine headache. J Emerg Med, 1999, 17(1): 137-144.
14.	Kowacs F, Roesler CAP, Piovesan ÉJ, et al. Consensus of the Brazilian Headache Society on the treatment of chronic migraine. Arq Neuropsiquiatr, 2019, 77(7): 509-520.
15.	Sacco S, Bendtsen L, Ashina M, et al. European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain, 2019, 20(1): 58.
16.	Huang TC, Lai TH, Taiwan Headache Society TGSOTHS. Medical treatment guidelines for preventive treatment of migraine. Acta Neurol Taiwan, 2017, 26(1): 33-53.
17.	Giacomozzi AR, Vindas AP, Silva AA, et al. Latin American consensus on guidelines for chronic migraine treatment. Arq Neuropsiquiatr, 2013, 71(7): 478-486.
18.	Pringsheim T, Davenport W, Mackie G, et al. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci, 2012, 39(2 Suppl 2): S1-S59.
19.	Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 2012, 78(17): 1346-1353.
20.	Silberstein SD, Holland S, Freitag F, et al. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 2012, 78(17): 1337-1345.
21.	Araki N, Takeshima T, Ando N, et al. Clinical practice guideline for chronic headache 2013. Neurology Clin Neurosci, 2019, 7(5): 1-284.
22.	Kouremenos E, Arvaniti C, Constantinidis TS, et al. Consensus of the Hellenic Headache Society on the diagnosis and treatment of migraine. J Headache Pain, 2019, 20(1): 113.
23.	American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache, 2019, 59(1): 1-18.
24.	Scottish Intercollegiate Guidelines Network (SIGN). Pharmacological management of migraine. 2018. Available from: http://www.sign.ac.uk.
25.	中华医学会疼痛学分会头面痛学组, 中国医师协会神经内科医师分会疼痛和感觉障碍专委会. 中国偏头痛防治指南. 中国疼痛医学杂志, 2016, 22(10): 721-727.
26.	Becker WJ, Findlay T, Moga C, et al. Guideline for primary care management of headache in adults. Can Fam Physician, 2015, 61(8): 670-679.
27.	National Institute for Health and Care Excellence (NICE). Diagnosis and management of headaches in young people and adults: evidence update October 2014. Available from: https://www.evidence.nhs.uk/search?q=Diagnosis+and+management+of+headaches+in+young+people+and+adults.
28.	Haag G, Diener HC, May A, et al. Self-medication of migraine and tension-type headache: summary of the evidence-based recommendations of the Deutsche Migräne und Kopfschmerzgesellschaft (DMKG), the Deutsche Gesellschaft für Neurologie (DGN), the Österreichische Kopfschmerzgesellschaft (ÖKSG) and the Schweizerische Kopfwehgesellschaft (SKG). J Headache Pain, 2011, 12(2): 201-217.
29.	Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force. Eur J Neurol, 2009, 16(9): 968-981.
30.	Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2000, 55(6): 754-762.
31.	Pryse-Phillips WE, Dodick DW, Edmeads JG, et al. Guidelines for the diagnosis and management of migraine in clinical practice. Canadian Headache Society. CMAJ, 1997, 156(9): 1273-1287.
32.	赵国桢, 冯硕, 张霄潇, 等. 中医药临床实践指南: 现状和思考. 中国循证医学杂志, 2018, 18(12): 1386-1390.
33.	张莉, 栾勇, 孙成春. 曲坦类药物治疗偏头痛的临床应用进展. 解放军药学学报, 2012, 28(6): 551-553, 557.
34.	Xu H, Han W, Wang J, et al. Network meta-analysis of migraine disorder treatment by NSAIDs and triptans. J Headache Pain, 2016, 17(1): 1-18.
35.	郭莉, 孙茂苍. 用托吡酯治疗偏头疼的效果观察. 当代医药论丛, 2019, 17(13): 144-145.
36.	徐晓琳, 解丽丽. 探讨托吡酯治疗偏头痛的临床疗效及对患者脑血管病变与神经元放电指标的影响. 中国医药指南, 2020, 18(5): 127-128.
37.	鲍丽. 托吡酯治疗偏头痛的临床疗效及其对脑血管病变和神经元放电的影响研究. 系统医学, 2019, 4(7): 73-75.
38.	屈文英, 师媛, 解建国, 等. 氟桂利嗪分别联合普萘洛尔与托吡酯治疗偏头痛的临床价值分析. 脑与神经疾病杂志, 2019, 27(3): 182-186.
39.	National Institute for Health and Care Excellence. Botulinum toxin type A for the prevention of headaches in adults with chronic migraine. Available from: https://www.nice.org.uk/guidance/ta260.
40.	孙鑫, 谭婧, 唐立, 等. 重新认识真实世界研究. 中国循证医学杂志, 2017, 17(2): 126-130.

1. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol, 2019, 18(5): 459-480.
2. 偏头痛诊断与防治专家共识组. 偏头痛诊断与防治专家共识. 中华内科杂志, 2006, 45(8): 694-696.
3. 头面痛学组. 中国偏头痛诊断治疗指南. 中国疼痛医学杂志, 2011, 17(2): 65-86.
4. 中国中医科学院, 中国针灸学会组. 中医循证临床实践指南. 北京: 中国中医药出版社, 2011.
5. 韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREE Ⅱ)工具实例解读. 中国循证儿科杂志, 2013, 8(4): 316-319.
6. Brouwers MC, Kho ME, Browman GP, et al. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18): E839-842.
7. 陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10): 1180-1194.
8. Steiner TJ, Jensen R, Katsarava Z, et al. Aids to management of headache disorders in primary care (2nd edition). J Headache Pain, 2019, 20(1): 57.
