Table. Effectiveness of Triptans and Nonsteroidal Anti-inflammatory Drugs (NSAIDs) From Previous Systematic Reviewsa.
| Comparison | Outcome | Time | Findings, RR (95% CI)a | Study design and sample size |
|---|---|---|---|---|
| Triptans | ||||
| Naratriptan, 2.5 mg (oral) vs placebo11 | Pain free | 2 h | 2.52 (1.78-3.57) | 6 RCTs; 2358 patients |
| 1 d | 2.58 (1.99-3.35) | |||
| Pain relief | 2 h | 1.81 (1.55-2.11) | ||
| 1 d | 2.11 (1.75-2.54) | |||
| Sustained pain relief | 1 d | 2.43 (2.11-2.80) | ||
| Zolmitriptan, 2.5 mg (oral and nasal spray) vs placebo12 | Pain relief | 2 h | 2.06 (1.91-2.22) | 11 RCTs; 4904 patients |
| Sustained pain free | 1 d | 3.51 (2.12-5.79) | 2 RCTs; 984 patients | |
| Sustained pain relief | 1 d | 2.92 (2.37-3.61) | 4 RCTs; 2059 patients | |
| Rizatriptan, 10 mg (oral) vs placebo13 | Pain relief | 2 h | 71% vs 38%; P < .001 | 7 RCTs; 3328 patients |
| Pain free | 2 h | 41% vs 10%; P < .001 | ||
| Sustained pain relief | 1 d | 37% vs 18%; P < .001 | ||
| Sustained pain free | 1 d | 25% vs 7%; P < .001 | ||
| Frovatriptan, 2.5 mg (oral) vs placebo14 | Pain free | 2 h | 3.70 (2.59-5.29) | 5 RCTs; 2866 patients |
| RD, 0.09 (0.07-0.10) | ||||
| 1 d | 2.67 (2.21-3.22) | |||
| RD, 0.18 (0.15-0.21) | ||||
| Pain relief | 2 h | 1.66 (1.47-1.88) | ||
| 1 d | 1.83 (1.66-2.00) | |||
| Almotriptan, 12.5 mg (oral) vs placebo15 | Pain relief | 2 h | 1.68 (1.42-1.98); I2 = 41.90% | 5 RCTs; 1429 patients |
| RD, 0.25 (0.19-0.31) | ||||
| Pain free | 2 h | 2.15 (1.64-2.80); I2 = 39.60% | 5 RCTs; 1590 patients | |
| RD, 0.19 (0.14-0.25) | ||||
| Sustained pain free | 1 d | 2.12 (1.64-2.75) | 5 RCTs | |
| RD, 0.14 (0.11-0.18) | ||||
| Sumatriptan, 100 mg (oral) vs placebo16 | Pain free | 2 h | 3.20 (2.84-3.62); I2 = 37.00% | 15 RCTs and comparative observational studies; 6571 patients |
| Pain relief | 2 h | 1.93 (1.82-2.04); I2 = 67.00% | 20 RCTs and comparative observational studies; 7811 patients | |
| Sustained pain free | 1 d | 2.81 (2.30-3.44); I2 = 31.00% | 5 RCTs and comparative observational studies, 2891 patients | |
| Sustained pain relief | 1 d | 2.12 (1.87-2.39); I2 = 0.00% | 5 RCTs and comparative observational studies; 4116 patients | |
| Improved function | 2 h | 1.87 (1.65-2.11); I2 = 0.00% | 6 RCTs and comparative observational studies; 1827 patients | |
| Sumatriptan, 6 mg (subcutaneous) vs placebo17 | Pain free | 2 h | 3.85 (3.32-4.46); I2 = 62.00% | 11 RCTs and comparative observational studies; 2522 patients |
| Pain relief | 2 h | 2.50 (2.29-2.73); I2 = 75.00% | 12 RCTs and comparative observational studies; 2738 patients | |
| Sustained pain free | 1 d | 2.18 (1.61-2.95) | 2 RCTs and comparative observational studies; 752 patients | |
| Restored function | 2 h | 3.40 (2.66-4.35) | 2 RCTs and comparative observational studies; 750 patients | |
| Improved function | 2 h | 3.21 (2.68-3.84) | 3 RCTs and comparative observational studies; 1328 patients | |
| NSAIDs | ||||
| Diclofenac, 50 mg (oral) vs placebo18 | Pain free | 2 h | 2.02 (1.57-2.61); I2 = 63.00% | 2 RCTs; 1477 patients |
| Pain relief | 2 h | 1.47 (1.31-1.65); I2 = 0.00% | 2 RCTs; 1477 patients | |
| Sustained pain free | 1 d | 2.25 (1.68-3.01); I2 = 45.00% | 2 RCTs; 1578 patients | |
| Restored function | 2 h | 2.36 (1.80-3.08); I2 = 0.00% | 2 RCTs; 873 patients | |
| Ibuprofen, 400 mg (oral) vs placebo19 | Pain free | 2 h | 1.91 (1.60-2.28); I2 = 81.00% | 6 RCTs; 2575 patients |
| Pain relief | 2 h | 2.17 (1.92-2.45); I2 = 92.00% | 7 RCTs; 1815 patients | |
| Sustained pain relief | 1 d | 2.17 (1.76-2.69); I2 = 75.00% | 4 RCTs; 879 patients | |
| Improved function | 2 h | 1.61 (1.38-1.89); I2 = 78.00% | 3 RCTs; 1114 patients | |
| Aspirin (oral) vs placebo20 | Pain free | 2 h | 2.08 (1.70-2.55); I2 = 0.00% | 6 RCTs; 2027 patients |
| Pain relief | 2 h | 1.64 (1.48-1.83); I2 = 0.00% | 6 RCTs; 2027 patients | |
| Sustained pain relief | 1 d | 1.63 (1.37-1.95); I2 = 0.00% | 3 RCTs; 1142 patients | |
| Triptans plus NSAIDs | ||||
| Sumatriptan (oral) plus naproxen (oral) vs placebo21 | Pain free | 2 h | 3.65 (2.97-4.49); I2 = 38.00% | 4 RCTs; 2596 patients |
| Pain relief | 2 h | 2.16 (1.95-2.39); I2 = 0.00% | 4 RCTs; 2596 patients | |
| Sustained pain free | 1 d | 3.43 (2.69-4.36); I2 = 0.00% | 4 RCTs; 2596 patients | |
| Sustained pain relief | 1 d | 2.61 (2.27-2.99); I2 = 0.00% | 4 RCTs; 2596 patients | |
| Improved function | 2 h | 3.36 (2.63-4.29); I2 = 0.00% | 3 RCTs; 1984 patients | |
Abbreviations: NSAID, nonsteroidal anti-inflammatory drug; RCT, randomized clinical trial; RD, risk difference; RR, relative risk.
a
Results extracted from existing systematic reviews with various details. Data are RR (95% CI) unless otherwise noted.