Frontiers in Pharmacology最新文献

{"title":"Traditional utilization, botany, phytochemistry, pharmacology, pharmaceutical analysis, processing and application of the seeds of <i>Herpetospermum pedunculosum</i> (Ser.) C.B. Clarke: a comprehensive review.","authors":"Zhixia Jiang, Chuang Zhang, Xinran Yu, Kaiyi Wang, Zhenqi Sang, Wan Gong, Qiaoyan Zhang, Xiongyu Meng, Lupin Qin, Qiming Zhao","doi":"10.3389/fphar.2024.1498768","DOIUrl":"10.3389/fphar.2024.1498768","url":null,"abstract":"<p><p>The seed of <i>Herpetospermum pedunculosum</i> (Ser.) C.B. Clarke, known in Chinese as Bo-Leng-Gua-Zi and in Tibetan as Sejimedo, are here abbreviated as <i>H. pedunculosum</i> seeds. <i>Herpetospermum pedunculosum</i> seeds is a traditional Chinese medicine for protecting the liver, clearing heat, and detoxifying. A total of 125 chemical metabolites of <i>H. pedunculosum</i> seeds are found, including lignans, fatty acids, terpenes, coumarins, and others. The pharmacological activities of <i>H. pedunculosum</i> seeds are mainly in hepatoprotective, antioxidant, anti-cancer cells, and anticholestatic effects. In clinical application, it is mainly used in combination with other traditional Chinese medicines to play a key role in treating the liver disease. This paper gives a systematic review of above research aspects, proposes the potential limitations and put forward plausible solutions. Relevant literatures were searched in PubMed, Web of Science and Chinese National Knowledge Infrastructure with <i>Herpetospermum</i> as the key word. A number of studies have shown that <i>H. pedunculosum</i> seeds exert excellent hepatoprotective effects by acting on NF-κB, TGF-β, and Keap1-Nrf2 signaling pathways, which provide a solid base for its clinic application. However, more research is needed to explore the standard cultivation and quality evaluation of <i>H. pedunculosum</i> seeds and systematical structure-activity relationship of its active metabolites.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1498768"},"PeriodicalIF":4.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxylipins as therapeutic indicators of herbal medicines in cardiovascular diseases: a review.","authors":"Mengqi Li, Min He, Mengmeng Sun, Yongping Li, Mengyuan Li, Xiaobo Jiang, Yanxin Wang, Hongfeng Wang","doi":"10.3389/fphar.2024.1454348","DOIUrl":"10.3389/fphar.2024.1454348","url":null,"abstract":"<p><p>Globally, cardiovascular diseases (CVDs) remain the leading cause of death, and their prevention and treatment continue to face major challenges. Oxylipins, as novel circulating markers of cardiovascular disease, are crucial mediators linking cardiovascular risk factors such as inflammation and platelet activation, and they play an important role in unraveling cardiovascular pathogenesis and therapeutic mechanisms. Chinese herbal medicine plays an important role in the adjuvant treatment of cardiovascular diseases, which has predominantly focused on the key pathways of classic lipids, inflammation, and oxidative stress to elucidate the therapeutic mechanisms of cardiovascular diseases. However,The regulatory effect of traditional Chinese medicine on oxylipins in cardiovascular diseases remains largely unknown. With the increasing number of recent reports on the regulation of oxylipins by Chinese herbal medicine in cardiovascular diseases, it is necessary to comprehensively elucidate the regulatory role of Chinese herbal medicine in cardiovascular diseases from the perspective of oxylipins. This approach not only benefits further research on the therapeutic targets of Chinese herbal medicine, but also brings new perspectives to the treatment of cardiovascular diseases.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1454348"},"PeriodicalIF":4.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting posaconazole plasma concentrations: a meta-analysis and systematic review.","authors":"Ruochen Qu, Yan Liu, Yan Zhao, Ziyi Wang, Shizhao Yuan, Shuai Liu, Jing Yu","doi":"10.3389/fphar.2024.1450120","DOIUrl":"10.3389/fphar.2024.1450120","url":null,"abstract":"<p><strong>Background: </strong>Posaconazole is a potent antifungal agent widely used to manage invasive fungal infections, especially in immunocompromised individuals. Achieving optimal therapeutic concentrations of posaconazole can be challenging due to interpatient variability, the availability of multiple formulations, and various dosing strategies.