Intravenous metoclopramide versus dexketoprofen trometamol versus metoclopramide+ dexketoprofen trometamol in acute migraine attack in the emergency department: A randomized double-blind controlled trial

Yavuz, Erdal; Gülaçtı, Umut; Lök, Uğur; Turgut, Kasım

doi:10.1016/j.ajem.2020.04.038

Cited by 10 publications

(26 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, three articles were also searched by citation searching, and two articles met the pre-specified criteria. Finally, 14 articles[ 10 , 16 - 28 ] with 1661 participants were included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Pain reduction and adverse effects of intravenous metoclopramide for acute migraine attack: A systematic review and meta-analysis of randomized-controlled trials

Ungrungseesopon¹,

Wongtanasarasin²

2022

WJM

View full text Add to dashboard Cite

BACKGROUND Metoclopramide may be used to treat people suffering from acute migraine. However, no comprehensive investigation on this issue has been recorded. This review will provide more solid evidence for the use of metoclopramide in treating acute migraine. AIM To compare the efficacy of intravenous metoclopramide with other therapies in migraine attack treatment in an emergency department (ED). METHODS We included randomized controlled trials of participants older than 18 years with acute migraine headaches, which included at least one arm that received intravenous (IV) metoclopramide at the ED. A literature search of PubMed, Web of Science, Cochrane Collaboration, and Reference Citation Analysis on December 31, 2021 retrieved other drugs or placebo-controlled studies without language limitation. The risk of bias was assessed using the Cochrane risk of bias tool. The primary endpoint was pain reduction at 60 min or closest to 1 h after treatment, as measured by the pain scale. Secondary endpoints included adverse effects or reactions resulting from metoclopramide or comparisons. RESULTS Fourteen trials with a total of 1661 individuals were eligible for review. The risk of bias ranged from low to intermediate. IV metoclopramide administration was not associated with higher pain reduction at 1 h (Standard mean difference [SMD] = -0.03, 95% confidence interval [CI]: -0.33-0.28, P = 0.87). However, metoclopramide was associated with better pain reduction than placebo (SMD = 1.04, 95%CI: 0.50-1.58, P = 0.0002). In addition, side effects were not significantly different between IV metoclopramide and other drugs or placebo (odds ratio [OR] = 0.76, 95%CI: 0.48-1.19, P = 0.09 and OR = 0.92, 95%CI: 0.31-2.74, P = 0.54, respectively). CONCLUSION Metoclopramide is more effective than placebo in treating migraine in the ED. Despite the observed tendency of decreased side effects, its effectiveness compared to other regimens is poorly understood. More research on this area is needed to treat migraine in acute care settings effectively.

show abstract

Section: Resultsmentioning

confidence: 99%

Pain reduction and adverse effects of intravenous metoclopramide for acute migraine attack: A systematic review and meta-analysis of randomized-controlled trials

Ungrungseesopon¹,

Wongtanasarasin²

2022

WJM

View full text Add to dashboard Cite

show abstract

“…Metoclopramide / DEX treatment had better results at 30 minutes than metoclopramide and DEX alone. No side effects were observed in any of the treatment groups [18].…”

Section: Resultsmentioning

confidence: 84%

“…Yavuz E. et al conducted a randomized, singlecenter, double-blind, controlled trial in which they assessed the safety and efficacy of intravenous metoclopramide 10 mg, DEX 50 mg and metoclopramide 10 mg in combination with DEX 50 mg in the treatment of acute migraine attacks [18]. The study involved 150 adult patients who were randomly divided into 3 groups, 50 people each.…”

