To determine the comparative effectiveness and safety of all available preventive treatments for vestibular migraine, including pharmacological and non-pharmacological options, using network meta-analysis.
Key Findings:
All medications significantly reduced vertigo attacks, indicating their effectiveness in managing vestibular migraine.
Propranolol showed the largest benefits among traditional migraine preventives, suggesting its potential as a first-line treatment.
CGRP antibody galcanezumab demonstrated the strongest evidence quality and best tolerability, highlighting its promise in clinical use.
Interpretation:
The analysis aids clinicians and patients in choosing treatments by balancing effectiveness, evidence quality, and side effects, highlighting the need for direct comparisons of promising treatments.
Limitations:
Potential bias due to varying diagnostic criteria over time and in study selection.
Limited number of head-to-head trials for comprehensive comparisons, affecting the robustness of conclusions.
Risk of bias in included studies, particularly in observational studies.
Conclusion:
The findings underscore the importance of further direct comparison studies to enhance clinical guidance for vestibular migraine treatments, ultimately improving patient outcomes.
