Summary of findings 1. Should ibuprofen be used to treat children with migraine?
| Ibuprofen compared with placebo in children with migraine | |||||
| Patient or population: acute treatment of migraine in children Setting: ambulatory Intervention: ibuprofen Comparison: placebo | |||||
| Outcomes | Anticipated absolute effectsa (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Response with placebo | Response with Ibuprofen | ||||
| Pain freedom at 2 h | Study population | RR 1.87 (1.15 to 3.04) | 125 (2 RCTs) | ⨁⨁◯◯b,c Low | |
| 267 per 1000 | 499 per 1000 (307 to 811) | ||||
| Adverse events | 100 per 1000 | 0 per 1000 (− 13 to 13) |
RD 0.00 (− 0.13 to 0.13) |
80 (1 RCT) |
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GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: 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 quality: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low quality: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. CI: confidence interval; RR: risk ratio; RD: risk difference | |||||
aThe response 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). bIn the two studies, there were no serious risks of bias, inconsistency, indirectness, or publication bias. We downgraded quality of evidence by two levels due to very serious imprecision (small sample size, few events, and wide confidence interval).
cHigh (⨁⨁⨁⨁) = further research is very unlikely to change our confidence in the estimate of effect; Moderate (⨁⨁⨁◯) = further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate; Low (⨁⨁◯◯) = further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate; Very Low (⨁◯◯◯) = any estimate of effect is very uncertain.