Drugs for the Acute Treatment of Migraine in Children and Adolescents

Summary

A Cochrane review [Abstract] 1 included 27 studies with a total of 9158 children and adolescents with migraine. A total of 7630 children and adolescents (range of mean age between 8.2 and 14.7 years) received medication. Twenty-four studies focused on drugs in the triptan class. Other medications studied included paracetamol (acetaminophen) and ibuprofen. More than half of the studies evaluated sumatriptan. Triptans as a class of medication were superior to placebo in producing pain freedom in children (RR 1.67, 95% CI 1.06 to 2.62, NNTB 13; 3 studies, n=273) and in adolescents (RR 1.32, 95% CI 1.19 to 1.47, NNTB 6; 21 studies, n=7026). There was no significant difference in the effect sizes between studies involving children vs. adolescents. Triptans were associated with an increased risk of non-serious adverse events in adolescents (RD 0.13, 95% CI 0.08 to 0.18, NNTH 8), but studies did not report any serious adverse events. The risk of minor adverse events was not significant in children (RD 0.06, 95% CI − 0.04 to 0.17, NNTH 17). Sumatriptan plus naproxen sodium was superior to placebo in (RR 3.25, 95% CI 1.78 to 5.94, NNTB 6; one study, n= 490). Ibuprofen was more effective than placebo for producing pain freedom at 2 hours (RR 1.87, 95% CI 1.15 to 3.04; 2 studies, n=162). Paracetamol was not superior to placebo (one study, n=80).