In patients who experience migraine attacks, dexketoprofen supplementation can enhance pain control at 48 hours and decrease the need for the use of rescue therapy, according to study results published in Medicine.
A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the effect of supplementation with dexketoprofen vs placebo on the control of pain in patients with migraine attacks. All possible databases were searched through March 2019. The inclusion criteria for the retrieved studies and relevant reviews were: (1) study design was an RCT; (2) patients had been diagnosed with migraine attack; and (3) intervention therapies were dexketoprofen (or dexketoprofen supplementation) vs placebo. The primary outcome investigated was being pain-free at 2 hours. Secondary outcomes included being pain-free at 48 hours, attaining pain relief at 2 hours, the need for rescue medication, and adverse events.
A total of 5 RCTs that involved 794 patients were ultimately selected for the meta-analysis. With respect to the primary outcome, compared with the control group for migraine attacks, the dexketoprofen supplementation group showed a significantly increased pain-free state at 2 hours (risk ratio [RR], 1.90; 95% CI, 1.43-2.53; P <.0001). There was with no heterogeneity among the studies.
Regarding the secondary outcomes overall, compared with the control intervention group, dexketoprofen supplementation was associated with a significantly increased pain-free state at 48 hours (RR, 1.63; 95% CI, 1.07-2.49; P =.02), good or excellent treatment (RR, 1.48; 95% CI, 1.24-1.78; P <.0001), and pain relief at 2 hours (RR, 1.80; 95% CI, 1.17-2.77; P =.007). In addition, dexketoprofen supplementation was associated with a significantly decreased need for the use of rescue medication (RR, 0.64; 95% CI, 0.43-0.94; P =.02) but had no significant impact on the occurrence of adverse events (RR, 1.51; 95% CI, 0.87-2.62; P =.14).
A major study limitation was the
fact that the meta-analysis was based on
5 RCTs only. In order to adequately explore the issues in question, more RCTs with larger sample sizes should be conducted. Moreover, the optimal dexketoprofen dose and combination methods of dexketoprofen treatment remain unclear.
The investigators concluded that dexketoprofen supplementation provides benefits for patients with migraine attacks in terms of the improvement of pain control at 48 hours and a reduction in the need for rescue medication in this population.
Yang B, Xu Z, Chen L, Chen X, Xie Y. 17. The efficacy of dexketoprofen for migraine attack: a meta-analysis of randomized controlled studies. Medicine (Baltimore). 2019;98(46):e17734.