Migraine - The Enigma Of Trial Results

Editor's Choice
Academic Journal
Main Category: Headache / Migraine
Also Included In: Complementary Medicine / Alternative Medicine
Article Date: 10 Jan 2012 - 9:00 PST

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In order to find out the effect of acupuncture compared with sham acupuncture in treating migraines, a team of investigators carried out a randomized controlled human trial. 480 individuals at 9 hospitals in China who experienced migraines for over one year, with two or three migraines in the 3 months prior to the investigation, were enrolled to participate in the study.

The researchers randomly assigned the volunteers to four groups. Those in one group received sham acupuncture, while participants in the other three groups received different types of acupuncture. Their ages ranged from 18 to 65 years.

In the United States and England, migraines affect approximately 16% to 18% of women and 6% to 8% of men. Evidence on how effective acupuncture is at treating migraines is mixed, as some studies suggest it is the placebo effect, instead of a therapeutic effect that relieves symptoms. Acupuncture distinguishes between real acupuncture points and nonacupuncture (sham) points.

Dr. Fan-rong Liang, Chengdu University of Traditional Chinese Medicine, Chengdu, China, explains:

"We found that the outcomes following acupuncture were significantly better than with sham acupuncture during weeks 13-16, but the effect was clinically minor."

After 16 weeks, approximately half to three-quarters of participants were better after sham acupuncture and proper acupuncture. The researchers said:

"Acupuncture has a large effect on treating migraines, but the specific therapeutic effect may be minor."

In an associated commentary, Dr. Albrecht Molsberger, Ruhr University, Bochum, Germany and the University of North Carolina, explains that according to previous evidence, acupuncture helps treat severe migraine attacks.

Molsberger explains:

"On the basis of the existing evidence, acupuncture should be an option for the first-line treatment of migraine to supplement other nonpharmacologic treatment options."

In a second randomized controlled trial, investigators in the Netherlands enrolled 490 patients from 64 general practices, 233 of them attended consultations to assess treatment of their migraines, as well as 257 in the control group. The researchers set out to examine whether a proactive approach by primary care physicians to patients with suboptimal migraine treatment would result in improvements.

In the Netherlands, only 8% to 12% of all patients with migraines used prophylaxis, while a considerable amount of individuals used too much medication for migraine attacks.

Even though more individuals took prescription medication to prevent migraines as a result of the approach, the researchers observed no clinically relevant effect after six months.

Dr. Antonia Smelt, Leiden University Medical Center, Leiden, the Netherlands, with coauthors, explained:

"We found no clinically relevant effect of a proactive approach to migraine in primary care for patients who were using two or more doses of triptan per month."

The researchers conclude:

"It is possible that the intervention resulted in better treatment for patients not using prophylactic medication at baseline who had two or more attacks of migraine per month. Future interventions in primary care should target these patients."

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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