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Summaries of recent papers
  1. Adrian White1,
  2. Prem Bajaj2,
  3. Michael Meinen3,
  4. Amer Sheikh4
  1. 1Primary Care Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
  2. 2Modern Health, Uxbridge, UK
  3. 3Denton Park Medical Group, Denton Park Health Centre, Newcastle Upon Tyne, UK
  4. 4Ashford Health Centre, Ashford Hospital, Ashford, Middlesex, UK
  1. Correspondence to Dr Adrian White, N21 ITTC Building, Tamar Science Park, Plymouth PL6 8BX, UK; Adrian.white{at}pms.ac.uk

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Migraine prophylaxis

▸ Facco E, Liguori A, Petti F, et al. Acupuncture versus valproic acid in the prophylaxis of migraine without aura: a prospective controlled study. Minerva Anestesiol 2013;79:634–42.

An open-label randomised controlled trial (RCT) (n=100).

Methods

A total of 100 consecutive patients with migraine without aura were recruited from outpatient departments in Italy. They were randomised into two equal groups to receive acupuncture (group A), or valproic acid (group V) which is an antiepileptic drug shown to be effective in migraine prophylaxis.

Acupuncture was carried out by experienced practitioners using manual stimulation to achieve de qi and needles retained for 30 min. Acupuncture points were chosen according to Traditional Chinese Medicine (TCM) syndrome theory. Patients in group A received 2 courses of 10 acupuncture treatments, twice a week, with 1 week between the 2 courses. Patients in group V were treated with 600 mg/day of valproic acid for 3 months in order to correlate with the time span taken for treatment in group A. Both groups were allowed to take risatriptan for relief in acute attacks of migraine.

The primary outcome measure was the Midas Index, which measures negative patient experiences including disability, and has been shown to correlate with quality of life. Secondary outcomes included the Pain Relief Score (PRS), risatriptan intake and pain intensity (PI) on a 0–10 scale. Measurements were taken at baseline (T0), and at 3 months (T1) and 6 months (T2) from the start of treatment.

Results

Both groups showed similar and significant improvements in Midas Score at T1 (p=0.1) and T2 (p=0.1) compared to baseline, as well as improvement in the number of days with pain (p=0.63 at T1 and p=0.1 at T2), shown in figure 1. PI was better at T1 in group V (p<0.0001), whereas group A showed better improvement at T2 for PI (p=0.02) and PRS (p=0.02). Risatriptan use …

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