SynthesisBMJ (Clinical research ed.)2008
Parenteral dexamethasone for acute severe migraine headache: meta-analysis of randomised controlled trials for preventing recurrence.
Synthesis in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07605065 (Comparison of Efficacy of Combination Dexamethasone With Metoclopramide Versus Paracetamol/NSAIDs for Treatment of Primary Headache in ED at Tertiary Care Hospital), which is not on this map. Cited by 32 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Efficacy of Combination Dexamethasone With Metoclopramide Versus Paracetamol/NSAIDs for Treatment of Primary Headache in ED at Tertiary Care Hospital: A Randomized Controlled Trial
Who cites it
32 citing papers in PubMed, 170 citations in OpenAlex.
- Trial
- Randomized Trial Comparing Low- vs High-Dose IV Dexamethasone for Patients With Moderate to Severe Migraine.Neurology · 2023Trial
- Effectiveness of intravenous dexamethasone versus propofol for pain relief in the migraine headache: a prospective double blind randomized clinical trial.BMC neurology · 2012Trial
- Metoclopramide for acute migraine: a dose-finding randomized clinical trial.Annals of emergency medicine · 2011Trial
- Treating headache recurrence after emergency department discharge: a randomized controlled trial of naproxen versus sumatriptan.Annals of emergency medicine · 2010Trial
- Acute Headache Management and Emergency Department Throughput: A Multicenter Retrospective Analysis.The western journal of emergency medicine · 2026Observational
- G2DR: a genotype-first framework for genetics-informed target prioritization and drug repurposing.Briefings in bioinformatics · 2026Article
- Meningeal neuropeptide and neuroimmune interactions in the context of migraine.The journal of headache and pain · 2026Review
- Review
- Steroids in Headache: A Comprehensive Review of Recent Research.Annals of neurosciences · 2023Review
- Article
- Article
- Non-invasively triggered spreading depolarizations induce a rapid pro-inflammatory response in cerebral cortex.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2020Article
- Acute headache management in emergency department. A narrative review.Internal and emergency medicine · 2020Review
- Current Approach to Undifferentiated Headache Management in the Emergency Department.Current pain and headache reports · 2019Review
- Comparing the Therapeutic Effects of Dexamethasone-Metoclopramide with Ketorolac in Relieving Headache in Patients with Acute Migraine Attacks Presenting to the Emergency Department.Advanced journal of emergency medicine · 2019Article
- Management of Episodic Migraine in Children and Adolescents: a Practical Approach.Current neurology and neuroscience reports · 2018Review
- Headache and Its Management in Patients With Multiple Sclerosis.Current treatment options in neurology · 2018Review
- Single-dose intravenous sodium valproate (Depakine) versus dexamethasone for the treatment of acute migraine headache: a double-blind randomized clinical trial.Clinical and experimental emergency medicine · 2017Article
- Effectiveness of the Concurrent Intravenous Injection of Dexamethasone and Metoclopramide for Pain Management in Patients with Primary Headaches Presenting to Emergency Department.Advanced journal of emergency medicine · 2017Article
Corrections and comments
- Commented on by
Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the effectiveness of parenteral corticosteroids for the relief of acute severe migraine headache and prevention of recurrent headaches.
designMeta-analysis. DATA SOURCES: Electronic databases (Cochrane Central Register of Controlled Trials, Medline, Embase, LILACS, and CINAHL), conference proceedings, clinical practice guidelines, contacts with industry, and correspondence with authors. SELECTION CRITERIA: Randomised controlled trials in which corticosteroids (alone or combined with standard abortive therapy) were compared with placebo or any other standard treatment for acute migraine in adults. REVIEW
methodsTwo reviewers independently assessed relevance, inclusion, and study quality. Weighted mean differences and relative risks were calculated and are reported with 95% confidence intervals.
resultsFrom 666 potentially relevant abstracts, seven studies met the inclusion criteria. All included trials used standard abortive therapy and subsequently compared single dose parenteral dexamethasone with placebo, examining pain relief and recurrence of headache within 72 hours. Dexamethasone and placebo provided similar acute pain reduction (weighted mean difference 0.37, 95% confidence interval -0.20 to 0.94). Dexamethasone was, however, more effective than placebo in reducing recurrence rates (relative risk 0.74, 95% confidence interval 0.60 to 0.90). Side effect profiles between dexamethasone and placebo groups were similar.
conclusionWhen added to standard abortive therapy for migraine headache, single dose parenteral dexamethasone is associated with a 26% relative reduction in headache recurrence (number needed to treat=9) within 72 hours.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.