Adjuvant Vitamin D to topiramate therapy effective option for prophylaxis of pediatric migraine

Oman: A recent study published in the Journal of Child Neurology has concluded that Vitamin D supplementation  to topiramate therapy could be a safe and effective strategy in migraine prophylaxis of pediatric patients.

The researchers added that this therapy is well-tolerable in such cases.

Migraine patients may suffer from vitamin D insufficiency. To combat such deficiency, dietary supplementation has been recommended for complementary treatment of migraine.

Vitamin D has anti-inflammatory and antioxidant properties. Evidence in the literature mentions the reduced frequency of migraine attacks due to Vitamin D supplementation.

In migraine patients, vitamin D deficiency prevalence remains high, but it is not prescribed in clinical practice. There needs to be more data on trials mentioning the effects of supplementation of Vitamin D on migraine.

A study by Betül Kılıç from the Department of Child Neurology, University of Health Sciences, Derince Training and Research Hospital, Turkey, has previously reported that there is a marked correlation between pediatric migraine and vitamin D levels. The researchers added that Vitamin D therapy is beneficial in pediatric migraine patients.

The available data needs confirmation. There is an urgent need for more research on whether Vitamin D3 supplementation is effective in migraine prophylaxis.

Considering this, a study was conducted by Moustafa Kotb Elmala, MD from the Pediatric Department, Nizwa Hospital, Nizwa, Sultanate of Oman to evaluate: "What are the effects and safety of vitamin D3 supplementation to topiramate on pediatric migraine?"

The key points of the study are:

• The type of clinical trial was a double-blinded prospective clinical trial.

• The study was conducted on children with a history of migraine aged 5- to 14 years.

• There were two groups: supplementation (vitamin D3 supplementation) and placebo (without Vitamin D supplementation).

• The children were randomly assigned into these two groups in a ratio of 1:1.

• The children in the supplementation group received topiramate plus one 5000-IU dose of vitamin D3 daily. This was given for a period of 4 months.

• In the placebo group, the children were given topiramate and a placebo capsule; the placebo capsule did not contain any effective substance.

• The monthly frequency of headache attacks, an excellent response to treatment, and a reduction in migraine severity, duration, and disability (before and after treatment) were the primary outcomes measured in the study.

• 56 children completed the trial.

• The supplementation group was more effective than the placebo group.

• There was a reduction in the monthly frequency of migraine attacks in the supplementation group compared to the placebo group, 6231.31 vs 9792.24 times. The P value was 0 .01.

• The disability score for migraine in the supplementation vs placebo group was 17 566.43 vs 25 187.65. The P value was 0 .04.

• The response rate in the supplementation group was reasonable and was observed in 76.13% of patients compared to 53.5% of patients in the placebo group.

• Vitamin D3 supplementation was more effective than the placebo group, and the P value was significant with a value of 0 .01.

• The percentage of side effects in the intervention group was 13.3%.

• In the placebo group, 20% of the side effect was reported. The p-value was 0.5.

The researcher that the findings of our study concluded that Vitamin D3 supplementation is beneficial in pediatric migraine prophylaxis.

Further reading:

Kotb Elmala M, Suliman HA, Al-shokary AH, et al. The Impact of Vitamin D3 Supplementation to Topiramate Therapy on Pediatric Migraine Prophylaxis. Journal of Child Neurology. 2022;37(10-11):833-839.