title: Intravenous dexketoprofen vs placebo for migraine attack in the emergency department: A randomized, placebo-controlled trial.
abstract: OBJECTIVE
  Migraine is a leading headache etiology that frequently presents to the emergency department (ED). In the present study, we aimed to determine the efficacy of dexketoprofen in aborting migraine headaches in the ED.
  
  
  METHODS
  This prospective, randomized, double-blind study was conducted in an ED of a tertiary care hospital using allocation concealment. Patients were allocated into two arms to receive the study drug; 50 mg dexketoprofen in 50 ml saline and 50 ml saline as placebo. Change in pain intensity was measured by the visual analog scale at baseline, both at 30 and 45 minutes after the study medication was administered. Rescue medication requirement and pain relapse were also recorded by a telephone follow-up at 48 hours.
  
  
  RESULTS
  A total of 224 patients (112 in each group) were included into the final analysis. Mean age of the study participants was 37 ± 11 (SD) and 25% (n = 56) of them were male. The median pain improvement at 45 minutes for patients receiving dexketoprofen was 55 (IQR: 49 to 60) and 30 (IQR: 25 to 35) for those receiving placebo. The mean difference between the two groups at 45 minutes was 21.4 (95% CI: 14.4. to 28.5). Rescue drugs were needed in 22.3% of patients who received dexketoprofen compared to 55.4% in patients who received placebo (dif: 33.1%; 95% CI: 20% to 45%). There were no adverse events reported in either group during the study period.
  
  
  CONCLUSIONS
  Intravenous dexketoprofen is superior to placebo in relieving migraine headaches in the ED. It may be a suitable therapy with minimum side effects in patients presenting with a migraine headache to the ED.
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Gungor
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Turkey.
authors.forename: Kamil Can
authors.initials: KC
authors.lastname: Akyol
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kesapli
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Celik
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Turkey.
authors.forename: Adeviye
authors.initials: A
authors.lastname: Karaca
authors.affiliation: Antalya Training and Research Hospital, Department of Emergency Medicine, Turkey.
authors.forename: Mehmet Nuri
authors.initials: MN
authors.lastname: Bozdemir
authors.affiliation: Akdeniz University Medical Faculty, Department of Emergency Medicine, Turkey cenkereken@akdeniz.edu.tr.
authors.forename: Cenker
authors.initials: C
authors.lastname: Eken
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007660:Ketoprofen / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011446:Prospective Studies; D014325:Tromethamine / Q000627:therapeutic use*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D014325:Tromethamine; D007660:Ketoprofen; C118296:dexketoprofen trometamol
keywords: Migraine; dexketoprofen; emergency department; placebo