Acupuncture versus tricyclic antidepressants in the prophylactic treatment of tension-type headaches: an indirect treatment comparison meta-analysis.
J Headache Pain
; 25(1): 67, 2024 Apr 29.
Article
em En
| MEDLINE
| ID: mdl-38679721
ABSTRACT
BACKGROUND:
Acupuncture showed better improvement than sham acupuncture in reducing attack frequency of tension-type headache (TTH), but its effectiveness relative to first-line drugs for TTH is unknown, which impedes the recommendation of acupuncture for patients who are intolerant to drugs for TTH. We aimed to estimate the relative effectiveness between acupuncture and tricyclic antidepressants (TCAs) through indirect treatment comparison (ITC) meta-analysis.METHODS:
We searched Ovid Medline, Embase, and Cochrane Library from database inception until April 13, 2023. Randomized controlled trials of TCAs or acupuncture in the prevention of TTH in adults were included. The primary outcome was headache frequency. The secondary outcomes were headache intensity, responder rate, and adverse event rate. Bayesian random-effect models were used to perform ITC meta-analysis, and confidence of evidence was evaluated by using the GRADE approach.RESULTS:
A total of 34 trials involving 4426 participants were included. Acupuncture had similar effect with TCAs in decreasing TTH frequency (amitriptyline mean difference [MD] -1.29, 95% CI -5.28 to 3.02; amitriptylinoxide MD -0.05, 95% CI -6.86 to 7.06) and reducing TTH intensity (amitriptyline MD 2.35, 95% CI -1.20 to 5.78; clomipramine MD 1.83, 95% CI -4.23 to 8.20). Amitriptyline had a higher rate of adverse events than acupuncture (OR 4.73, 95% CI 1.42 to 14.23).CONCLUSION:
Acupuncture had similar effect as TCAs in reducing headache frequency of TTH, and acupuncture had a lower adverse events rate than amitriptyline, as shown by very low certainty of evidence.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Terapia por Acupuntura
/
Cefaleia do Tipo Tensional
/
Antidepressivos Tricíclicos
Limite:
Humans
Idioma:
En
Revista:
J Headache Pain
Assunto da revista:
MEDICINA INTERNA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
China
País de publicação:
Reino Unido