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, EMBASE, and the Cochrane Library to identify studies evaluating factors that influence blood concentrations of posaconazole. The primary outcome was the assessment of posaconazole concentrations in relation to various influencing factors, including age, sex, drug interactions, disease state, administered dose, and formulation.</p><p><strong>Results: </strong>Our analysis included 46 studies involving a total of 8,505 patients. Co-administration of drugs that affect posaconazole metabolism significantly reduced its concentrations. High-fat meals, age, and sex did not have a significant impact on posaconazole oral suspension (POS) concentrations. Diarrhea substantially decreased concentrations of both delayed-release tablets (DRT) and POS. Neither vomiting nor mucositis significantly affected POS concentrations. Acid-suppressing agents, such as H2 receptor antagonists and proton pump inhibitors, notably decreased POS concentrations but had no significant effect on DRT. Comparative studies of different dosage forms revealed significantly higher concentrations with DRT compared to POS.</p><p><strong>Conclusion: </strong>DRT maintain more stable concentrations than POS and are not affected by acid-suppressing drugs. Given the significant fluctuations in posaconazole concentrations, patients experiencing diarrhea require close monitoring.</p><p><strong>Systematic review registration: </strong>PROSPERO, Identifier CRD42023428822 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023428822).</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1450120"},"PeriodicalIF":4.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pharmacovigilance study of the association between proton pump inhibitors and tumor adverse events based on the FDA adverse event reporting system database.","authors":"Ya-Jun Zhang, Dan-Dan Duan, Qian-Yu Tian, Cai-E Wang, Shu-Xun Wei","doi":"10.3389/fphar.2024.1524903","DOIUrl":"10.3389/fphar.2024.1524903","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are effective treatments for acid-related disorders but may pose tumor risks with long-term use. Current research on PPI-associated tumor adverse events (TAEs) is limited and inconclusive. This study aims to comprehensively analyze the relationship between PPIs and TAEs.</p><p><strong>Methods: </strong>We analyzed PPI adverse reaction reports from the FDA Adverse Event Reporting System (FAERS) database spanning from 2004 to 2024, focusing on five commonly used PPIs: esomeprazole, pantoprazole, lansoprazole, omeprazole, and rabeprazole. We conducted a disproportionality analysis utilizing the Reporting Odds Ratio (ROR) to identify potential TAEs associated with PPIs. We conducted univariate logistic regression analysis to explore the influencing factors.</p><p><strong>Results: </strong>A total of 3,133 TAEs were identified, representing 2.36% of all PPI-related adverse events (AEs). The most common TAEs were gastric cancer (19.05%) and malignant neoplasm (7.23%). Disproportionality analysis revealed ten significant TAEs associated with PPIs, including gastric adenocarcinoma and renal cell carcinoma. The median age of those reporting TAEs was 59 (interquartile range [IQR]: 51-70), and 29.70% of them resulted in a fatality. TAEs associated with PPIs were less likely to occur in elderly patients (65-75: OR = 0.91 [0.87-0.95], <i>p</i> < 0.001; >75: OR = 0.93 [0.89-0.98], <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>TAEs constitute a small but significant fraction of PPI-related AEs. This study highlights the need for cautious long-term use of PPIs and further research to understand the underlying mechanisms and risk factors. Clinicians should be aware of the potential tumor risks associated with prolonged PPI treatment.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1524903"},"PeriodicalIF":4.