Comparative effects of different drugs for the acute management of migraine episodes in adults: systematic review and network meta-analysis

Data sources: Until 24 June 2023, the Cochrane Register of Controlled Trials, Medline, Embase, ClinicalTrials.gov, the EU Clinical Trials Register, the WHO International Clinical Trials Registration System, and the websites of regulatory agencies and pharmaceutical companies without language restriction.

Methods: Selection, data extraction, coding and assessment of risk of bias were performed independently and in duplicate. Random-effects network meta-analyses were performed for primary analyses. Primary outcomes were the proportion of participants who were pain-free 2 hours after dosing and the proportion of participants who were pain-free between 2 and 24 hours after dosing, in both cases without the use of rescue medication. Certainty of evidence was assessed using the online tool CINeMA (confidence in network meta-analysis). Vitruvian diagrams were used to summarise the results. An international panel of clinicians and people with experience of migraine were involved in designing the study and interpreting the results.