The effectiveness of aspirin for migraine prophylaxis: a systematic review

ABSTRACT CONTEXT AND OBJECTIVE: Many researchers have suggested that aspirin prevents migraines. However, the evidence is unclear. The aim of this study was to analyze the available evidence on the effect of aspirin as a migraine prophylactic. DESIGN AND SETTING: Systematic review, conducted at the Pontifícia Universidade Católica do Paraná, Brazil, and at the University of São Paulo, Brazil. METHODS: We performed electronic searches in the databases of MEDLINE/PubMed, Embase, WEB OF SCIENCE, the World Health Organization, CENTRAL and OpenGrey, and we also searched manually for interventional studies published before April 2016 that compared the effects of aspirin with a control, in adults. Two authors independently extracted data on the publication, population recruited, intervention (aspirin dosage, follow-up and combined treatment) and main outcomes (frequency, severity and duration of migraine). We evaluated the quality of the studies using the Cochrane risk-of-bias tool. RESULTS: Our search retrieved 1,098 references, of which 8 met the selection criteria for this systematic review. The total population was 28,326 participants (18-64 years old); most (96%) were men. The dosage varied from 50 to 650 mg/day across the studies. The risk of bias was generally low or unclear. The only outcome for which most of the studies included (6/8) reported a significant reduction was frequency of migraine, which was reduced at an aspirin dosage of at least 325 mg/day. CONCLUSION: Aspirin can reduce the frequency of migraines. However, the optimal dosage is unclear.

【背景与研究目的】已有诸多研究者提出阿司匹林（aspirin）可预防偏头痛（migraine），但相关证据尚不明确。本研究旨在分析现有关于阿司匹林作为偏头痛预防性治疗药物的疗效证据。【研究设计与实施地点】本研究为系统综述（Systematic review），在巴西巴拉那天主教大学（Pontifícia Universidade Católica do Paraná）及巴西圣保罗大学（University of São Paulo）开展。【研究方法】本研究通过MEDLINE/PubMed、Embase、Web of Science、世界卫生组织（World Health Organization）、CENTRAL及OpenGrey数据库进行电子检索，并手工检索2016年4月之前发表的、针对成年人群比较阿司匹林与对照干预措施疗效的干预性研究。由两名研究者独立提取数据，内容包括文献发表信息、纳入研究人群、干预措施（阿司匹林剂量、随访情况及联合治疗方案）及主要结局指标（偏头痛的发作频率、严重程度与持续时间）。本研究采用Cochrane偏倚风险评估工具（Cochrane risk-of-bias tool）对纳入研究的质量进行评价。【研究结果】本研究共检索到1098篇相关文献，其中8篇符合本系统综述的纳入标准。纳入研究的总样本量为28326名受试者（年龄18~64岁），其中大多数（96%）为男性。各研究中阿司匹林的给药剂量范围为50~650 mg/日。纳入研究的偏倚风险总体较低或尚不明确。在所有结局指标中，仅偏头痛发作频率一项有6/8的纳入研究报告其出现显著降低，且当阿司匹林给药剂量≥325 mg/日时，该指标可得到有效改善。【研究结论】阿司匹林可降低偏头痛的发作频率，但最佳给药剂量尚不明确。