AUTHOR=Peng Jing , Liu Linhui , Li Qiaoling , Liu Maochang , Zhou Rong , Chen Li , Liu Zhisheng TITLE=Efficacy and safety of levetiracetam for migraine prophylaxis in children: a systematic review and meta-analysis JOURNAL=Frontiers in Pharmacology VOLUME=15 YEAR=2024 URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1407897 DOI=10.3389/fphar.2024.1407897 ISSN=1663-9812 ABSTRACT=Background

Levetiracetam (LEV), an antiepileptic drug, has been effective in adult migraine prevention but lacks extensive research in children. This study evaluates LEV’s efficacy and safety for pediatric migraine prophylaxis.

Methods

We reviewed randomized controlled trials (RCTs) and non-RCTs in major databases through 8 January 2024, focusing on four efficacy endpoints and adverse drug reactions (ADRs). Data synthesis involved pooled relative risks or odds ratios for dichotomous outcomes and mean differences for continuous outcomes, using fixed- or random-effects models as appropriate.

Results

Eight studies with 190 participants showed that after taking LEV, the mean headache frequency decreased 5.19 per month (MD: −5.19, 95% CI: −7.11 to −3.27, p < 0.00001) and improved headache-free rates to 28% (95% CI: 0.17–0.41). More than 83% experienced a >50% reduction in monthly headache frequency. The migraine disability score decreased by 33.51 points (MD: −33.51, 95% CI: −38.46 to −28.55, p < 0.00001). ADR incidence did not significantly differ between LEV and control groups (RR: 1.06, 95% CI: 0.39 to 2.85, p = 0.91), with an overall ADR rate of 18% (95% CI: 0.13–0.24). The most common ADR was irritability (12%), leading to treatment discontinuation in 13% of cases (95% CI: 0.05–0.30).

Conclusion

LEV has shown good efficacy in preventing pediatric migraines. However, its safety requires further confirmation through more extensive and well-designed RCTs.

Systematic Review Registration

Identifier PROSPERO CRD42024497643.