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Vitamins and Minerals for Migraine Prophylaxis: A Systematic Review and Meta-analysis

  • George N. Okoli (a1), Rasheda Rabbani (a1) (a2), Hessam H. Kashani (a1), Aleksandra K. Wierzbowski (a1), Christine Neilson (a3), Behzad Mansouri (a4) (a5) (a6), Ryan Zarychanski (a1) (a2) (a7) and Ahmed M. Abou-Setta (a1) (a2)...

Abstract:

Objective: To summarize the findings of randomized controlled trials (RCTs) on the efficacy and safety of vitamins and minerals for migraine prophylaxis. Methods: We systematically searched bibliographic databases and relevant websites for parallel and crossover RCTs reporting efficacy and/or safety of vitamins and/or minerals for migraine prophylaxis. Our primary outcomes were migraine frequency (number of attacks) and duration (hours). Secondary outcomes were severity (intensity), days with migraine, and adverse events. Meta-analysis was conducted when analyzable data were available from at least two trials. Results: Eighteen placebo-controlled trials met our eligibility criteria. Only coenzyme Q10 and magnesium contributed to meta-analyses. In adults, compared with placebo, coenzyme Q10 did not significantly decrease migraine frequency (mean difference (MD) −0.44 (−2.14 to 1.26); I2 53%; 2 trials; 97 participants; moderate strength of the evidence), duration (MD −1.97 (−4.82 to 0.87); I2 0%; 2 trials; 97 participants; moderate strength of the evidence), or severity (ratio of means (RoM) −0.05 (−0.20 to 0.11); I2 0%; 2 trials; 97 participants). In adults, compared with placebo, magnesium did not significantly decrease migraine severity (RoM −0.17 (−0.36 to 0.02); I2 48%; 3 trials; 226 participants; low strength of the evidence). Meta-analysis of other vitamins and minerals, and other outcomes were not feasible due to a lack of sufficiently reported data. Conclusions: Based on insufficient evidence, it is unknown if coenzyme Q10 and magnesium are effective for migraine prophylaxis in adults. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and safety of vitamins and minerals for migraine prophylaxis.

Des vitamines et des minéraux pour traiter de façon préventive la migraine : une revue systématique et une méta-analyse. Objectif: Résumer les résultats d’essais randomisés contrôlés (ERC) portant sur l’efficacité et la sécurité des vitamines et des minéraux dans le traitement préventif de la migraine. Méthodes: Nous avons passé en revue de façon systématique les bases de données bibliographiques et les sites Internet jugés pertinents afin d’identifier des ERC parallèles et transversaux faisant état de l’efficacité et/ou de la sécurité des vitamines et/ou des minéraux dans le traitement préventif de la migraine. Nos principaux résultats thérapeutiques ont concerné la fréquence des migraines (nombre de crises) ainsi que leur durée (nombre d’heures). Les résultats thérapeutiques secondaires ont porté quant à eux sur l’acuité (l’intensité) des crises, sur le nombre de jours durant lesquels les patients étaient aux prises avec la migraine et sur les effets indésirables. Fait à noter, nous avons effectué une méta-analyse dans la mesure où des données analysables étaient disponibles à partir d’au moins deux ERC. Résultats: Au total, dix-huit essais contrôlés par placebo ont satisfait à nos critères d’admissibilité. Seuls la coenzyme Q10 (CoQ10) et le magnésium ont pu contribuer à nos méta-analyses. Par rapport aux individus à qui l’on avait administré un placebo, la CoQ10 n’a pas diminué de façon notable la fréquence de crises migraineuses chez des sujets adultes (différence moyenne ou DM de − 0,44 [−2,14 à 1,26] ; I2 53 % ; 2 ERC ; 97 participants ; fiabilité modérée des preuves), leur durée (DM de − 1,97 [− 4,82 à 0,87] ; I2 0 % ; 2 ERC ; 97 participants ; fiabilité modérée des preuves) ou leur acuité (rapport de moyennes ou RM de − 0,05 [− 0,20 à 0,11] ; I2 0 % ; 2 ERC ; 97 participants). Par rapport aux individus à qui l’on avait administré un placebo, le magnésium n’a pas permis de diminuer de façon importante l’acuité des migraines chez des sujets adultes (RM de − 0,17 [− 0,36 à 0,02] ; I2 48 % ; 3 ERC ; 226 participants ; faible fiabilité des preuves). Enfin, il n’a pas été possible d’effectuer une méta-analyse des autres vitamines et minéraux et d’évaluer leurs résultats potentiels en raison d’un nombre insuffisant de données publiées. Conclusions: Faute de preuves suffisantes, on ignore toujours si la CoQ10 et le magnésium sont efficaces en ce qui regarde le traitement préventif de la migraine chez les adultes. Des ERC de grande qualité et suffisamment alimenté en données demeurent ainsi nécessaires afin d’évaluer pleinement l’efficacité et la sécurité des vitamines et des minéraux dans le traitement préventif de la migraine.

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Corresponding author

Correspondence to: George N. Okoli, George & Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, 3rd Floor – 753 McDermot Avenue, Winnipeg, MB R3E 0T6, Canada. Email: George.Okoli@umanitoba.ca

References

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