SynthesisCephalalgia : an international journal of headache2021
CGRP-antibodies, topiramate and botulinum toxin type A in episodic and chronic migraine: A systematic review and meta-analysis.
Synthesis in Cephalalgia : an international journal of headache, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 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
29 citing papers in PubMed, 5 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Botulinum Toxin Type A for the Prevention of Migraines: An Umbrella Review of Systematic Reviews.Toxins · 2026Pooled it
- Saudi clinical practice guidelines for the treatment and prevention of migraine headache.Neurosciences (Riyadh, Saudi Arabia) · 2025Guideline
- Effectiveness and safety of pharmacological prophylaxis for chronic migraine: a systematic review and network meta-analysis.Journal of neurology · 2024Pooled it
- Utility of Repetitive Transcranial Magnetic Stimulation for Chronic Daily Headache Prophylaxis: A Systematic Review and Meta-Analysis.Current pain and headache reports · 2024Pooled it
- European Headache Federation (EHF) critical reappraisal and meta-analysis of oral drugs in migraine prevention - part 3: topiramate.The journal of headache and pain · 2023Pooled it
- Geriatric Migraine, Geroscience, and Sustainable Development Goals: Bridging Clinical Complexity and Public Health Priorities.Journal of clinical medicine · 2026Review
- Comparing the Efficacy and Safety of Anti-CGRP Monoclonal Antibodies Versus Topiramate for Migraine Prophylaxis: Six-Month, Real-World, Intention-to-Treat Retrospective Evidence from the GRASP Study Group.Neurology international · 2026Article
- Drugs for Migraine Prophylaxis.Deutsches Arzteblatt international · 2026Review
- Long-term effectiveness of fremanezumab in episodic and chronic migraine patients in clinical routine - 24-months results from the prospective non-interventional FINESSE study.The journal of headache and pain · 2025Article
- Injection-Based Therapies for Migraine in Older Adults: A Narrative Review of OnabotulinumtoxinA, Greater Occipital Nerve Block, and Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies.Journal of Korean medical science · 2025Review
- Hispidulin Isolated from the Leaves of Clerodendrum inerme (L.) Gaertn Suppresses Trigeminovascular System Activation in a Rat Model Mimicking Migraine.Pharmaceutical research · 2025Article
- Quickest way to less headache days: an operational research model and its implementation for chronic migraine.BMC neurology · 2025Article
- Nanoformulation innovations: Revolutionizing precision in migraine therapy.Iranian journal of basic medical sciences · 2025Review
- Comparative effectiveness and tolerability of calcitonin gene-related peptide (CGRP) monoclonal antibodies and onabotulinumtoxinA in chronic migraine: A multicenter, real-world study in Taiwan.European journal of neurology · 2024Article
- Review
- Clinic-Based Characterization of Adolescents and Young Adults With Migraine: Psychological Functioning, Headache Days, and Disability.Neurology. Clinical practice · 2024Article
- Real-world effectiveness of Anti-CGRP monoclonal antibodies compared to OnabotulinumtoxinA (RAMO) in chronic migraine: a retrospective, observational, multicenter, cohort study.The journal of headache and pain · 2024Observational
- Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study.The journal of headache and pain · 2023Article
- Monoclonal antibodies against CGRP (R): non-responders and switchers: real world data from an austrian case series.BMC neurology · 2023Article
- Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe approval of monoclonal antibodies for prevention of migraine has revolutionized treatment for patients. Oral preventatives are still considered first line treatments as head-to-head trials comparing them with antibodies are lacking.
methodsThe main purpose of this study was to provide a comparative overview of the efficacy of three commonly prescribed migraine preventative medication classes. For this systematic review and meta-analysis, we searched the databases CENTRAL, EMBASE, and MEDLINE until 20 March 2020. We included RCTs reporting the 50% response rates for topiramate, Botulinum Toxin Type A and monoclonal antibodies against CGRP(r). Studies were excluded if response rates were not reported, treatment allocation was unclear, or if study quality was insufficient. Primary outcome measure were the 50% response rates. The pooled odds ratios with 95% confidence intervals were calculated with the random effects model. The study was registered at PROSPERO (CRD42020222880).
findingsWe identified 6552 reports. Thirty-two were eligible for our review. Studies assessing monoclonal antibodies included 13,302 patients and yielded pooled odds ratios for the 50% response rate of 2.30 (CI: 2.11-2.50). Topiramate had an overall effect estimate of 2.70 (CI: 1.97-3.69) with 1989 included patients and Botulinum Toxin Type A achieved 1.28 (CI: 0.98-1. 67) with 2472 patients included.
interpretationTopiramate, botulinum toxin type A and monoclonal antibodies showed higher odds ratios in achieving a 50% response rate compared to placebo. Topiramate numerically demonstrated the greatest effect size but also the highest drop-out rate.
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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.