Evidence map›Paper›PMID 39989443›Full record

SynthesisHeadache2025

Do antithrombotic drugs have a role in migraine prevention? A systematic review.

Federico De Santis, Matteo Foschi, Michele Romoli, Vincenzo Mastrangelo, Chiara Rosignoli, Agnese Onofri, Simona Sacco, Raffaele Ornello

Abstract readSystematic Review
In one paragraph

Synthesis in Headache, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
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.

Federico De SantisDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID 0000-0002-8059-6427
Matteo FoschiDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID 0000-0002-0321-7155
Michele RomoliDepartment of Neuroscience, Maurizio Bufalini Hospital, AUSL Romagna, Cesena, Italy.ORCID 0000-0001-8009-8543
Vincenzo MastrangeloNeurology Unit, "Infermi" Hospital, AUSL Romagna, Rimini, Italy.ORCID 0000-0002-7218-2267
Chiara RosignoliDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID 0009-0003-5241-9655
Agnese OnofriDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID 0000-0002-9697-0970
Simona SaccoDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID 0000-0003-0651-1939
Raffaele OrnelloDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.ORCID 0000-0001-9501-4031

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore the available evidence on the role of antithrombotics as migraine preventive medication.

backgroundIn clinical practice, the use of antithrombotic drugs in individuals with migraine is sometimes considered, especially in the case of frequent auras, association with patent foramen ovale, or prothrombotic states. This paper systematically reviews evidence on antithrombotic agents' efficacy for migraine prevention.

methodsWe performed a systematic literature search on PubMed and Scopus including observational and interventional studies focused on antiplatelets or anticoagulants as preventive treatments for migraine. The search included studies published until June 30th, 2024. Ongoing trials on Clinicaltrials.org were also explored. Quality assessment used the Cochrane Risk of Bias 2 (RoB-2) tool for randomized controlled trials (RCTs) and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) for observational studies. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO identifier CRD42024501531).

resultsOut of 1854 records, we found 12 RCTs and 8 observational studies investigating the impact of antithrombotic drugs in migraine prevention. Due to heterogeneity of data, a meta-analysis was not feasible. RCTs tested acetylsalicylic acid (ASA) alone (seven), ASA in combination with other preventive treatments (two), clopidogrel (one), dual antiplatelet treatment (one), and vitamin K antagonists (one). Observational studies tested ASA (three), vitamin K antagonists (three), and clopidogrel (two). No clear evidence of efficacy was found for the overall population of individuals with migraine. Limited evidence from old RCTs-not specifically addressing the role of antithrombotic drugs for migraine prevention-and observational studies showed a potential improvement of migraine with the use of antiplatelet agents, mostly ASA, in special populations, including males, individuals with migraine with aura, and those with patent foramen ovale.

conclusionsEvidence supporting the effectiveness of antithrombotic drugs as a preventive treatment for patients with migraine is insufficient. As preliminary data show potential improvements in special populations in whom those agents act indirectly by ameliorating vascular function, RCTs are worth conducting.

Indexed as

Fibrinolytic AgentsMigraine DisordersPlatelet Aggregation InhibitorsHumansObservational Studies as TopicFibrinolytic AgentsPlatelet Aggregation Inhibitorsantithromboticauramicroembolismmigrainepreventive treatmentprothrombotic state

Identifiers

PMID39989443
PMCPMC11951400

What OpenQuestion holds

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LicenceCC BY
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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.