Tanacetum parthenium migraine research Update
Efficacy and safety of 6.25 mg t.i.d. Tanacetum parthenium extract MIG-99 in migraine prevention--a randomized, double-blind, multicentre, placebo-controlled study.
Cephalalgia. 2005 Nov;25(11):1031-41.
The efficacy and tolerability of a CO(2)-extract of Tanacetum parthenium  (MIG-99, 6.25 mg t.i.d.) for migraine prevention were investigated in a randomized, double-blind, placebo-controlled, multicentre, parallel-group study. Patients (N = 170 intention-to-treat; MIG-99, N = 89; placebo, N = 81) suffering from migraine according to International Headache Society criteria were treated for 16 weeks after a 4-week baseline period. The primary endpoint was the average number of migraine attacks per 28 days during the treatment months 2 and 3 compared with baseline. Safety parameters included adverse events, laboratory parameters, vital signs and physical examination. The migraine frequency decreased from 4.76 by 1.9 attacks per month in the MIG-99 group and by 1.3 attacks in the placebo group. Logistic regression of responder rates showed an odds ratio of 3.4 in favour of Tanacetum parthenium . Adverse events possibly related to study medication were 9/107 (8%) with Tanacetum parthenium  and 11/108 (10%) with placebo. Tanacetum parthenium  is effective and shows a favourable benefit-risk ratio.
     A stable extract of the popular herbal remedy Tanacetum parthenium, called MIG-99, appears to be particularly effective in preventing migraine, German researchers report in the November 2005 issue of Cephalagia. Tanacetum parthenium herb has traditionally been used to treat migraine, and clinical trials of the powdered herb have shown promising results. However, tests using extracts of Tanacetum parthenium have been less successful. To evaluate Tanacetum parthenium , the researchers conducted a trial with 170 migraine patients. At the beginning of the trial, migraine frequency was approximately five attacks over a 4-week period. The subjects were then randomly assigned to treatment with Tanacetum parthenium, three times a day or to placebo, or "sugar pill," for up to 16 weeks. In the Tanacetum parthenium  treatment group, migraine frequency declined by two attacks per month. In the placebo patients, the corresponding decrease was only one per month. Possible medication-related adverse events occurred in about 8.4 percent of Tanacetum parthenium patients and 10.2 percent of placebo patients. Further analysis of responder rates revealed that Tanacetum parthenium was 3.4-times more effective than placebo.

Tanacetum parthenium  for preventing migraine.
Cochrane Database Syst Rev. 2004;(1):CD002286. Department of Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, 25 Victoria Park Road, Exeter, Devon, UK, EX2 4NT.
Tanacetum parthenium extract is a herbal remedy used for preventing attacks of migraine. To systematically review the evidence from double-blind randomised controlled trials assessing the clinical efficacy and safety of Tanacetum parthenium versus placebo for preventing migraine. Trials using clinical outcome measures were included. Trials focusing exclusively on physiological parameters were excluded. There were no restrictions regarding the language of publication. Data on patients, interventions, methods, outcome measures, results and adverse events were extracted systematically. Two reviewers independently selected studies, assessed methodological quality and extracted data. Disagreements concerning evaluation of individual trials were resolved through discussion. Five trials (343 patients) met the inclusion criteria. Results from these trials were mixed and did not convincingly establish that Tanacetum parthenium is efficacious for preventing migraine. Only mild and transient adverse events were reported in the included trials. There is insufficient evidence from randomised, double-blind trials to suggest an effect of Tanacetum parthenium over and above placebo for preventing migraine. It appears from the data reviewed that Tanacetum parthenium presents no major safety problems.

The efficacy and safety of Tanacetum parthenium in migraine prophylaxis--a double-blind, multicentre, randomized placebo-controlled dose-response study.
Cephalalgia. 2002 Sep;22(7):523-32.
Tanacetum parthenium herb has been used as a prevention for migraine headache. The primary objective was to show a dose-response of a new stable extract (MIG-99) reproducibly manufactured with supercritical CO2 from Tanacetum parthenium herb. Furthermore, the study should provide data on the safety and tolerability of MIG-99. In a randomized, double-blind, multicentre, controlled trial with an adaptive design, the clinical efficacy and safety of three dosages of MIG-99 (2.08 mg; 6.25 mg; 18.75 mg t.i.d.) were compared with placebo. The patients suffered from migraine with and without aura according to International Headache Society (IHS) criteria and were treated with one of the study medications for 12 weeks after a 4-week baseline period. The primary efficacy parameter was the number of migraine attacks during the last 28 days of the treatment period compared with baseline. Secondary endpoints were total and average duration and intensity of migraine attacks, mean duration of the single attack, number of days with accompanying migraine symptoms, number of days with inability to work due to migraine as well as type and amount of additionally taken medications for the treatment of migraine attacks. The design of the study included a pre-planned adaptive interim analysis for patients with at least four migraine attacks within the baseline period. With respect to the primary and secondary efficacy parameter, a statistically significant difference was not found between the overall and the confirmatory intention-to-treat (ITT) sample in the exploratorily analysed four treatment groups. The frequency of migraine attacks for the predefined confirmatory subgroup of patients (n = 49) with at least four migraine attacks during the baseline period decreased in a dose-dependent manner (P = 0.001). The highest absolute change of migraine attacks was observed under Tanacetum parthenium treatment with 6.25 mg t.i.d. compared with placebo. Overall, 52 of 147 (35%) patients reported at least one adverse event (AE). The incidence of AEs in the Tanacetum parthenium treatment groups was similar to that in the placebo group, and no dose-related effect was observed in any safety parameter. MIG-99 failed to show a significant migraine prophylactic effect in general. Accordingly, in the ITT analysis a dose-response relationship could not be observed. MIG-99 was shown to be effective only in a small predefined subgroup of patients with at least four attacks during the 28-day baseline period where the most favourable benefit-risk ratio was observed with a dosage of three capsules of 6.25 mg MIG-99 extract per day. Because of the low number of patients, these findings need to be verified in a larger sample. The incidence of AEs was similar for all treatment groups.

Tanacetum parthenium  extract as anti-inflammatory substance
Tanacetum parthenium  herb -- The Yale team found that Tanacetum parthenium's active ingredient -- parthenolide -- specifically binds to and inhibits the protein IKK-beta, which plays a role in the body's inflammatory process. Fever is part of the body's inflammatory response, and inflammation contributes to a range of ailments--including migraines. 100 to 300 mg up to qid, 0.2 to 0.4% parthenolide