Petasites hybridus: scientific evidence A

Abstract

Migraine is the leading cause of disability in individuals aged 15 to 49 worldwide, emphasizing the need for diverse preventive treatments. In 2023, Brazil introduced highly purified Petasites hybridus. This article comment the manuscript Loder and coworkers, 2012 one of the primary studies that positioned Petasites hybridus among the Level A evidence medications in the American Consensus of the episodic migraine preventive treatment in 2012.
Development
A 1990s German study, randomized and placebo-controlled, involved 60 patients using a Petasites hybridus root extract for migraine prevention. Though effective, the study had notable shortcomings. To validate its findings, independent investigators and statisticians conducted a comprehensive efficacy reassessment following International Conference on Harmonisation E9 Guidelines. Results showed a significant -50% reduction in migraine episodes for 45% of the treatment group, compared to 15% in the placebo group. The active treatment group also saw a significant drop in migraine attacks needing acute medication (from 20.6% to 7.1%), unlike the placebo group (12.8% to 11.7%). The reanalysis confirmed the treatment group's superiority across 12 primary efficacy metrics, supporting its effectiveness.
Commentary
Several studies, including this reanalysis and an American study, support Petasites hybridus for migraine prevention, leading to its Level A evidence classification. Its mechanisms include antinociceptive, anti-CGRP, anti-inflammatory, and antispasmodic effects.
Conclusion
The reanalysis confirmed the efficacy of Petasites hybridus from Grossman’s study. The German team minimized bias through rigorous statistical methods. Petasites hybridus should be considered for first-line and subsequent migraine prevention, potentially combined with other medications based on patient needs.