Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Guideline Adherence in Clinical Trials of Chronic Migraine

Most clinical trials that examine the efficacy of preventive treatments in chronic migraine in adults adhere to the recommendations of the 2008 International Headache Society (IHS); however, adherence to migraine-specific recommendations was lower. This according to a review in which researchers used a 13-item scoring system enlisting essential recommendations adapted from the guidelines to evaluate trial quality. They found:

  • Of 3,352 retrieved records, 16 were included in the analysis.
  • The median score was 6.5 (range 2‒13).
  • All trials were randomized, with most (81.25%) placebo-controlled and double-blinded (87.5%).
  • Adherence was lowest on: a priori definition of outcomes (31.25%), primary endpoint definition (37.5%), and trial registration (37.5%).


Deen M, Martinelli D, Pijpers J, et al. Adherence to the 2008 IHS guidelines for controlled drugs for the preventive treatment of chronic migraine in adults. [Published online ahead of print May 1, 2019]. Cephalalgia. doi: 10.1177/0333102419847751.