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ORIGINAL RESEARCH article

Front. Pharmacol.
Sec. Neuropharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1407897
This article is part of the Research Topic 'Pain and pain-related neuropsychiatric disorders: from mechanistic insights to innovative therapeutic strategies.' View all articles

Efficacy and Safety of Levetiracetam for Migraine Prophylaxis in Children: A Systematic Review and Meta-Analysis

Provisionally accepted
Jing Peng Jing Peng 1Linhui Liu Linhui Liu 1*Qiaoling LI Qiaoling LI 1Maochang Liu Maochang Liu 1*Rong Zhou Rong Zhou 1*Chen Li Chen Li 1*Zhisheng Liu Zhisheng Liu 2*
  • 1 Department of Pharmacy, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China
  • 2 Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China

The final, formatted version of the article will be published soon.

    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.We reviewed randomized controlled trials (RCTs) and non-RCTs in major databases through January 8, 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.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 to 0.41). Over 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 to 0.24).The most common ADR was irritability (12%), leading to treatment discontinuation in 13% of cases (95% CI: 0.05 to 0.30).Conclusions LEV has shown good efficacy in preventing pediatric migraines. However, its safety requires further confirmation through more extensive and well-designed RCTs.

    Keywords: levetiracetam, Migraine, prophylaxis, Meta-analysis, Children

    Received: 27 Mar 2024; Accepted: 11 Jul 2024.

    Copyright: © 2024 Peng, Liu, LI, Liu, Zhou, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Linhui Liu, Department of Pharmacy, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China
    Maochang Liu, Department of Pharmacy, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China
    Rong Zhou, Department of Pharmacy, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China
    Chen Li, Department of Pharmacy, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China
    Zhisheng Liu, Department of Neurology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hebei Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.