Summary of findings 1. Triptans compared to placebo for acute attacks of vestibular migraine.
| Triptans compared to placebo for acute attacks of vestibular migraine | ||||||
| Patient or population: adults with acute attacks of vestibular migraine Setting: outpatient Intervention: triptans Comparison: placebo | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with placebo | Risk with triptans | |||||
| Improvement in vertigo (global score) ‐ up to 2 hours Assessed with: change from moderate/severe to mild/no vertigo |
Study population | RR 0.84 (0.66 to 1.07) | 262 (2 RCTs) | ⊕⊝⊝⊝ Very low1,2,3 | Triptans may have little or no effect on improvement in vertigo at up to 2 hours, but the evidence is very uncertain. | |
| 545 improved per 1000 attacks | 457 improved per 1000 attacks (359 to 583) | |||||
| Change in vertigo | No studies reported this outcome. | |||||
| Serious adverse events | Study population | Not estimable | 114 (1 RCT) |
⊕⊝⊝⊝ Very low1,3,4 | The evidence is very uncertain about the effect of triptans on serious adverse events. | |
| 0 per 1000 | 0 per 1000 | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
1Serious risk of attrition bias. Multiple domains rated at unclear risk of bias.
2Analysis method fails to account for correlation between outcomes reported by the same individual.
3Sample size fails to meet the optimal information size, taken to be 300 events for a dichotomous outcome or 400 participants for a continuous outcome, as a rule of thumb.
4No events in either arm, therefore cannot calculate an effect estimate.