Association Between Asthma and Migraine: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

Objectives: The purpose of this study was to determine the association between asthma and migraine and assess the risk for migraine in patients with asthma.Methods: We systematically searched the Cochrane Library, PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), and Excerpta Medica dataBASE (EMBASE) databases from inception to September 26, 2021, for indexed observational studies that examined either the odds or risk of migraine in subjects with asthma. The qualities of the included studies were evaluated using the Newcastle–Ottawa Scale. A random-effects meta-analysis was performed to calculate the odds ratio for case-control and cross-sectional studies and the risk ratio for cohort studies.Results: Seven observational studies (four cross-sectional and three cohort studies) with a total of 549,534 study subjects were included in this systematic review and meta-analysis and selected for data extraction. Four articles were considered to be of moderate quality; other studies were considered to be of high quality. Asthma was associated with increased odds (OR, 1.85; 95%CI, 1.39–2.45) and risk of migraine (RR, 1.70; 95%CI, 1.52–1.90).Conclusions: The available evidence that supports the existence of an association between asthma and migraine is limited. Clinicians should be aware that patients with asthma show both increased prevalence and incidence of migraine. Further studies are warranted to further clarify the relationship between asthma and migraine.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=185881, identifier: CRD42020185881.

Association between asthma and headache: Findings from the NHANES 2001–2004

“…Persons previously diagnosed with asthma were more likely to have headache than those without it. This finding supported the results of similar studies using different population‐based dataset from different countries 3–11 . For example, the Head‐HUNT study showed that asthma patients were 1.5‐fold more possibly to have headache, both migraine and nonmigrainous, than people without asthma 3 .…”

“…This finding supported the results of similar studies using different population-based dataset from different countries. [3][4][5][6][7][8][9][10][11] For example, the Head-HUNT study showed that asthma patients were 1.5-fold more possibly to have headache, both migraine and nonmigrainous, than people without asthma. 3 A key contribution of our study was pointing out those who had asthma attack in the past year had higher odds to have headache but emergency care visit in the past year did not.…”

“…1,2 There are studies demonstrating possible overlapping between asthma and headache. [3][4][5][6][7][8][9][10][11] With the use of a nationally representative dataset, our study aims to investigate the association between asthma and headache and whether the association varies across subgroups.…”

Migraine, Allergy, and Histamine: Is There a Link?

“…(4) Childhood allergic diseases, such as asthma, atopic dermatitis, allergic conjunctivitis, and rhinitis [24,26], were found to be associated with migraine headaches in adolescence. In addition to population-based studies, several systematic reviews and meta-analyses (not included in Table 1) have confirmed an association between asthma and migraine [61][62][63]. In a systematic review involving 389,573 participants performed to assess the overlapping risk of migraines in asthma patients and vice versa, the odds ratio (OR) of migraines in asthma patients compared with non-asthmatic individuals was found to be 1.62 (95% CI: 1.43-1.82) and migraines were associated with a significantly increased risk of asthma (relative risk (RR): 1.56; 95% CI: 1.51-1.60; p < 0.00001) [61].…”

“…A meta-analysis of 15 published population-based studies covering a total of 1,188,780 individuals showed that migraines were associated with increased odds (OR = 1.54; 95% CI: 1.34~1.77) and risk of asthma (HR = 1.42; 95% CI: 1.26~1.60) and asthma was associated with increased odds (OR = 1.45; 95% CI: 1.22~1.72) and risk of migraines (HR = 1.47; 95% CI: 1.41~1.52) [63]. In a systematic review and meta-analysis of observational studies, including seven studies with a total of 549,534 individuals, to determine the association between asthma and migraine, asthma was also associated with increased odds (OR = 1.85; 95% CI: 1.39-2.45) and risk of migraines (RR = 1.70; 95% CI: 1.52-1.90) [62]. However, the same authors concluded that evidence associating asthma and migraine is limited [62].…”