Feverfew (Tanacetum parthenium) for Migraine Prophylaxis: A Systematic Review

Abstract

Introduction: Migraine is a debilitating neurological disorder. Feverfew is an herbal remedy that has been used for centuries for its prevention. This review systematically evaluates the evidence from RCTs regarding the efficacy of feverfew in migraine prophylaxis.

Methods: We searched MEDLINE, Embase, and CENTRAL up to August 2019 for placebo-controlled RCTs assessing the efficacy of feverfew in adult patients with migraine. The primary outcome was the mean reduction in migraine attack frequency per month.

Results: Six RCTs with 561 patients met the inclusion criteria. The studies were highly heterogeneous in terms of feverfew preparation and patient populations. A meta-analysis showed a small but statistically significant reduction in the frequency of migraine attacks compared to placebo (Mean Difference = -0.6 attacks per month; 95% CI: -1.1 to -0.1).

Discussion: Feverfew appears to be modestly more effective than placebo for the prevention of migraine. However, the clinical significance of this small effect is debatable. The variability in parthenolide content, the proposed active ingredient, across different commercial products is a major concern.

Conclusion: Pre-2020 evidence suggests that feverfew may offer a small benefit in migraine prophylaxis, but the evidence is not robust. It may be an option for patients seeking alternative treatments.