BACKGROUND

Feverfew (Tanacetum parthenium L.) is a popular herbal remedy for migraine.

OBJECTIVE

To systematically review the evidence for or against the efficacy of feverfew versus placebo for the prevention of migraine.

METHODS

Electronic literature searches were performed using the databases CISCOM (Research Council for Complementary Medicine, London, UK), MEDLINE, EMBASE, Biosis and the Cochrane Library (each from its inception to April 1998). Manufacturers were contacted and the bibliographies of identified articles checked for further trials.

METHODS

Randomised, placebo-controlled, double-blind trials assessing the efficacy of feverfew for preventing migraine were included. No restrictions regarding the language of publication were imposed.

METHODS

Data on patients, interventions, methods, outcomes and results were extracted in a pre-defined, standardised manner. Methodological quality was evaluated using the scoring system developed by Jadad and colleagues. Both data extraction and the assessment of methodological quality were performed independently by two reviewers.

RESULTS

Four trials met the inclusion criteria. The majority of these trials suggested beneficial effects of feverfew compared with placebo. However, the trial with the highest methodological quality, which was also among the largest, found no significant difference between feverfew and placebo.

CONCLUSIONS

The efficacy of feverfew for the prevention of migraine has not been established beyond reasonable doubt.