Topiramate for the prophylaxis of episodic migraine in adults

Mattias Linde; Wim M Mulleners; Edward P Chronicle; Douglas C McCrory

doi:10.1002/14651858.CD010610

Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados
Respuestas clínicas Cochrane
Guías
Temas

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Topics

Temas

Figure 1

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 3

Forest plot of comparison: 1 Topiramate (combined analyses based on most relevant dose in each study) versus placebo, outcome: 1.1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 4

Forest plot of comparison: 2 Topiramate (separate analyses of various doses) versus placebo, outcome: 2.1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Figure 5

Forest plot of comparison: 1 Topiramate (combined analyses based on most relevant dose in each study) versus placebo, outcome: 1.3 RRs for responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.1

Comparison 1 Topiramate (combined analyses based on most relevant dose in each study) versus placebo, Outcome 1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.2

Comparison 1 Topiramate (combined analyses based on most relevant dose in each study) versus placebo, Outcome 2 ORs for responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 1.3

Comparison 1 Topiramate (combined analyses based on most relevant dose in each study) versus placebo, Outcome 3 RRs for responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.1

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.2

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 2 Responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.3

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 3 Any adverse event.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.4

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 4 Anorexia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.5

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 5 Fatigue.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.6

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 6 Memory problems.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.7

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 7 Nausea.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.8

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 8 Paresthesia.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.9

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 9 Taste disturbance.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.10

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 10 Weight loss.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.11

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 11 MSQ‐role function restrictive.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.12

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 12 MSQ‐role function prevention.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.13

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 13 MSQ‐emotional function.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.14

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 14 SF‐36 role physical.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.15

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 15 SF‐36 vitality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.16

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 16 SF‐36 physical functioning.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.17

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 17 SF‐36 bodily pain.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.18

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 18 SF‐36 general health.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.19

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 19 SF‐36 social functioning.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.20

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 20 SF‐36 role emotional.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 2.21

Comparison 2 Topiramate (separate analyses of various doses) versus placebo, Outcome 21 SF‐36 mental health.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.1

Comparison 3 Topiramate direct dose comparisons, Outcome 1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.2

Comparison 3 Topiramate direct dose comparisons, Outcome 2 Responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.3

Comparison 3 Topiramate direct dose comparisons, Outcome 3 MSQ‐role function restrictive.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.4

Comparison 3 Topiramate direct dose comparisons, Outcome 4 MSQ‐role function prevention.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.5

Comparison 3 Topiramate direct dose comparisons, Outcome 5 MSQ‐emotional function.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.6

Comparison 3 Topiramate direct dose comparisons, Outcome 6 SF‐36 role physical.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.7

Comparison 3 Topiramate direct dose comparisons, Outcome 7 SF‐36 vitality.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.8

Comparison 3 Topiramate direct dose comparisons, Outcome 8 SF‐36 physical functioning.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.9

Comparison 3 Topiramate direct dose comparisons, Outcome 9 SF‐36 bodily pain.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.10

Comparison 3 Topiramate direct dose comparisons, Outcome 10 SF‐36 general health.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.11

Comparison 3 Topiramate direct dose comparisons, Outcome 11 SF‐36 social functioning.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.12

Comparison 3 Topiramate direct dose comparisons, Outcome 12 SF‐36 role emotional.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 3.13

Comparison 3 Topiramate direct dose comparisons, Outcome 13 SF‐36 mental health.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.1

Comparison 4 Topiramate versus amitriptyline, Outcome 1 Responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 4.2

Comparison 4 Topiramate versus amitriptyline, Outcome 2 MIDAS score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.1

Comparison 5 Topiramate versus flunarizine, Outcome 1 Headache frequency (post‐treatment).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 5.2

Comparison 5 Topiramate versus flunarizine, Outcome 2 Responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.1

Comparison 6 Topiramate versus propranolol, Outcome 1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 6.2

Comparison 6 Topiramate versus propranolol, Outcome 2 Responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.1

Comparison 7 Topiramate versus sodium valproate, Outcome 1 Headache frequency (post‐treatment).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 7.2

Comparison 7 Topiramate versus sodium valproate, Outcome 2 MIDAS score.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.1

Comparison 8 Topiramate versus relaxation, Outcome 1 Headache frequency (change from baseline to post‐treatment).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.2