9. Hsu YC, Lin KC, Taiwan Headache Society TGSOTHS. Medical treatment guidelines for acute migraine attacks. Acta Neurol Taiwan, 2017, 26(2): 78-96.
10. Orr SL, Friedman BW, Christie S, et al. Management of adults with acute migraine in the emergency department: the American Headache Society evidence assessment of parenteral pharmacotherapies. Headache, 2016, 56(6): 911-940.
11. Orr SL, Aubé M, Becker WJ, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia, 2015, 35(3): 271-284.
12. Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society guideline: acute drug therapy for migraine headache. Can J Neurol Sci, 2013, 40(5 Suppl 3): S1-S80.
13. Ducharme J. Canadian Association of Emergency Physicians guidelines for the acute management of migraine headache. J Emerg Med, 1999, 17(1): 137-144.
14. Kowacs F, Roesler CAP, Piovesan ÉJ, et al. Consensus of the Brazilian Headache Society on the treatment of chronic migraine. Arq Neuropsiquiatr, 2019, 77(7): 509-520.
15. Sacco S, Bendtsen L, Ashina M, et al. European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain, 2019, 20(1): 58.
16. Huang TC, Lai TH, Taiwan Headache Society TGSOTHS. Medical treatment guidelines for preventive treatment of migraine. Acta Neurol Taiwan, 2017, 26(1): 33-53.
17. Giacomozzi AR, Vindas AP, Silva AA, et al. Latin American consensus on guidelines for chronic migraine treatment. Arq Neuropsiquiatr, 2013, 71(7): 478-486.
18. Pringsheim T, Davenport W, Mackie G, et al. Canadian Headache Society guideline for migraine prophylaxis. Can J Neurol Sci, 2012, 39(2 Suppl 2): S1-S59.
19. Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 2012, 78(17): 1346-1353.
20. Silberstein SD, Holland S, Freitag F, et al. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 2012, 78(17): 1337-1345.
21. Araki N, Takeshima T, Ando N, et al. Clinical practice guideline for chronic headache 2013. Neurology Clin Neurosci, 2019, 7(5): 1-284.
22. Kouremenos E, Arvaniti C, Constantinidis TS, et al. Consensus of the Hellenic Headache Society on the diagnosis and treatment of migraine. J Headache Pain, 2019, 20(1): 113.
23. American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache, 2019, 59(1): 1-18.
24. Scottish Intercollegiate Guidelines Network (SIGN). Pharmacological management of migraine. 2018. Available from: http://www.sign.ac.uk.
25. 中华医学会疼痛学分会头面痛学组, 中国医师协会神经内科医师分会疼痛和感觉障碍专委会. 中国偏头痛防治指南. 中国疼痛医学杂志, 2016, 22(10): 721-727.
26. Becker WJ, Findlay T, Moga C, et al. Guideline for primary care management of headache in adults. Can Fam Physician, 2015, 61(8): 670-679.
27. National Institute for Health and Care Excellence (NICE). Diagnosis and management of headaches in young people and adults: evidence update October 2014. Available from: https://www.evidence.nhs.uk/search?q=Diagnosis+and+management+of+headaches+in+young+people+and+adults.
28. Haag G, Diener HC, May A, et al. Self-medication of migraine and tension-type headache: summary of the evidence-based recommendations of the Deutsche Migräne und Kopfschmerzgesellschaft (DMKG), the Deutsche Gesellschaft für Neurologie (DGN), the Österreichische Kopfschmerzgesellschaft (ÖKSG) and the Schweizerische Kopfwehgesellschaft (SKG). J Headache Pain, 2011, 12(2): 201-217.
29. Evers S, Afra J, Frese A, et al. EFNS guideline on the drug treatment of migraine--revised report of an EFNS task force. Eur J Neurol, 2009, 16(9): 968-981.
30. Silberstein SD. Practice parameter: evidence-based guidelines for migraine headache (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2000, 55(6): 754-762.
31. Pryse-Phillips WE, Dodick DW, Edmeads JG, et al. Guidelines for the diagnosis and management of migraine in clinical practice. Canadian Headache Society. CMAJ, 1997, 156(9): 1273-1287.
32. 赵国桢, 冯硕, 张霄潇, 等. 中医药临床实践指南: 现状和思考. 中国循证医学杂志, 2018, 18(12): 1386-1390.
33. 张莉, 栾勇, 孙成春. 曲坦类药物治疗偏头痛的临床应用进展. 解放军药学学报, 2012, 28(6): 551-553, 557.
34. Xu H, Han W, Wang J, et al. Network meta-analysis of migraine disorder treatment by NSAIDs and triptans. J Headache Pain, 2016, 17(1): 1-18.
35. 郭莉, 孙茂苍. 用托吡酯治疗偏头疼的效果观察. 当代医药论丛, 2019, 17(13): 144-145.
36. 徐晓琳, 解丽丽. 探讨托吡酯治疗偏头痛的临床疗效及对患者脑血管病变与神经元放电指标的影响. 中国医药指南, 2020, 18(5): 127-128.
37. 鲍丽. 托吡酯治疗偏头痛的临床疗效及其对脑血管病变和神经元放电的影响研究. 系统医学, 2019, 4(7): 73-75.
38. 屈文英, 师媛, 解建国, 等. 氟桂利嗪分别联合普萘洛尔与托吡酯治疗偏头痛的临床价值分析. 脑与神经疾病杂志, 2019, 27(3): 182-186.
39. National Institute for Health and Care Excellence. Botulinum toxin type A for the prevention of headaches in adults with chronic migraine. Available from: https://www.nice.org.uk/guidance/ta260.
40. 孙鑫, 谭婧, 唐立, 等. 重新认识真实世界研究. 中国循证医学杂志, 2017, 17(2): 126-130.

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