Acupuncture versus placebo versus sumatriptan for early treatment of migraine attacks: a randomized controlled trial

Authors


Abstract

Abstract.  Melchart D, Thormaehlen J, Hager S, Liao J, Linde K, Weidenhammer W (Technical University, Munich, Germany; University Zurich, Switzerland; and Hospital for Traditional Chinese Medicine, Koetzting, Germany). Acupuncture versus placebo versus sumatriptan for early treatment of migraine attacks: a randomized controlled trial. J Intern Med 2003; 253: 181–188.

Objectives.  To investigate whether acupuncture is superior to placebo and equivalent to sumatriptan for the early treatment of an acute migraine attack.

Design.  Randomized, partly double-blind (sumatriptan versus placebo) trial.

Setting.  Two hospitals in Germany (one specialized in traditional Chinese medicine and one in the treatment of headache).

Subjects.  A total of 179 migraineurs experiencing the first symptoms of a developing migraine attack.

Interventions.  Traditional Chinese acupuncture, sumatriptan (6 mg subcutaneously) or placebo injection.

Main outcome measure.  Number of patients in whom a full migraine attack (defined as severe migraine headache) within 48 h was prevented. In patients who developed a migraine attack in spite of early treatment, acupuncture and sumatriptan were applied a second time, whilst patients initially randomized to placebo received sumatriptan.

Results.  A full migraine attack was prevented in 21 of 60 (35%) patients receiving acupuncture, 21 of 58 (36%) patients receiving sumatriptan and 11 of 61 (18%) patients receiving placebo (relative risk of having a full attack 0.79 (95% CI, 0.64–0.99) for acupuncture versus placebo, and 0.78 (95% CI, 0.62–0.98) for sumatriptan versus placebo). Response to the second intervention in patients who developed a full attack was better with sumatriptan (17/31 patients who received sumatriptan twice and 37/46 patients who had had placebo first) than with acupuncture (4/31). The number of patients reporting side-effects was 14 in the acupuncture group, 23 in the sumatriptan group and 10 in the placebo group.

Conclusions.  In this trial acupuncture and sumatriptan were more effective than a placebo injection in the early treatment of an acute migraine attack. When an attack could not be prevented, sumatriptan was more effective than acupuncture at relieving headache.

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