Section: Resultsmentioning

confidence: 99%

New Studies on Dexketoprofen

Kuczyńska

Pawlak

Nieradko-Iwanicka

2021

Polish Hyperbaric Research

View full text Add to dashboard Cite

Introduction. Dexketoprofen(DEX) belongs to nonsteroidal anti-inflammatory drugs (NSAIDs) and has analgesic, anti-inflammatory, and antipyretic properties. DEX is an enantiomer of ketoprofen (S+) and has a stronger effect than ketoprofen. It is highly effective even after the administration of small doses. The therapy with DEX does not cause serious side effects and is additionally tolerated by the body. Aim. The review aimed to find original scientific publications on DEX in recent years and its therapeutic efficacy, safety, and tolerability. Method. A systematic review of scientific articles published no earlier than 2015 was carried out. Materials from the PubMed, Google Scholar, and Medline Complete databases were used. The literature review was carried out in November 2021. Among the publications found, 28 scientific articles were selected for analysis. Results and discussion. Over the recent years, there have been many publications about DEX. Articles describing new data on DEX in the treatment of pain were analyzed, compared with other drugs and mesotherapy, the latest reports of its combination with tramadol and thiocolchicoside were reviewed, and a new slow release form of DEX and new therapeutic applications of this drug were investigated. After analyzing all the studies, it was found that DEX produced similar or more effective analgesia compared to other drugs and reduced the need for emergency medications. In addition, it was noted that using DEX in combination therapy was far better than taking it alone, and was also found to be effective in raising the epileptic threshold. Mesotherapy achieved higher results in the treatment of pain symptoms compared to DEX. The side effects that appeared as a result of the use of DEX therapy were not life-threatening. Conclusion. The results of the review confirm that DEX is a very good analgesic, which is more potent than paracetamol and diclofenac sodium while having similar effects to dexmedetomidine and lidocaine. DEX in combination with tramadol or thiocolchicoside is more effective than when the two drugs are used alone. Scientists are working on the long-acting DEX and are looking for new applications of the drug in epilepsy and oncology.

show abstract

“…From the 27 trials, 8 –34 11 studies investigated the use of intramuscular (IM) medication for acute migraine, 8 –16,22,29 while 16 investigated intravenous (IV) use. 17 –21,23 –28,30 –34 Fourteen articles were for ketorolac, 5 for dexketoprofen, 3 for acetylsalicylic acid, 2 for diclofenac, 2 for ibuprofen, and 1 for lysine cloxinate (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Parenteral NSAIDs for acute treatment of migraine: Adherence to the IHS guidelines for controlled trials

Curran

Waters

Yuan

2022

Cephalalgia Reports

View full text Add to dashboard Cite

Background: Parenteral non-steroidal anti-inflammatory drugs (NSAIDs) are important alternatives to oral NSAIDs, especially in patients with severe migraine who have emesis or gastroparesis. With increasing research on using parenteral NSAIDs for acute migraine, it is critical to examine the quality of these studies. Our goal was to assess the adherence of these trials to the International Headache Society (IHS) controlled trial guidelines for acute treatment of migraine. Methods: We queried PubMed for clinical trials investigating parenteral NSAIDs for acute treatment of migraine in adult patients. We developed a 14-point scoring system based on the essential components of the IHS guidelines. To date, four versions of the IHS’s Guidelines for controlled trials of acute treatment of migraine attacks have been published. Each trial was evaluated with the appropriate edition of the guidelines. Results: We identified 216 studies and assessed 27 eligible clinical trials. The mean score was 6.7 ± 2.1 (2–11). Most trials followed the IHS migraine diagnosis criteria (85.2%), but only six (22.2%) selected patients based on the recommended headache frequency. Most trials were randomized (88.8%), but fewer were double-blinded (74.1%) or placebo-controlled (11.1%). Almost every trial clearly explained the pain scale (96.3%), and three-quarters (77.8%) assessed headache-associated symptoms. However, no trial utilized the recommended primary endpoint: pain-freedom at 2-hours. Conclusions: Most clinical trials on parenteral NSAIDs for acute migraine did not fully adhere to the IHS recommendations. Future studies should pay special attention to the IHS guideline to improve the quality of clinical trials for the acute treatment of migraine.

show abstract

Intravenous metoclopramide versus dexketoprofen trometamol versus metoclopramide+ dexketoprofen trometamol in acute migraine attack in the emergency department: A randomized double-blind controlled trial

Cited by 10 publications

References 16 publications

Pain reduction and adverse effects of intravenous metoclopramide for acute migraine attack: A systematic review and meta-analysis of randomized-controlled trials

Pain reduction and adverse effects of intravenous metoclopramide for acute migraine attack: A systematic review and meta-analysis of randomized-controlled trials

New Studies on Dexketoprofen

Parenteral NSAIDs for acute treatment of migraine: Adherence to the IHS guidelines for controlled trials

Contact Info

Product

Resources

About