Recent Trends in the Pharmacological Treatment of Chronic Migraine: A Systematic Review of Randomized Controlled Trials.

Chronic migraine is one of the debilitating neurological conditions affecting the lives of several patients. This systematic review aimed to explore the recent trends in the pharmacological treatment of chronic migraine. We conducted this systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The literature search encompassed extensive databases such as PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials. The analysis included studies published from 2014 to 2024, and the quality of the included studies was evaluated using the appropriate tools according to the study design. The synthesis and data analysis included a summary of study characteristics, interventions, outcomes measured, and main study results/conclusions. Sample sizes in the included studies ranged from 1,072 to 2,436 participants. The most common pharmacological treatments used for chronic migraine were eptinezumab, onabotulinumtoxinA, and galcanezumab, which emerged from 14 quality randomized controlled trials. Studies observed significant improvements across various metrics, including headache frequency, severity, quality of life measures, and patient-reported outcomes. The Headache Impact Test-6 score, monthly migraine headache days, Migraine-Specific Quality-of-Life score, and Migraine Disability Assessment score were particularly useful in quantifying the treatment's effectiveness. This systematic review concludes the effectiveness and safety of newer treatments such as eptinezumab, galcanezumab, and onabotulinumtoxinA in managing chronic migraine, illustrating notable improvements in both clinical outcomes and quality of life for patients.