The effectiveness of aspirin for migraine prophylaxis: a systematic review

• Published in: São Paulo medical journal Vol. 135; no. 1; pp. 42 - 49
• Main Authors: Baena, Cristina Pellegrino, D'Amico, Raíssa Campos, Slongo, Helena, Brunoni, André Russowsky, Goulart, Alessandra Carvalho, Benseñor, Isabela
• Format: Journal Article
• Language: English
• Published: Brazil Associação Paulista de Medicina - APM 01-01-2017; Associação Paulista de Medicina
• Subjects: Aspirin - administration & dosage; Aspirina; Cefaleia; Female; Humans; Inibidores da agregação de plaquetas; Male; MEDICINE, GENERAL & INTERNAL; Migraine Disorders - prevention & control; Platelet Aggregation Inhibitors - administration & dosage; Revisão; Terapêutica; Transtornos de enxaqueca; Terapêutica; Headache; Aspirina; Revisão; Aspirin; Migraine disorders; Cefaleia; Inibidores da agregação de plaquetas; Review [publication type]; Transtornos de enxaqueca; Therapeutics; Platelet aggregation inhibitors
• ISSN: 1516-3180; 1806-9460; 1806-9460; 1516-3180
• DOI: 10.1590/1516-3180.2016.0165050916

Many researchers have suggested that aspirin prevents migraines. However, the evidence is unclear. The aim of this study was to analyze the available evidence on the effect of aspirin as a migraine prophylactic.
Systematic review, conducted at the Pontifícia Universidade Católica do Paraná, Brazil, and at the University of São Paulo, Brazil.
We performed electronic searches in the databases of MEDLINE/PubMed, Embase, WEB OF SCIENCE, the World Health Organization, CENTRAL and OpenGrey, and we also searched manually for interventional studies published before April 2016 that compared the effects of aspirin with a control, in adults. Two authors independently extracted data on the publication, population recruited, intervention (aspirin dosage, follow-up and combined treatment) and main outcomes (frequency, severity and duration of migraine). We evaluated the quality of the studies using the Cochrane risk-of-bias tool.
Our search retrieved 1,098 references, of which 8 met the selection criteria for this systematic review. The total population was 28,326 participants (18-64 years old); most (96%) were men. The dosage varied from 50 to 650 mg/day across the studies. The risk of bias was generally low or unclear. The only outcome for which most of the studies included (6/8) reported a significant reduction was frequency of migraine, which was reduced at an aspirin dosage of at least 325 mg/day.
Aspirin can reduce the frequency of migraines. However, the optimal dosage is unclear.