@article{db57a99806a343fda5af004e45fa8827,
title = "High Dosage Omega-3 Fatty Acids Outperform Existing Pharmacological Options for Migraine Prophylaxis: A Network Meta-Analysis",
abstract = "Migraine is a highly prevalent neurologic disorder with prevalence rates ranging from 9% to 18% worldwide. Current pharmacologic prophylactic strategies for migraine have limited efficacy and acceptability, with relatively low response rates of 40% to 50% and limited safety profiles. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are considered promising therapeutic agents for migraine prophylaxis. The aim of this network meta-analysis (NMA) was to compare the efficacy and acceptability of various dosages of EPA/DHA and other current Food and Drug Administration–approved or guideline-recommended prophylactic pharmacologic interventions for migraine. Randomized controlled trials (RCTs) were eligible for inclusion if they enrolled participants with a diagnosis of either episodic or chronic migraine. All NMA procedures were conducted under the frequentist model. The primary outcomes assessed were 1) changes in migraine frequency and 2) acceptability (i.e., dropout for any reason). Secondary outcomes included response rates, changes in migraine severity, changes in the frequency of using rescue medications, and frequency of any adverse events. Forty RCTs were included (N = 6616; mean age = 35.0 y; 78.9% women). Our analysis showed that supplementation with high dosage EPA/DHA yields the highest decrease in migraine frequency [standardized mean difference (SMD): −1.36; 95% confidence interval (CI): −2.32, −0.39 compared with placebo] and the largest decrease in migraine severity (SMD: −2.23; 95% CI: −3.17, −1.30 compared with placebo) in all studied interventions. Furthermore, supplementation with high dosage EPA/DHA showed the most favorable acceptability rates (odds ratio: 1.00; 95% CI: 0.06, 17.41 compared with placebo) of all examined prophylactic treatments. This study provides compelling evidence that high dosage EPA/DHA supplementation can be considered a first-choice treatment of migraine prophylaxis because this treatment displayed the highest efficacy and highest acceptability of all studied treatments. This study was registered in PROSPERO as CRD42022319577.",
keywords = "DHA, EPA, migraine, network meta-analysis, polyunsaturated fatty acid, prevention",
author = "Tseng, {Ping Tao} and Zeng, {Bing Yan} and Chen, {Jiann Jy} and Kuo, {Chun Hsien} and Zeng, {Bing Syuan} and Kuo, {John S.} and Cheng, {Yu Shian} and Sun, {Cheuk Kwan} and Wu, {Yi Cheng} and Tu, {Yu Kang} and Brendon Stubbs and Carvalho, {Andre F.} and Liang, {Chih Sung} and Chen, {Tien Yu} and Hsu, {Chih Wei} and Suen, {Mein Woei} and Yang, {Chun Pai} and Hsu, {Shih Pin} and Chen, {Yen Wen} and Shiue, {Yow Ling} and Hung, {Chao Ming} and Su, {Kuan Pin} and Lin, {Pao Yen}",
note = "Funding Information: The authors were supported by the following grants: Brendon Stubbs is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England and the National Institute for Health Research (NIHR). Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. Brendon Stubbs is also supported by the Maudsley Charity, King{\textquoteright}s College London. Kuan-Pin Su is supported by the MOST 109-2320-B-038-057-MY3, 109-2320-B-039-066, 110-2321-B-006-004, 110-2811-B-039-507, 110-2320-B-039-048-MY2, and 110-2320-B-039-047-MY3 from the Ministry of Science and Technology, Taiwan; ANHRF 109-31, 109-40, 110-13, 110-26, 110-44, and 110-45 from An-Nan Hospital, China Medical University, Tainan, Taiwan; CMRC-CMA-2 from Higher Education Sprout Project by the Ministry of Education (MOE), Taiwan; CMU 110-AWARD-02, CMU108-SR-106 from the China Medical University, Taichung, Taiwan; and CRS-108-048, DMR-102-076, DMR-103-084, DMR-106-225, DMR-107-204, DMR-108-216, DMR-109-102, DMR-109-244, DMR-HHC-109-11, DMR-HHC-109-12, DMR-HHC-110-10, and DMR-110-124 from the China Medical University Hospital, Taichung, Taiwan. John S. Kuo is partly supported by a Yu Shan Scholar award from the MOE, Taiwan. This article presents independent research. The views expressed in this publication are those of the authors and not necessarily those of the acknowledged institutions. None of the above funders played any roles in the design and conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript, and decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} 2024 The Authors",
year = "2024",
month = feb,
doi = "10.1016/j.advnut.2023.100163",
language = "English",
volume = "15",
journal = "Advances in Nutrition",
issn = "2161-8313",
publisher = "American Society for Nutrition",
number = "2",
}