Chen L, Cai Z The efficacy of ginger for the treatment of migraine: A meta-analysis of randomized controlled studies. Am J Emerg Med. 2020 Nov 17. pii: S0735-6757(20)31039-1. doi: 10.1016/j.ajem.2020.11.030. (Systematic review)

INTRODUCTION: The efficacy of ginger for migraine remains controversial. We conduct a systematic review and meta-analysis to explore the influence of ginger versus placebo on treatment in migraine patients.

METHODS: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2020 for randomized controlled trials (RCTs) assessing the effect of ginger versus placebo on treatment efficacy in migraine patients. This meta-analysis is performed using the random-effect model.

RESULTS: Three RCTs are included in the meta-analysis. Overall, compared with control group in migraine patients, ginger treatment is associated with substantially improved pain free at 2 h (RR = 1.79; 95% CI = 1.04-3.09; P = 0.04) and reduced pain scores at 2 h (MD = -1.27; 95% CI = -1.46 to -1.07; P < 0.00001), but reveals no obvious impact on treatment response (RR = 2.04; 95% CI = 0.35-11.94; P = 0.43) or total adverse events (RR = 0.80; 95% CI = 0.46-1.41; P = 0.44). The incidence of nausea and vomiting is obviously lower in ginger group than that in control group.

CONCLUSIONS: Ginger is safe and effective in treating migraine patients with pain outcomes assessed at 2 h.

Discipline Area Score
Physician 5 / 7
Comments from MORE raters

Physician rater

It was unclear what was meant by "treatment response."

Physician rater

Ginger is not as effective as Prochlorperazine and Metoclopramide; however, it may be worthwhile to inform ED Migraine patients discharged home.

Physician rater

This is an interesting meta-analysis on the use of ginger for migraine. However, the main outcome of pain-free and pain intensity at 2h is based on a total of only 75 patients and only one study was performed in the ED. This needs to be confirmed in a large RCT.

Physician rater

There are three small RCTs - two by the same author. There is no assessment of analytic intent thru examination of trial registration. Eg, selective reporting bias and publication bias may be lurking.

Physician rater

A meta analysis with 3 Papers and 220 patients is not of high level of quality. I can’t wait to have ginger in my pharmacopoeia.
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