Evidence map›Paper›PMID 39639191›Full record

ReviewThe journal of headache and pain2024

Combining treatments for migraine prophylaxis: the state-of-the-art.

Lanfranco Pellesi, David Garcia-Azorin, Eloisa Rubio-Beltrán, Wook-Seok Ha, Roberta Messina, Raffaele Ornello, Igor Petrusic, Bianca Raffaelli, Alejandro Labastida-Ramirez, Ruth Ruscheweyh and 5 more

Erratum issuedAbstract readReview
In one paragraph

Review in The journal of headache and pain, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Observational
  5. Article
  6. Botulinum toxin for chronic migraine.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  7. Review
  8. Article
  9. Article
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Non-invasive brain stimulation for neuropathic orofacial pain: a mini-review.Frontiers in pain research (Lausanne, Switzerland) · 2026
    Review
  17. Review
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Lanfranco PellesiDepartment of Public Health, Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Campusvej 55, Odense, 5230, Denmark. lpellesi@health.sdu.dk.
David Garcia-AzorinDepartment of Medicine, Toxicology and Dermatology, Faculty of Medicine, University of Valladolid, Valladolid, Spain.
Eloisa Rubio-BeltránHeadache Group, Wolfson Sensory, Pain and Regeneration Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Wook-Seok HaDepartment of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Roberta MessinaNeuroimaging Research Unit and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Raffaele OrnelloDepartment of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
Igor PetrusicLaboratory for Advanced Analysis of Neuroimages, Faculty of Physical Chemistry, University of Belgrade, Belgrade, Serbia.
Bianca RaffaelliDepartment of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Alejandro Labastida-RamirezDivision of Neuroscience, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, United Kingdom.
Ruth RuscheweyhDepartment of Neurology, LMU University Hospital, LMU Munich, Munich, Germany.
Claudio TanaCenter of Excellence on Headache, Geriatrics Clinic, Ss. Annunziata of Chieti, Italy.
Doga VuralliDepartment of Neurology and Algology, Faculty of Medicine, Gazi University, Ankara, Türkiye.
Marta Waliszewska-ProsółDepartment of Neurology, Wroclaw Medical University, Wroclaw, Poland.
Wei WangDepartment of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
William Wells-GatnikDepartment of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Combination treatments for migraine prophylaxis present a promising approach to addressing the diverse and complex mechanisms underlying migraine. This review explores the potential of combining oral conventional prophylactics, onabotulinumtoxin A, monoclonal antibodies (mAbs) targeting the calcitonin gene-related peptide (CGRP) pathway, and small molecule CGRP receptor antagonists (gepants). Among the most promising strategies, dual CGRP inhibition through mAbs and gepants may enhance efficacy by targeting both the CGRP peptide and its receptor, while the combination of onabotulinumtoxin A with CGRP treatments offers synergistic pain relief. Oral non-CGRP treatments, which are accessible and often prescribed for patients with comorbid conditions, provide an affordable and practical option in combination regimens. Despite the potential of these combinations, there is a lack of evidence to support their widespread inclusion in clinical guidelines. The high cost of certain combinations, such as onabotulinumtoxin A with a CGRP mAb or dual anti-CGRP mAbs, presents feasibility challenges. Further large-scale trials are needed to establish safe and effective combination protocols and solidify their role in clinical practice, particularly for treatment-resistant patients.

Indexed as

Botulinum Toxins, Type ACalcitonin Gene-Related Peptide Receptor AntagonistsMigraine DisordersAntibodies, MonoclonalCalcitonin Gene-Related PeptideDrug Therapy, CombinationHumansAntibodies, MonoclonalBotulinum Toxins, Type ACalcitonin Gene-Related PeptideCalcitonin Gene-Related Peptide Receptor Antagonistsonabotulinum toxin ACGRPGepantsOnabotulinumtoxin APropranololRational polytherapyTopiramate

Identifiers

PMID39639191
PMCPMC11619619

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.