Comparison 8 Topiramate versus relaxation, Outcome 2 Responders (patients with ≥ 50% reduction in headache frequency).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Analysis 8.3

Comparison 8 Topiramate versus relaxation, Outcome 3 Change from baseline in MSQoL.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Table 1. NNHs (with 95% CIs), by dose, for placebo‐controlled trials of topiramate and proportion of withdrawals in trials with active intervention or placebo as control

Type of AE	50 mg/day	100 mg/day	200 mg/day
Any AE	NNH not defined*	11 (7 to 33)	5 (3 to 12)
Anorexia	NNH not defined*	17 (10 to 50)	12 (8 to 20)
Fatigue	NNH not defined*	25 (17 to 100)	12 (8 to 25)
Memory problems	NNH not defined*	25 (17 to 100)	12 (9 to 17)
Nausea	NNH not defined*	NNH not defined*	17 (9 to 50)
Paresthesia	NNH not defined*	3 (2 to 6)	2 (2 to 3)
Taste disturbance	7 (5 to 14)	14 (8 to 100)	7 (5 to 11)
Weight loss	25 (14 to 100)	17 (11 to 33)	11 (8 to 14)
Percentage of patients in active group withdrawing because of AEs	Afshari 2012: 5%; Ashtari 2008: 3%; Brandes 2004: 17%; Gupta 2007: 2%; Silberstein 2004: 17%	Brandes 2004: 26%; de Tommaso 2007: 8%; Diener 2004: 28%; Dodick 2009: 20%; Lipton 2011: 12%; Mei 2004: 29%; Silberstein 2004: 19%	Brandes 2004: 21%; Diener 2004: 44%; Edwards 2000: 27%; Silberstein 2004: 32%; Silberstein 2006: 15%; Storey 2001: 11%; Varkey 2011: 12%
* The 95% CI of the difference in AE rates between treatment and placebo arms (the risk difference, RD) crosses zero. Abbreviations: AE = adverse event; CI = confidence interval; NNH = number needed to harm

Table 1. NNHs (with 95% CIs), by dose, for placebo‐controlled trials of topiramate and proportion of withdrawals in trials with active intervention or placebo as control

Ir a la tabla de la revisión

Comparison 1. Topiramate (combined analyses based on most relevant dose in each study) versus placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone) Show forest plot	9	1793	Mean Difference (IV, Random, 95% CI)	‐1.20 [‐1.59, ‐0.80]

2 ORs for responders (patients with ≥ 50% reduction in headache frequency) Show forest plot	9	1246	Odds Ratio (M‐H, Random, 95% CI)	3.18 [2.10, 4.82]

3 RRs for responders (patients with ≥ 50% reduction in headache frequency) Show forest plot	9	1246	Risk Ratio (M‐H, Random, 95% CI)	2.02 [1.57, 2.60]

Comparison 1. Topiramate (combined analyses based on most relevant dose in each study) versus placebo

Ir a la tabla de la revisión

Comparison 2. Topiramate (separate analyses of various doses) versus placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone) Show forest plot	9		Mean Difference (IV, Random, 95% CI)	Subtotals only

1.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	3	576	Mean Difference (IV, Random, 95% CI)	‐0.95 [‐1.95, 0.04]
1.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	6	1620	Mean Difference (IV, Random, 95% CI)	‐1.15 [‐1.58, ‐0.71]
1.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	5	804	Mean Difference (IV, Random, 95% CI)	‐0.94 [‐1.53, ‐0.36]
2 Responders (patients with ≥ 50% reduction in headache frequency) Show forest plot	9		Odds Ratio (M‐H, Random, 95% CI)	Subtotals only

2.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	3	575	Odds Ratio (M‐H, Random, 95% CI)	2.35 [1.60, 3.44]
2.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	5	852	Odds Ratio (M‐H, Random, 95% CI)	3.49 [2.23, 5.45]
2.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	6	1025	Odds Ratio (M‐H, Random, 95% CI)	2.49 [1.61, 3.87]
3 Any adverse event Show forest plot	4		Risk Difference (M‐H, Random, 95% CI)	Subtotals only

