Efectividad del tratamiento profiláctico farmacológico en pacientes pediátricos con migraña, una revisión sistemática

Abstract

Introduction: migraine is one of the most important primary headaches in the pediatric population; its treatment is based on acute treatment and prophylactic treatment that includes pharmacological and non-pharmacological measures. There is still no solid evidence on the effectiveness of prophylactic treatment in patients under 18 years of age and what would be the best drugs available for this population. Objective: to evaluate the effectiveness of prophylactic pharmacological treatment, compared to non-pharmacological treatment in a period of at least 3 months in patients under 18 years of age with a diagnosis of migraine. Materials and methods: systematic review of the literature that included randomized clinical trials and prospective cohort studies in patients under 18 years of age through the MEDLINE, Embase, Google Scholar, LILACS, BVS and Cochrane Database of Clinical Trials databases. , following the guidelines of the Cochrane Collaboration for systematic reviews and meta-analyses. Inclusion and exclusion criteria were established. Statistical analysis was performed using the mean difference between the variables of interest. Results: demographic aspects, pharmacological and non-pharmacological treatments, the main adverse effects of pharmacological treatments, the frequency and intensity of migraine attacks and the quality of life of the established population were characterized. Significant differences were found between the mean pre-treatment and post-pharmacological seizure frequency (p<0.001) of 7.1 seizures on average (95% CI [4.77 - 9.43]), with a pre-treatment seizure frequency of 12.3 (SD 5.22) seizures. per month versus 5.24 (SD 4.12) post-treatment crisis. Conclusions: Preventive treatment for migraine in children and adolescents can be effective. Prophylaxis is recommended for pediatric patients with migraine with or without aura. Overall data on adverse events show a favorable benefit-risk profile for the use of these therapies in the prevention of pediatric migraine.