Comparison of ibuprofen and dexketoprofen in the management of migraine-related headache in the emergency department

The aim of this randomized controlled study was to compare the efficacy and safety of intravenous (IV) ibuprofen with IV dexketoprofen trometamol in patients with migraine attack-related headaches and receiving IV metoclopramide as part of their standard care.

This double-blinded and randomized controlled study was conducted among patients with acute migraine-related headaches admitted to the emergency department (ED). Eligible patients were randomly assigned in a 1:1 ratio to receive ibuprofen or dexketoprofen trometamol. In addition, all participants received 10 mg of IV metoclopramide. All patients’ headache scores were measured with a visual analog scale (VAS); 0 points was considered no pain, while 100 points were considered worst pain. The primary outcome was defined as the absolute change in the headache scores between the groups at 0 and 60 min.

A total of 160 patients were randomized into two groups with similar baseline migraine characteristics and VAS scores. In each group, the baseline VAS scores significantly decreased statistically over time. However, when the decreasing trends of VAS values were compared according to the treatment groups, a statistically significant difference was found in the VAS values at 30 min, but no difference was found for the 60 min VAS values. There was no statistically significant difference in the need for rescue treatment and side effects between the two groups.

Intravenous ibuprofen and dexketoprofen trometamol treatments are equal to each other in terms of efficacy, side effects, and need for rescue treatment in the management of acute migraine-related headaches.