3.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	1	120	Risk Difference (M‐H, Random, 95% CI)	0.05 [‐0.07, 0.17]
3.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	873	Risk Difference (M‐H, Random, 95% CI)	0.09 [0.03, 0.15]
3.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	1	213	Risk Difference (M‐H, Random, 95% CI)	0.20 [0.08, 0.32]
4 Anorexia Show forest plot	8		Risk Difference (M‐H, Random, 95% CI)	Subtotals only

4.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	3	584	Risk Difference (M‐H, Random, 95% CI)	0.01 [‐0.04, 0.07]
4.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	5	1631	Risk Difference (M‐H, Random, 95% CI)	0.06 [0.02, 0.10]
4.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	5	999	Risk Difference (M‐H, Random, 95% CI)	0.08 [0.05, 0.12]
5 Fatigue Show forest plot	6		Risk Difference (M‐H, Random, 95% CI)	Subtotals only

5.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	464	Risk Difference (M‐H, Random, 95% CI)	0.04 [‐0.07, 0.15]
5.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	5	1631	Risk Difference (M‐H, Random, 95% CI)	0.04 [0.01, 0.06]
5.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	4	959	Risk Difference (M‐H, Random, 95% CI)	0.08 [0.04, 0.13]
6 Memory problems Show forest plot	5		Risk Difference (M‐H, Random, 95% CI)	Subtotals only

6.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	464	Risk Difference (M‐H, Random, 95% CI)	0.04 [‐0.01, 0.09]
6.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	3	758	Risk Difference (M‐H, Random, 95% CI)	0.04 [0.01, 0.06]
6.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	5	999	Risk Difference (M‐H, Random, 95% CI)	0.08 [0.06, 0.11]
7 Nausea Show forest plot	6		Risk Difference (M‐H, Random, 95% CI)	Subtotals only

7.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	464	Risk Difference (M‐H, Random, 95% CI)	‐0.01 [‐0.10, 0.09]
7.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	5	1631	Risk Difference (M‐H, Random, 95% CI)	0.02 [‐0.01, 0.04]
7.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	4	959	Risk Difference (M‐H, Random, 95% CI)	0.06 [0.02, 0.11]
8 Paresthesia Show forest plot	8		Risk Difference (M‐H, Random, 95% CI)	Subtotals only

8.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	3	584	Risk Difference (M‐H, Random, 95% CI)	0.21 [‐0.02, 0.43]
8.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	5	1631	Risk Difference (M‐H, Random, 95% CI)	0.33 [0.18, 0.48]
8.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	5	999	Risk Difference (M‐H, Random, 95% CI)	0.44 [0.39, 0.49]
9 Taste disturbance Show forest plot	6		Risk Difference (M‐H, Random, 95% CI)	Subtotals only

9.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	464	Risk Difference (M‐H, Random, 95% CI)	0.14 [0.07, 0.21]
9.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	5	1623	Risk Difference (M‐H, Random, 95% CI)	0.07 [0.01, 0.12]
9.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	4	786	Risk Difference (M‐H, Random, 95% CI)	0.14 [0.09, 0.19]
10 Weight loss Show forest plot	6		Risk Difference (M‐H, Random, 95% CI)	Subtotals only

10.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	464	Risk Difference (M‐H, Random, 95% CI)	0.04 [0.01, 0.07]
10.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	4	1270	Risk Difference (M‐H, Random, 95% CI)	0.06 [0.03, 0.09]
10.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	5	999	Risk Difference (M‐H, Random, 95% CI)	0.09 [0.07, 0.12]
11 MSQ‐role function restrictive Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

11.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	5.83 [2.25, 9.41]
11.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	10.08 [6.55, 13.60]
11.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	10.36 [6.68, 14.04]
12 MSQ‐role function prevention Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

12.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	2.84 [‐0.24, 5.92]
12.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	6.39 [3.37, 9.41]
12.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	5.06 [1.87, 8.25]
13 MSQ‐emotional function Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

13.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	4.58 [0.61, 8.54]
13.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	10.22 [6.31, 14.14]
13.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	8.45 [4.38, 12.52]
14 SF‐36 role physical Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

14.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	3.00 [‐3.89, 9.90]
14.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	10.80 [‐2.42, 24.03]
14.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	8.59 [0.65, 16.52]
15 SF‐36 vitality Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

15.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	2.08 [‐4.68, 8.84]
15.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	4.48 [‐7.77, 16.73]
15.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	1.36 [‐4.52, 7.24]
16 SF‐36 physical functioning Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

