Feverfew for preventing migraine

Pittler MH, Ernst E

Published Online:

January 21, 2009

Feverfew (Tanacetum parthenium L.) extract is a herbal remedy used for preventing attacks of migraine. Five trials were identified that assessed the efficacy of feverfew (taken as an oral preparation) compared with placebo. Results from these trials were mixed and did not convincingly establish that feverfew is more effective than placebo for preventing migraine. No major side effects were associated with feverfew in the included studies. Further large and rigorously conducted trials are needed.

Abstract (click to read)

Background:

Feverfew (Tanacetum parthenium L.) extract is a herbal remedy used for preventing attacks of migraine.

Objectives:

To systematically review the evidence from double-blind randomised controlled trials (RCTs) assessing the clinical efficacy and safety of feverfew versus placebo for preventing migraine.

Search strategy:

Publications describing (or which might describe) double-blind RCTs of feverfew extract for migraine were sought through the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 2, 2003); PREMEDLINE/MEDLINE (1966 to July 2003); EMBASE (1974 to July 2003); the trials register of the Cochrane Pain, Palliative and Supportive care group (July 2003); and AMED (1985 to July 2003). Manufacturers of feverfew were contacted and the bibliographies of identified articles checked for further trials.

Selection criteria:

Randomised, placebo-controlled, double-blind trials assessing the efficacy of feverfew for preventing migraine were included. Trials using clinical outcome measures were included. Trials focusing exclusively on physiological parameters were excluded. There were no restrictions regarding the language of publication.

Data collection and analysis:

Data on patients, interventions, methods, outcome measures, results and adverse events were extracted systematically. Methodological quality was evaluated using the scoring system developed by Jadad and colleagues. Two reviewers independently selected studies, assessed methodological quality and extracted data. Disagreements concerning evaluation of individual trials were resolved through discussion.

Main results:

Five trials (343 patients) met the inclusion criteria. Results from these trials were mixed and did not convincingly establish that feverfew is efficacious for preventing migraine. Only mild and transient adverse events were reported in the included trials.

Authors' conclusions:

There is insufficient evidence from randomised, double-blind trials to suggest an effect of feverfew over and above placebo for preventing migraine. It appears from the data reviewed that feverfew presents no major safety problems.

This record should be cited as:

Pittler MH, Ernst E. Feverfew for preventing migraine. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD002286. DOI: 10.1002/14651858.CD002286.pub2

Assessed as up to date:

July 25, 2003

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Primary Review Group:

Pain, Palliative and Supportive Care Group

Health topics:

Neurology > Headache & migraine > Prevention

Complementary & alternative medicine > Neurology > Headache & migraine

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Independent high-quality evidence for health care decision making

Feverfew for preventing migraine

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