Association between proton pump inhibitor use and migraine: a systematic review and meta-analysis.

IF 7.3 1区医学 Q1 CLINICAL NEUROLOGY

Journal of Headache and Pain Pub Date : 2025-03-28 DOI:10.1186/s10194-025-02000-8

Prakasini Satapathy, Mahalaqua Nazli Khatib, Nasir Vadia, Soumya V Menon, Kattela Chennakesavulu, Rajashree Panigrahi, Muhammed Shabil, Mahendra Singh, Sanjit Sah, Doddolla Lingamaiah, Khang Wen Goh, Edward Mawejje, Ganesh Bushi

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引用次数: 0

Abstract

Background: Migraine is a common neurological disorder with potential pharmacological triggers. Proton pump inhibitors (PPIs), commonly prescribed for managing gastroesophageal reflux disease and other acid-related gastrointestinal disorders, have been linked to headaches. However, their association with migraine remains unclear. This systematic review and meta-analysis assessed the association between PPI use and the incidence of migraine.

Method: A systematic search of PubMed, Embase, and Web of Science was conducted in accordance with the PRISMA framework and registered with PROSPERO (ID: CRD42025644604) to enhance transparency. The search, conducted up to January 2024, included studies focusing on the association between migraine and PPI use. Data screening and extraction were performed using Nested Knowledge software. Meta-analyses were conducted in R software, with heterogeneity assessed through the I² statistic. Pooled adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Sensitivity analyses were also performed to assess the robustness of the results. Gender and migraine subtype were considered in subgroup analyses. Additionally, the GRADE approach was applied to assess the certainty of the evidence across the pooled outcomes.

Results: Five studies involving over 1.5 million participants met the inclusion criteria. The overall pooled adjusted odds ratio (aOR) was 2.508 (95% CI, 0.790-7.969; I² = 91.2%). However, there was a significant association in males (aOR, 3.875; 95% CI, 2.413-6.222; I² = 0%) but not in females (aOR, 2.475; 95% CI, 0.563-10.890; I² = 91.1%). No significant differences were found between migraine types: with aura (aOR, 2.079; 95% CI, 0.945-4.576; I² = 25.4%) and without aura (aOR, 2.524; 95% CI, 0.807-7.896; I² = 96.5%). The GRADE assessment indicated a very low certainty of the evidence.

Conclusion: This review found no significant overall association between PPI use and migraine. However, a significant association was observed in males but not in females. Further research is needed to clarify this association and explore the underlying causality mechanisms, and migraine subtypes, particularly why the association appears more pronounced in males.

Clinical trial number: Not applicable.

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质子泵抑制剂的使用与偏头痛的关系：一项系统回顾和荟萃分析。

背景：偏头痛是一种常见的神经系统疾病，具有潜在的药理诱因。质子泵抑制剂（PPIs）通常用于治疗胃食管反流疾病和其他与酸相关的胃肠道疾病，与头痛有关。然而，它们与偏头痛的关系尚不清楚。本系统综述和荟萃分析评估了PPI使用与偏头痛发病率之间的关系。方法：按照PRISMA框架对PubMed、Embase和Web of Science进行系统检索，并在PROSPERO注册（ID: CRD42025644604）以提高透明度。这项研究一直进行到2024年1月，包括关注偏头痛和PPI使用之间关系的研究。使用Nested Knowledge软件进行数据筛选和提取。采用R软件进行meta分析，通过I²统计量评估异质性。采用随机效应模型计算合并校正优势比（aor）和95%置信区间（ci）。还进行敏感性分析以评估结果的稳健性。在亚组分析中考虑性别和偏头痛亚型。此外，GRADE方法被用于评估合并结果证据的确定性。结果：5项超过150万参与者的研究符合纳入标准。总合并校正优势比（aOR）为2.508 (95% CI, 0.790-7.969；I²= 91.2%)。然而，男性存在显著相关性(aOR, 3.875；95% ci, 2.413-6.222；I²= 0%)，但女性没有(aOR, 2.475；95% ci, 0.563-10.890；I²= 91.1%)。两种偏头痛类型间无显著差异：先兆偏头痛(aOR, 2.079；95% ci, 0.945-4.576；I²= 25.4%)，无先兆(aOR, 2.524；95% ci, 0.807-7.896；I²= 96.5%)。GRADE评估表明证据的确定性非常低。结论：本综述发现PPI的使用与偏头痛之间没有显著的总体关联。然而，在男性中观察到显著的关联，而在女性中则没有。需要进一步的研究来澄清这种关联，并探索潜在的因果机制和偏头痛亚型，特别是为什么这种关联在男性中更为明显。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Headache and Pain 医学-临床神经学

CiteScore

11.80

自引率

13.50%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.