16.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	0.54 [‐3.28, 4.36]
16.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	2.78 [‐3.29, 8.86]
16.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	‐0.96 [‐5.27, 3.35]
17 SF‐36 bodily pain Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

17.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	4.35 [0.04, 8.66]
17.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	6.35 [‐1.29, 14.00]
17.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	5.12 [‐1.25, 11.49]
18 SF‐36 general health Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

18.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	1.45 [‐2.18, 5.08]
18.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	4.18 [‐1.21, 9.57]
18.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	2.58 [‐1.00, 6.15]
19 SF‐36 social functioning Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

19.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	2.00 [‐1.92, 5.92]
19.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	3.13 [‐3.73, 9.99]
19.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	1.94 [‐2.07, 5.96]
20 SF‐36 role emotional Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

20.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	2.30 [‐4.56, 9.16]
20.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	4.64 [‐3.39, 12.68]
20.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	2.75 [‐4.99, 10.48]
21 SF‐36 mental health Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

21.1 Topiramate titrated to 50 mg/day or maximum tolerated dose < 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	1.19 [‐4.59, 6.98]
21.2 Topiramate titrated to 100 mg/day or maximum tolerated dose < 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	2.58 [‐5.65, 10.81]
21.3 Topiramate titrated to 200 mg/day or maximum tolerated dose < 200 mg	2	458	Mean Difference (IV, Random, 95% CI)	1.57 [‐4.21, 7.35]

Comparison 2. Topiramate (separate analyses of various doses) versus placebo

Ir a la tabla de la revisión

Comparison 3. Topiramate direct dose comparisons

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone) Show forest plot	3		Mean Difference (IV, Random, 95% CI)	Subtotals only

1.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	‐0.71 [‐1.32, ‐0.10]
1.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	‐0.96 [‐1.53, ‐0.40]
1.3 Topiramate 200 mg versus 100 mg	3	756	Mean Difference (IV, Random, 95% CI)	0.03 [‐0.55, 0.61]
2 Responders (patients with ≥ 50% reduction in headache frequency) Show forest plot	3		Odds Ratio (M‐H, Random, 95% CI)	Subtotals only

2.1 Topiramate 100 mg versus 50 mg	2	478	Odds Ratio (M‐H, Random, 95% CI)	1.80 [1.25, 2.60]
2.2 Topiramate 200 mg versus 50 mg	2	462	Odds Ratio (M‐H, Random, 95% CI)	1.66 [1.15, 2.41]
2.3 Topiramate 200 mg versus 100 mg	3	756	Odds Ratio (M‐H, Random, 95% CI)	0.93 [0.69, 1.24]
3 MSQ‐role function restrictive Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

3.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	4.22 [0.65, 7.80]
3.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	4.55 [0.82, 8.28]
3.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	0.31 [‐3.37, 3.99]
4 MSQ‐role function prevention Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

4.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	3.54 [0.48, 6.60]
4.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	2.28 [‐2.13, 6.69]
4.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐1.18 [‐6.67, 4.30]
5 MSQ‐emotional function Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

5.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	5.62 [1.67, 9.58]
5.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	3.90 [‐0.21, 8.02]
5.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐1.73 [‐5.80, 2.34]
6 SF‐36 role physical Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

6.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	7.70 [‐8.27, 23.67]
6.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	5.51 [‐5.17, 16.19]
6.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐2.20 [‐9.31, 4.90]
7 SF‐36 vitality Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

7.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	2.44 [‐3.05, 7.92]
7.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	‐0.63 [‐4.64, 3.39]
7.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐3.01 [‐9.38, 3.35]
8 SF‐36 physical functioning Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

8.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	2.35 [‐1.02, 5.72]
8.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	‐1.44 [‐4.92, 2.04]
8.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐3.75 [‐7.18, ‐0.32]
9 SF‐36 bodily pain Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

9.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	2.13 [‐1.83, 6.08]
9.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	0.85 [‐3.27, 4.96]
9.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐1.16 [‐5.23, 2.91]
10 SF‐36 general health Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

10.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	2.72 [‐0.76, 6.21]
10.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	1.13 [‐4.36, 6.62]
10.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐1.60 [‐8.85, 5.65]
11 SF‐36 social functioning Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

