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10.1001/jamapediatrics.2013.508 http://scihub22266oqcxt.onion/10.1001/jamapediatrics.2013.508 C4692044!4692044!23358935     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=23358935&cmd=llinks): Failed to open stream: HTTP request failed! 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A comparative effectiveness meta-analysis of drugs for the prophylaxis of pediatric migraine headache |pdf=|usr=}}{{23358935}} gab.com Text A comparative effectiveness meta-analysis of drugs for the prophylaxis of pediatric migraine headache JO: JAMA Pediatr http://www.kidney.de/pget.php?&tw=1&pmid=23358935 #FOAvip Background: Childhood migraines are a common source of morbidity. Purpose: To assess the comparative effectiveness and side effects of migraine prophylactic medications in children. Data Sources: PUBMED, EMBASE, Cochrane Trial Registry, bibliography of retrieved articles through 25 April 2012. Study Selection: Randomized trials of children with migraine headaches. Data Extraction: Extracted independently in duplicate, including quality (JADAD, Cochrane Risk of Bias). We pooled headache frequency per month using random effects methods. Data Synthesis: Among 21 included trials, there were 13 placebo controlled and 11 comparative effectiveness trials (3 included placebo arms. Drugs more effective than placebo for episodic migraines (<15 headaches/month) included topiramate (?0.71 headaches/month, 95 % CI: ?1.19 to ?0.24, Q= 1.58, df=1, I2=0.0%) and trazodone (?0.60 headache/month, 95% CI: ?1.09 to ?0.11, 1 study, Figure 2). Ineffective drugs included clonidine, flunarizine, pizotifen, propranolol and valproate. A single trial of fluoxetine for chronic daily headaches found it ineffective. Patients given placebo experienced a significant (p=0.027) decline in headaches from 5.6 (95% CI: 4.52?6.77 Q=8.14, df=8, I2=1.7%) to 2.9 headaches/month (95% CI: 1.66?4.08, Q-4.72, df=10, I2=0.0%).Among the 10 comparative effectiveness trials, flunarizine was more effective than piracetam (?2.2 headaches/month, 9 CI: ?3.93 to ?0.47), but no better than aspirin, dihydroergotamine, and propranolol. Propranolol was compared to valproate as well as behavioral treatment and two studies compared different doses of topiramate; none of these trials showed a significant difference. Limitations: Few trials, lack of patient level data, changing definitions of migraine over time, few comparative effectiveness trials. Conclusion: Topiramate and trazodone have limited evidence supporting efficacy for episodic migraines. Placebo was effective in reducing headaches. Other commonly used drugs have no evidence supporting their use in children. Research in pediatric headaches is needed. Twit Text FOAVip A comparative effectiveness meta-analysis of drugs for the prophylaxis of pediatric migraine headache ????JAMA Pediatr http://www.kidney.de/pget.php?&tw=1&pmid=23358935 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=23358935 #FOAvip English Wikipedia <ref>{{Cite pmid|23358935}}</ref> A comparative effectiveness meta-analysis of drugs for the prophylaxis of pediatric migraine headache #MMPMID23358935 El-Chammas K; Keyes J; Thompson N; Vijayakumar J; Becher D; Jackson JL JAMA Pediatr 2013[Mar]; 167 (3): 250-8 PMID23358935show ga Background: Childhood migraines are a common source of morbidity. Purpose: To assess the comparative effectiveness and side effects of migraine prophylactic medications in children. Data Sources: PUBMED, EMBASE, Cochrane Trial Registry, bibliography of retrieved articles through 25 April 2012. Study Selection: Randomized trials of children with migraine headaches. Data Extraction: Extracted independently in duplicate, including quality (JADAD, Cochrane Risk of Bias). We pooled headache frequency per month using random effects methods. Data Synthesis: Among 21 included trials, there were 13 placebo controlled and 11 comparative effectiveness trials (3 included placebo arms. Drugs more effective than placebo for episodic migraines (<15 headaches/month) included topiramate (?0.71 headaches/month, 95 % CI: ?1.19 to ?0.24, Q= 1.58, df=1, I2=0.0%) and trazodone (?0.60 headache/month, 95% CI: ?1.09 to ?0.11, 1 study, Figure 2). Ineffective drugs included clonidine, flunarizine, pizotifen, propranolol and valproate. A single trial of fluoxetine for chronic daily headaches found it ineffective. Patients given placebo experienced a significant (p=0.027) decline in headaches from 5.6 (95% CI: 4.52?6.77 Q=8.14, df=8, I2=1.7%) to 2.9 headaches/month (95% CI: 1.66?4.08, Q-4.72, df=10, I2=0.0%).Among the 10 comparative effectiveness trials, flunarizine was more effective than piracetam (?2.2 headaches/month, 9 CI: ?3.93 to ?0.47), but no better than aspirin, dihydroergotamine, and propranolol. Propranolol was compared to valproate as well as behavioral treatment and two studies compared different doses of topiramate; none of these trials showed a significant difference. Limitations: Few trials, lack of patient level data, changing definitions of migraine over time, few comparative effectiveness trials. Conclusion: Topiramate and trazodone have limited evidence supporting efficacy for episodic migraines. Placebo was effective in reducing headaches. Other commonly used drugs have no evidence supporting their use in children. Research in pediatric headaches is needed. äA comparative effectiveness meta-analysis of drugs for the prophylaxis(epmc).pdf DeepDyve Pubget Overpricing