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dc.contributor.authorSanchez-del-Rio, Margarita
dc.contributor.authorde Vries, Tessa
dc.contributor.authorOrnello, Raffaele
dc.contributor.authorReuter, Uwe
dc.contributor.authorVersijpt, Jan
dc.contributor.authorHussain, Muizz
dc.contributor.authorZeraatkar, Dena
dc.contributor.authorLampl, Christian
dc.contributor.authorDeligianni, Christina I.
dc.contributor.authorSacco, Simona
dc.contributor.authorEkizoglu, Esme
dc.contributor.authorUluduz, Derya
dc.contributor.authorGil-Gouveia, Raquel
dc.contributor.authorMaassenVanDenBrink, Antoinette
dc.date.accessioned2023-10-10T13:13:05Z
dc.date.available2023-10-10T13:13:05Z
dc.date.issued2023
dc.identifier.citationDeligianni C. I., Sacco S., Ekizoglu E., Uluduz D., Gil-Gouveia R., MaassenVanDenBrink A., Ornello R., Sanchez-del-Rio M., Reuter U., Versijpt J., et al., "European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention—part 2: flunarizine", Journal of Headache and Pain, cilt.24, sa.1, 2023
dc.identifier.issn1129-2369
dc.identifier.othervv_1032021
dc.identifier.otherav_2e5aa3f8-fcf5-4ae7-881f-1967d81118b5
dc.identifier.urihttp://hdl.handle.net/20.500.12627/190499
dc.identifier.urihttps://doi.org/10.1186/s10194-023-01657-3
dc.identifier.urihttps://avesis.istanbul.edu.tr/api/publication/2e5aa3f8-fcf5-4ae7-881f-1967d81118b5/file
dc.description.abstractObjective: Novel disease-specific and mechanism-based treatments sharing good evidence of efficacy for migraine have been recently marketed. However, reimbursement by insurers depends on treatment failure with classic anti-migraine drugs. In this systematic review and meta-analysis, we aimed to identify and rate the evidence for efficacy of flunarizine, a repurposed, first- or second-line treatment for migraine prophylaxis. Methods: A systematic search in MEDLINE, Cochrane CENTRAL, and ClinicalTrials.gov was performed for trials of pharmacological treatment in migraine prophylaxis, following the Preferred Reporting Items for Systematic Reviews (PRISMA). Eligible trials for meta-analysis were randomized, placebo–controlled studies comparing flunarizine with placebo. Outcomes of interest according to the Outcome Set for preventive intervention trials in chronic and episodic migraine (COSMIG) were the proportion of patients reaching a 50% or more reduction in monthly migraine days, the change in monthly migraine days (MMDs), and Adverse Events (AEs) leading to discontinuation. Results: Five trials were eligible for narrative description and three for data synthesis and analysis. No studies reported the predefined outcomes, but one study assessed the 50% reduction in monthly migraine attacks with flunarizine as compared to placebo showing a benefit from flunarizine with a low or probably low risk of bias. We found that flunarizine may increase the proportion of patients who discontinue due to adverse events compared to placebo (risk difference: 0.02; 95% CI -0.03 to 0.06). Conclusions: Published flunarizine trials predate the recommended endpoints for evaluating migraine prophylaxis drugs, hence the lack of an adequate assessment for these endpoints. Further, modern-day, large‐scale studies would be valuable in re-evaluating the efficacy of flunarizine for the treatment of migraines, offering additional insights into its potential benefits.
dc.language.isoeng
dc.subjectNöroloji (klinik)
dc.subjectAnesteziyoloji ve Ağrı Tıbbı
dc.subjectAnesteziyoloji
dc.subjectCerrahi Tıp Bilimleri
dc.subjectSağlık Bilimleri
dc.subjectDahili Tıp Bilimleri
dc.subjectTıp
dc.subjectKLİNİK NÖROLOJİ
dc.subjectANESTEZİYOLOJİ
dc.subjectKlinik Tıp
dc.subjectKlinik Tıp (MED)
dc.subjectNöroloji
dc.titleEuropean Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention—part 2: flunarizine
dc.typeMakale
dc.relation.journalJournal of Headache and Pain
dc.contributor.departmentMcMaster University , ,
dc.identifier.volume24
dc.identifier.issue1
dc.contributor.firstauthorID4561181


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