Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Professor Alborzi Clinical Microbiology Research Center, Shiraz, Iran.
Pain Pract. 2022 Nov;22(8):733-745. doi: 10.1111/papr.13164. Epub 2022 Oct 5.
To investigate and analyze the available data on the prophylactic effectiveness of cinnarizine in migraine disorder.
Cinnarizine has demonstrated encouraging potential in preventing the attacks of migraine. Therefore, we opted to evaluate whether its sole administration leads to positive outcomes.
The PubMed, Scopus, Web of Science, and Embase databases were searched for English-only original interventional studies published until April 2022, then screened for relevancy and eligibility. The resulting data from the included studies, including the primary (ie, headache episode frequency, intensity, duration, monthly timing, and analgesic intake frequency) and secondary (ie, reported adverse events, quality of life, and activities of daily living) outcome changes compared to placebo and active controls (e.g., sodium valproate and propranolol) were then recorded by two independent assessors. Ultimately, these data were synthesized qualitatively and quantitatively (achieved by determining the mean difference via the random-effects model).
A total of 10 studies comprising seven randomized controlled trials and three quasi-experimental studies were included. Compared to placebo, cinnarizine demonstrated significant improvements in migraine episode frequency (Mean difference = -3.10; Confidence interval = [-3.33, -2.88]; p-value < 0.001; I < 0.001%), and intensity (Mean difference = -1.54; Confidence interval = [-2.08, -0.99]; p-value < 0.001; I < 37.97%). Moreover, cinnarizine led to similar or better results when compared to active controls, including sodium valproate, topiramate, and propranolol.
Cinnarizine can be considered a safe and effective medication for migraine prophylaxis. However, the relatively small sample size made reaching a definite conclusion impossible. Therefore, a higher number of randomized controlled trials are recommended to be taken place to clarify the situation further.
调查和分析桂利嗪预防偏头痛发作的有效性现有数据。
桂利嗪在预防偏头痛发作方面显示出令人鼓舞的潜力。因此，我们选择评估其单独使用是否会带来积极的结果。
检索了 2022 年 4 月前发表的仅英文原创干预性研究的 PubMed、Scopus、Web of Science 和 Embase 数据库，然后对相关性和合格性进行筛选。从纳入研究中获得的数据包括主要（即头痛发作频率、强度、持续时间、每月时间和镇痛药摄入频率）和次要（即报告的不良事件、生活质量和日常生活活动）结果变化与安慰剂和阳性对照（例如，丙戊酸钠和普萘洛尔）相比，然后由两名独立评估者记录。最终，这些数据通过定性和定量（通过随机效应模型确定平均差异来实现）进行综合。
共纳入 10 项研究，包括 7 项随机对照试验和 3 项准实验研究。与安慰剂相比，桂利嗪在偏头痛发作频率（平均差异=-3.10；置信区间=[-3.33，-2.88]；p 值<0.001；I 2<0.001%）和强度（平均差异=-1.54；置信区间=[-2.08，-0.99]；p 值<0.001；I 2<37.97%）方面均有显著改善。此外，桂利嗪与阳性对照（包括丙戊酸钠、托吡酯和普萘洛尔）相比，结果相似或更好。
桂利嗪可被视为预防偏头痛的一种安全有效的药物。然而，由于样本量相对较小，无法得出明确的结论。因此，建议进行更多的随机对照试验，以进一步阐明情况。