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microglial adenosine A_2A receptor in the paraventricular thalamic nucleus regulates pain sensation and analgesic effects independent of opioid and cannabinoid receptors.","authors":"Yiping Cao, Zhou Wu, Moruo Zhang, Ran Ji, Hongxing Zhang, Lingzhen Song","doi":"10.3389/fphar.2024.1467305","DOIUrl":"10.3389/fphar.2024.1467305","url":null,"abstract":"<p><strong>Introduction: </strong>The paraventricular thalamic nucleus (PVT) is recognized for its critical role in pain regulation, yet the precise molecular mechanisms involved remain poorly understood. Here, we demonstrated an essential role of the microglial adenosine A_2A receptor (A_2AR) in the PVT in regulating pain sensation and non-opioid analgesia.</p><p><strong>Method and results: </strong>Specifically, A_2AR was predominantly expressed in ionized calcium binding adapter molecule 1 (Iba1)-positive microglia cells within the PVT, with expression levels remaining unchanged in mice experiencing persistent inflammatory pain induced by complete Freund's adjuvant (CFA). Pharmacological activation of local PVT A_2AR with its agonist CGS21680 induced significantly decreased 50% paw withdrawal threshold (50%PWTs) and paw withdrawal latency (PWLs), as measured by the Von Frey test and Hargreaves test in adult mice. Conversely, intra-PVT infusion of A_2AR antagonist SCH58261 increased 50%PWTs and PWLs in mice; a robust analgesic effect was also observed in CFA mice with inflammatory pain. Importantly, these analgesic effects of A_2AR antagonist SCH58261 were not affected by adjunctive intraperitoneal administration of naloxone or rimonabant, inhibitors of opioid receptor and cannabinoid CB1 receptor (CB1R), respectively.</p><p><strong>Discussion: </strong>Overall, these pharmacological experiments underscore an essential role of microglia-expressed A_2AR with in PVT in pain sensation while revealing a novel analgesic action independent of opioid and cannabinoids receptors. Thus, these findings highlight PVT microglial adenosine A_2A receptor as a promising target for novel approaches to pain modulation and future analgesic development.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1467305"},"PeriodicalIF":4.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of echinocandins combination therapy with the standard of care compared to the standard of care monotherapy for the treatment of invasive aspergillosis infection: a meta-analysis.","authors":"Yazed Saleh Alsowaida, Bader Alshoumr, Shuroug A Alowais, Khalid Bin Saleh, Alia Alshammari, Kareemah Alshurtan, Haytham A Wali","doi":"10.3389/fphar.2024.1500529","DOIUrl":"10.3389/fphar.2024.1500529","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis aims to evaluate the effectiveness and safety of combining echinocandins with standard of care (SOC) antifungal drugs for treating invasive aspergillosis infection (IAI).</p><p><strong>Method: </strong>We searched PubMed, Embase, and Cochrane Library from their inception to 25 July 2024. Our outcomes included clinical cure, mortality, and adverse drug reactions (ADRs). We compared echinocandins in combination with SOC antifungal agents against SOC monotherapy therapy. We used the random-effects model for the meta-analysis, and our estimated effects were reported as odds ratios (ORs) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Ten studies were included in our meta-analysis comprising 1100 patients: 415 were in the echinocandin combination groups, and 685 were in the SOC groups. The clinical cure rate (OR 1.35, 95% CI: 0.75-2.42, <i>p</i> = 0.27), mortality (OR 0.90, 95% CI: 0.50-1.63, <i>p</i> = 0.73), and ADRs rate (OR 0.95, 95% CI: 0.49-1.82, <i>p</i> = 0.87) were not statistically different in echinocandins combination with SOC compared to SOC monotherapy. Notably, there is a signal for a better clinical cure rate in echinocandins in combination with SOC.</p><p><strong>Conclusion: </strong>Our meta-analysis found no differences in clinical cure and mortality rate when using combination therapy of echinocandin antifungal agents with the SOC compared to SOC monotherapy. However, there is a signal for better outcomes with the echinocandins combination group. The ADRs in the echinocandins combination group were not worse than SOC monotherapy.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1500529"},"PeriodicalIF":4.