Evidence map›Paper›PMID 31315864›Full record

SynthesisBMJ open2019

Cochrane systematic review and meta-analysis of botulinum toxin for the prevention of migraine.

Clare P Herd, Claire L Tomlinson, Caroline Rick, William J Scotton, Julie Edwards, Natalie J Ives, Carl E Clarke, A J Sinclair

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 14 pooled it
9.9field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 14 syntheses or guidelines pooled it, 135 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Clare P HerdInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID 0000-0002-1351-1112
Claire L TomlinsonBCTU, University of Birmingham, Birmingham, UK.
Caroline RickNottingham Clinical Trials Unit, University of Nottingham, Nottingham, Nottinghamshire, UK.
William J ScottonUniversity of Birmingham, Institute of Metabolism and Systems Research, Birmingham, UK.
Julie EdwardsSandwell and West Birmingham Hospitals NHS Trust, Department of Neurology, Birmingham, Birmingham, UK.
Natalie J IvesBCTU, University of Birmingham, Birmingham, UK.
Carl E ClarkeUniversity of Birmingham, Neurology, Birmingham, UK.
A J SinclairUniversity of Birmingham, Institute of Metabolism and Systems Research, Birmingham, UK.
University of Birmingham · GBSandwell & West Birmingham Hospitals NHS Trust · GBUniversity of Nottingham · GB

Funding

Medical Research Council MR/K015184/1
6 · The paper itself

Abstract

objectivesTo assess the effects of botulinum toxin for prevention of migraine in adults.

designSystematic review and meta-analysis. DATA SOURCES: CENTRAL, MEDLINE, Embase and trial registries. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) of botulinum toxin compared with placebo, active treatment or clinically relevant different dose for adults with chronic or episodic migraine, with or without the additional diagnosis of medication overuse headache. DATA EXTRACTION AND SYNTHESIS: Cochrane methods were used to review double-blind RCTs. Twelve week post-treatment time-point data was analysed.

resultsTwenty-eight trials (n=4190) were included. Trial quality was mixed. Botulinum toxin treatment resulted in reduced frequency of -2.0 migraine days/month (95% CI -2.8 to -1.1, n=1384) in chronic migraineurs compared with placebo. An improvement was seen in migraine severity, measured on a numerical rating scale 0 to 10 with 10 being maximal pain, of -2.70 cm (95% CI -3.31 to -2.09, n=75) and -4.9 cm (95% CI -6.56 to -3.24, n=32) for chronic and episodic migraine respectively. Botulinum toxin had a relative risk of treatment related adverse events twice that of placebo, but a reduced risk compared with active comparators (relative risk 0.76, 95% CI 0.59 to 0.98) and a low withdrawal rate (3%). Although individual trials reported non-inferiority to oral treatments, insufficient data were available for meta-analysis of effectiveness outcomes.

conclusionsIn chronic migraine, botulinum toxin reduces migraine frequency by 2 days/month and has a favourable safety profile. Inclusion of medication overuse headache does not preclude its effectiveness. Evidence to support or refute efficacy in episodic migraine was not identified.

Indexed as

AdultBotulinum Toxins, Type AChronic DiseaseHumansMigraine DisordersRandomized Controlled Trials as TopicBotulinum Toxins, Type Abotoxbotulinum toxinmigraine disordersrandomised controlled trialsystematic review

Identifiers

PMID31315864
PMCPMC6661560
OpenAlexW2961786467

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.