Ibuprofen confirmed effective for migraine in children
A systematic review of the management of migraine in children has concluded that ibuprofen is effective in relieving migraine headache in children (Pediatrics 2005;116:e295-e302).

The review, conducted to the standards of the Cochrane Collaboration, included 10 randomised trials involving a total of 1,575 children aged 4 to 18. The primary outcome was clinical improvement in headache, defined as at least a 50 percent reduction in pain severity after 2 hours.

Ibuprofen was significantly better than placebo (relative risk of headache improvement, RR, 1.5; CI95% 1.2 - 1.9). It also greatly reduced the need for rescue medication at 2 hours (RR 0.1, 0.0 - 0.4) with no increase in adverse effects compared with placebo. Paracetamol was similarly effective and there were no significant differences between the two drugs.

Of the alternative agents, there was placebo-controlled evidence of efficacy only for intranasal sumatriptan. Its efficacy was similar to that of ibuprofen but it was associated with a higher risk of adverse effects compared with placebo (RR 2.5, CI95% 1.7 - 3.7).

The authors recommend a large randomised trial to compare the different treatments for migraine in children; this should include quality of life, schooldays missed and child and parent satisfaction ratings among its endpoints.

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