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marine-derived polysaccharides: the potential agents against neurodegenerative diseases.","authors":"Lin Zhu, Yuqian Ren, Shenghan Zhang, Yunliang Guo, Jinbao Zong, Yingjuan Liu","doi":"10.3389/fphar.2024.1506789","DOIUrl":"10.3389/fphar.2024.1506789","url":null,"abstract":"<p><p>Neurodegenerative diseases are primarily characterized by the selective loss of neurons in the brain, leading to a significant and widespread global public health burden. Although numerous mechanisms underlying neurodegenerative diseases have been elucidated, effective therapeutic strategies are still being explored. Several drugs have been proposed to halt disease progression; however, they often come with severe side effects. Recently, polysaccharides have garnered considerable attention due to their antioxidant, anti-neuroinflammatory, anticholinesterase, and anti-amyloidogenic properties. The ocean contains a large number of animals, plants, algae and fungal species. Its rich sources and wide availability make the research on marine drugs become a hot topic. Recently, polysaccharides dominated by fucoidan and chitosan have been reported to inhibit the progression of neurodegenerative diseases in a variety of ways. In this review article, we provide a comprehensive summary of reported polysaccharides that intervene in neurodegenerative diseases with the aim of exploring their potential as therapeutic agents.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1506789"},"PeriodicalIF":4.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Literature review analysis of aortitis induced by granulocyte-colony stimulating factor.","authors":"Ting Zhao, Huanhuan Xu","doi":"10.3389/fphar.2024.1487501","DOIUrl":"10.3389/fphar.2024.1487501","url":null,"abstract":"<p><strong>Background: </strong>Recombinant human granulocyte-colony stimulating factors (G-CSF)-induced aortitis is a rare but particularly serious adverse event, commonly seen in cancer patients undergoing chemotherapy. The aim of this article is to clarify the clinical characteristics of G-CSF- induced aortitis and provide effective references for clinical diagnosis and intervention.</p><p><strong>Methods: </strong>Case reports of adverse reactions of aortitis induced by G-CSF were collected from the relevant databases. The patients' basic information and adverse reaction process were recorded and subjected to descriptive analysis.</p><p><strong>Results: </strong>A total of 72 patients were enrolled, including 14 males and 58 females, with a mean age of 61.83 ± 10.30 years. The G-CSF type with the highest frequency of occurrence of aortitis is pegfilgrastim. Apart from three healthy stem cell donors, G-CSF-induced aortitis was primarily found in patients with underlying malignancies, especially in patients with breast cancer. The most common anticancer drugs used at onset were docetaxel, cyclophosphamide, and doxorubicin. CT scan showed that aortitis most commonly occured in the aortic arch and its branches. Most patients had a good prognosis, but 3 cases developed complications. Importantly, G-CSF-induced aortitis was also found in 4 asymptomatic patients.</p><p><strong>Conclusion: </strong>This article found that G-CSF-induced aortitis not only occured in cancer patients undergoing chemotherapy as previously reported in literature, but also in healthy stem cell donors. Especially, asymptomatic patients with G-CSF-induced aortitis faced a greater risk of being missed by the attending physician.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1487501"},"PeriodicalIF":4.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteomic study of the inhibitory effects of tannic acid on MRSA biofilm.","authors":"Yang Miao, Wang Shuang, Qu Qianwei, Liu Xin, Peng Wei, Yang Hai, Zhou Yonghui, Yu Xinbo","doi":"10.3389/fphar.2024.1413669","DOIUrl":"10.3389/fphar.2024.1413669","url":null,"abstract":"<p><strong>Introduction: </strong>The mechanism of tannic acid (TA) intervention on methicillin-resistant <i>Staphylococcus aureus</i> (MRSA, USA 300) biofilm formation was explored using proteomics.