SynthesisPloS one2019
Beta-blockers for the prevention of headache in adults, a systematic review and meta-analysis.
Synthesis in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 4 syntheses or guidelines pooled it, 94 citations in OpenAlex.
- Saudi clinical practice guidelines for the treatment and prevention of migraine headache.Neurosciences (Riyadh, Saudi Arabia) · 2025Guideline
- European Headache Federation (EHF) critical re-appraisal and meta-analysis of oral drugs in migraine prevention - part 4: propranolol.The journal of headache and pain · 2024Pooled it
- Reconceptualizing autonomic function testing in migraine: a systematic review and meta-analysis.The journal of headache and pain · 2024Pooled it
- The comparative effectiveness of migraine preventive drugs: a systematic review and network meta-analysis.The journal of headache and pain · 2023Pooled it
- The Effect of Melatonin on Reducing the Frequency and Severity of Migraine Attacks: A Double-Blind, Randomized Clinical Trial.Iranian journal of medical sciences · 2024Trial
- Multimodal chiropractic care for migraine: A pilot randomized controlled trial.Cephalalgia : an international journal of headache · 2021Trial
- The Therapeutic Home Environment for Chronic Diseases: A Transdisciplinary Ecosystem for Achieving Migraine Freedom and Managing Comorbid Anxiety, Insomnia, and Chronic Pain.Healthcare (Basel, Switzerland) · 2026Article
- Practice-Based Consensus Amongst Indian Neurologists: Adopting Remote Electrical Neuromodulation for Effective Management of Migraine.Advances in therapy · 2026Article
- Drugs for Migraine Prophylaxis.Deutsches Arzteblatt international · 2026Review
- Neuro-ophthalmology and migraine: visual aura and its neural basis.International journal of emergency medicine · 2025Review
- Association of Migraine and Blood Pressure-Does Obesity Severity Have a Moderating Role?International journal of behavioral medicine · 2025Article
- Nanoformulation innovations: Revolutionizing precision in migraine therapy.Iranian journal of basic medical sciences · 2025Review
- CaThe journal of headache and pain · 2024Article
- One Molecule, Many Faces: Repositioning Cardiovascular Agents for Advanced Wound Healing.Molecules (Basel, Switzerland) · 2024Review
- Interictal Dysfunctions of Attention, Vigilance, and Executive Functions in Migraine and Their Reversal by Preventive Treatment: A longitudinal Controlled Study.Annals of Indian Academy of Neurology · 2024Article
- Associations between Cerebrovascular Function and the Expression of Genes Related to Endothelial Function in Hormonal Migraine.International journal of molecular sciences · 2024Article
- Repurposing antihypertensive drugs for pain disorders: a drug-target mendelian randomization study.Frontiers in pharmacology · 2024Article
- Non-CGRP Antagonist/Non-Triptan Options for Migraine Disease Treatment: Clinical Considerations.Current pain and headache reports · 2023Review
- [Consensus statement of the migraine and headache societies (DMKG, ÖKSG, and SKG) on the duration of pharmacological migraine prophylaxis].Der Nervenarzt · 2023Review
- Vestibular Migraine versus Méniere's Disease: Diagnostic Utility of Electrocochleography.Audiology research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHeadaches are a common source of pain and suffering. The study's purpose was to assess beta-blockers efficacy in preventing migraine and tension-type headache.
methodsCochrane Register of Controlled Trials; MEDLINE; EMBASE; ISI Web of Science, clinical trial registries, CNKI, Wanfang and CQVIP were searched through 21 August 2018, for randomized trials in which at least one comparison was a beta-blocker for the prevention of migraine or tension-type headache in adults. The primary outcome, headache frequency per month, was extracted in duplicate and pooled using random effects models. DATA SYNTHESIS: This study included 108 randomized controlled trials, 50 placebo-controlled and 58 comparative effectiveness trials. Compared to placebo, propranolol reduced episodic migraine headaches by 1.5 headaches/month at 8 weeks (95% CI: -2.3 to -0.65) and was more likely to reduce headaches by 50% (RR: 1.4, 95% CI: 1.1-1.7). Trial Sequential Analysis (TSA) found that these outcomes were unlikely to be due to a Type I error. A network analysis suggested that beta-blocker's benefit for episodic migraines may be a class effect. Trials comparing beta-blockers to other interventions were largely single, underpowered trials. Propranolol was comparable to other medications known to be effective including flunarizine, topiramate and valproate. For chronic migraine, propranolol was more likely to reduce headaches by at least 50% (RR: 2.0, 95% CI: 1.0-4.3). There was only one trial of beta-blockers for tension-type headache.
conclusionsThere is high quality evidence that propranolol is better than placebo for episodic migraine headache. Other comparisons were underpowered, rated as low-quality based on only including single trials, making definitive conclusions about comparative effectiveness impossible. There were few trials examining beta-blocker effectiveness for chronic migraine or tension-type headache though there was limited evidence of benefit. REGISTRATION: Prospero (ID: CRD42017050335).
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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.