11.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	1.13 [‐5.53, 7.79]
11.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	‐0.06 [‐4.07, 3.96]
11.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐1.05 [‐5.56, 3.46]
12 SF‐36 role emotional Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

12.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	2.33 [‐3.79, 8.45]
12.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	0.63 [‐5.69, 6.94]
12.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐1.65 [‐7.92, 4.63]
13 SF‐36 mental health Show forest plot	2		Mean Difference (IV, Random, 95% CI)	Subtotals only

13.1 Topiramate 100 mg versus 50 mg	2	479	Mean Difference (IV, Random, 95% CI)	1.31 [‐1.87, 4.49]
13.2 Topiramate 200 mg versus 50 mg	2	463	Mean Difference (IV, Random, 95% CI)	0.40 [‐2.87, 3.67]
13.3 Topiramate 200 mg versus 100 mg	2	474	Mean Difference (IV, Random, 95% CI)	‐0.87 [‐4.10, 2.36]

Comparison 3. Topiramate direct dose comparisons

Ir a la tabla de la revisión

Comparison 4. Topiramate versus amitriptyline

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Responders (patients with ≥ 50% reduction in headache frequency) Show forest plot	1		Odds Ratio (M‐H, Random, 95% CI)	Totals not selected

2 MIDAS score Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 4. Topiramate versus amitriptyline

Ir a la tabla de la revisión

Comparison 5. Topiramate versus flunarizine

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Headache frequency (post‐treatment) Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

2 Responders (patients with ≥ 50% reduction in headache frequency) Show forest plot	1		Odds Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 5. Topiramate versus flunarizine

Ir a la tabla de la revisión

Comparison 6. Topiramate versus propranolol

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Headache frequency (change from baseline to post‐treatment, or post‐treatment alone) Show forest plot	2	342	Mean Difference (IV, Random, 95% CI)	‐0.14 [‐0.61, 0.34]

1.1 Topiramate 50 mg versus propranolol 80 mg	1	60	Mean Difference (IV, Random, 95% CI)	‐0.37 [‐1.15, 0.41]
1.2 Topiramate 100 mg versus propranolol 160 mg	1	282	Mean Difference (IV, Random, 95% CI)	0.0 [‐0.60, 0.60]
2 Responders (patients with ≥ 50% reduction in headache frequency) Show forest plot	1		Odds Ratio (M‐H, Random, 95% CI)	Totals not selected

Comparison 6. Topiramate versus propranolol

Ir a la tabla de la revisión

Comparison 7. Topiramate versus sodium valproate

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Headache frequency (post‐treatment) Show forest plot	2	120	Mean Difference (IV, Random, 95% CI)	‐0.90 [‐1.58, ‐0.22]

2 MIDAS score Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 7. Topiramate versus sodium valproate

Ir a la tabla de la revisión

Comparison 8. Topiramate versus relaxation

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Headache frequency (change from baseline to post‐treatment) Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

2 Responders (patients with ≥ 50% reduction in headache frequency) Show forest plot	1		Odds Ratio (M‐H, Random, 95% CI)	Totals not selected

3 Change from baseline in MSQoL Show forest plot	1		Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 8. Topiramate versus relaxation

Ir a la tabla de la revisión

The Cochrane Library

Scolaris Language Selector Scolaris Language Selector

Idioma de la Revisión Cochrane

Idioma de la web

Scolaris Content Language Banner Portlet Scolaris Content Language Banner Portlet

Scolaris Content Display Scolaris Content Display

Temas

Scolaris Language Selector Scolaris Language Selector

Scolaris Content Display Scolaris Content Display

Instituciones a las que se accedió previamente

Scolaris Content Display Scolaris Content Display

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso

	Idioma de la Revisión Cochrane Escoja su idioma de preferencia para las revisiones Cochrane y otros contenidos. Las secciones sin una traducción aparecerán en inglés.

	Idioma de la web Escoja su idioma de preferencia para la web de la Biblioteca Cochrane.

Idioma de la Revisión Cochrane

Idioma de la web

Contenido relacionado

Revisiones y protocolos relacionados

Respuestas clínicas Cochrane

Temas

Copiar o descargar referencia

Idioma de la Revisión Cochrane

Idioma de la web

Instituciones a las que se accedió previamente

Usuarios institucionales

Instituciones a las que se accedió previamente

Otras opciones de acceso