</p><p><strong>Methods: </strong>The minimum inhibitory concentration (MIC) of TA against the MRSA standard strain USA 300 was determined by two-fold serial dilution of the microbroth. The effects of TA were studied using crystal violet staining. The morphology of TA-treated USA 300 cells was observed by scanning electron microscopy and confocal laser scanning microscopy. Differentially expressed proteins (DEPs) were screened using proteomic and biological information analyses, and their transcriptional levels were verified using real-time quantitative polymerase chain reaction.</p><p><strong>Results: </strong>The MIC of TA was 0.625 mg/mL, whereas 1/2 MIC (0.3125 mg/mL) of TA significantly inhibited biofilm formation without affecting the bacterial growth (<i>p</i> < 0.01) and prevented the formation of a complete three-dimensional biofilm structure. Using 1/2 MIC of TA, 208 DEPs were identified, of which 127 were upregulated and 81 were downregulated. The transcriptional levels of the genes corresponding to five randomly selected DEPs (<i>glnA, ribD, clpB, gap,</i> and <i>lukE</i>) were consistent with the proteomics data (<i>p</i> < 0.05). Bioinformatic analysis showed that the changes in the MRSA strains after TA intervention primarily involved pyrimidine and purine metabolisms, arginine biosynthesis, and the citric acid cycle.</p><p><strong>Conclusion: </strong>TA exerts an antibacterial effect on MRSA and can be used as a potential candidate for the development of anti-biofilm drugs, thereby laying a foundation for the treatment of MRSA biofilm-induced infections.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1413669"},"PeriodicalIF":4.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of memantine in adult migraine: a systematic review and network meta-analysis to compare memantine with existing migraine preventive medications.","authors":"Guanglu Li, Baoquan Qu, Tao Zheng, Shaojie Duan, Lei Liu, Zunjing Liu","doi":"10.3389/fphar.2024.1496621","DOIUrl":"10.3389/fphar.2024.1496621","url":null,"abstract":"<p><strong>Background: </strong>While memantine has been considered a promising drug for migraine prevention, no conclusive evidence exists comparing its efficacy with other migraine-preventive medications. This network meta-analysis (NMA) aimed to access the effectiveness and acceptability of memantine and other guideline-recommended prophylactic agents for migraine.</p><p><strong>Methods: </strong>We searched the Cochrane Register of Controlled Trials, Embase, PubMed, and ClinicalTrials databases from their inception to 1 June 2024. Randomized placebo-controlled trials (RCTs) examining the pharmacological prevention of adult migraine patients were included. The primary efficacy outcome was the change in migraine days, and the primary safety outcome was withdrawal due to adverse events. Secondary outcomes included 50% response rates and frequency of any adverse events. The analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.</p><p><strong>Results: </strong>Thirty-eight RCTs, including a total of 13,223 participants, were analyzed. Our analysis showed that memantine demonstrated the second-largest reduction in migraine days [standardized mean difference (SMD): -0.83; 95% confidence interval (CI): -1.26, -0.41 compared with placebo] and the highest 50% response rates [odds ratio (OR): 5.58, 95% CI: 1.31 to 23.69] in all studied interventions. Moreover, among all interventions, memantine appeared to show the lowest dropout rate and moderate frequency of adverse events. However, its confidence intervals contained null values.</p><p><strong>Conclusion: </strong>This study provides prioritisation evidence for memantine in migraine prevention, as memantine can significantly decrease the frequency of migraine attacks, improves response rates, and fair acceptability. These beneficial effects were not inferior to currently recommended pharmacological regimens. However, due to the lack of long-term efficacy and safety data, as well as few direct comparisons with active control agents, the estimates of memantine may be overly optimistic. Clinicians should interpret the findings of current NMA cautiously and apply them in a relatively conservative manner.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"15 ","pages":"1496621"},"PeriodicalIF":4.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11688350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}