Both European, American and Canadian treatment guidelines rank the evidence supporting some NSAIDs and other analgesics as high – that is, established as effective for acute migraine treatment based on available evidence.[Marmura et al., 2015; Worthington et al., 2013] Combination medications including acetaminophen and other analgesics are ranked lower, as being probably or possibly effective.[Marmura et al., 2015; Worthington et al., 2013]
Some NSAIDs are ranked in lower tiers of evidence – that is, probably, or possibly effective, or with conflicting or inadequate levels of evidence.[Marmura et al., 2015; Worthington et al., 2013]
References:
Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults: the American Headache Society evidence assessment of migraine pharmacotherapies. Headache 2015; 55 (1): 3–20.
Worthington I, Pringsheim T, Gawel MJ, et al. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci 2013; 40 (5 Suppl 3): S1–S80.
Other references used on slide:
Chandrasekharan NV, Dai H, Roos KLT, et al. COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: cloning, structure, and expression. Proc Natl Acad Sci USA 2002; 99 (21): 13926–13931.
Codispoti JR, Prior MJ, Fu M, et al. Efficacy of nonprescription doses of ibuprofen for treating migraine headache. a randomized controlled trial. Headache 2001; 41 (7): 665–679.
Derry S, Rabbie R, Moore RA. Diclofenac with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev 2013; (4): CD008783.
Eigenbrodt, AK, Ashina H, Khan S, Diener HC, Mitsikostas D, Sinclair AJ, … & Ashina M. Diagnosis and management of migraine in ten steps. Nat Rev Neurol 2021, 17(8): 501-514.
Kirthi V, Derry S, Moore RA. Aspirin with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev 2013; (4): CD008041.
Pardutz A, Schoenen J. NSAIDs in the acute treatment of migraine: a review of clinical and experimental data. Pharmaceuticals (Basel) 2010; 3 (6): 1966–1987.
Steiner TJ, Jensen R, Katsarave Z et al. Aids to management of headache disorders in primary care (2nd edition): on behalf of the European Headache Federation and Lifting The Burden: the Global Campaign against Headache. J Headache Pain; 20(1): 57.
Suthisisang CC, Poolsup N, Suksomboon N, et al. Meta-analysis of the efficacy and safety of naproxen sodium in the acute treatment of migraine. Headache 2010; 50 (5): 808–818. Vargas BB. Acute treatment of migraine. Continuum (Minneap Minn) 2018; 24 (4, headache): 1032–1051
