Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-20T15:26:47.508Z Has data issue: false hasContentIssue false
  • English
  • Français

The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review*

Published online by Cambridge University Press:  02 January 2007

E Ernst  and
MH Pittler
E Ernst*
Affiliation:
Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT, UK
MH Pittler
Affiliation:
Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT, UK
*
†Corresponding author: Email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

Feverfew (Tanacetum parthenium L.) is a popular herbal remedy often advocated for the prevention of migraine. The aims of this systematic review are to update the evidence from rigorous clinical trials for or against the efficacy of feverfew for migraine prevention and to provide a safety profile of this herbal remedy.

Design

Literature searches were performed using the following databases: Medline, Embase, Biosis, CISCOM and the Cochrane Library (all from their inception to December 1999). Only randomized, placebo-controlled, double-blind trials of feverfew mono-preparations for the prevention of migraine in human subjects were included. All articles were read by two independent reviewers. Data were extracted in a pre-defined, standardized fashion. The methodological quality of the trials was evaluated by the Jadad score. For the assessment of safety issues, major reference texts were also consulted.

Results

Six trials met the inclusion/exclusion criteria. The majority favour feverfew over placebo. Yet important caveats exist. The data also suggest that feverfew is associated with only mild and transient adverse effects and few other safety concerns.

Conclusions

Feverfew is likely to be effective in the prevention of migraine. There are no major safety problems.

Keywords

FeverfewMigraineHerbal medicinePreventionAlternative medicine
Type
Research Article
Information
Public Health Nutrition , Volume 3 , Supplement 4a , December 2000 , pp. 509 - 514
Copyright
Copyright © CABI Publishing 2000

Footnotes

*

A previous version of a similar paper was first published in 1998 (Vogler BK, Pittler MH, Ernst E. Feverfew as a preventive treatment for migraine: a systematic review. Cephalalgia 1998; 18: 704–8).

References

1: Eisenberg, DM, David, RB, Ettner, SL, et al. Trends in alternative medicine use in the United States, 1990–1997. JAMA 1998; 280: 1569–75.CrossRefGoogle ScholarPubMed
2: Heptinstall, S, White, A, Williamson, L, Mitchel, . Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Lancet 1998; i: 1071–4.Google Scholar
3: De Weerdt, CJ, Bootsma, HPR, Hendriks, . Herbal medicines in migraine prevention: randomized double-blind placebo-controlled crossover trial of a feverfew preparation. Phytomedicine 1998; 3: 225–30.CrossRefGoogle Scholar
4: Jadad, AR, Moore, RA, Carrol, D, Jenkinson, C, Reynolds, DJM, Gavaghan, , et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clin. Trials 1996; 17: 1–12.CrossRefGoogle ScholarPubMed
5: Johnson, ES, Kadam, NP, Hylands, DM, Hylands, PJ. Efficacy of feverfew as prophylactic treatment of migraine. BMJ 1998; 291: 569–73.CrossRefGoogle Scholar
6: Murphy, JJ, Heptinstall, S, Mitchell, JRA. Randomized double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet 1998; i: 189–92.Google Scholar
7: Palevitch, D, Earon, G, Carasso, . Feverfew (Tanacetum parthenium) as a prophylactic treatment for migraine: A double-blind placebo-controlled study. Phytother. Res. 1998; 11: 508–11.3.0.CO;2-H>CrossRefGoogle Scholar
8: Kuritzky, A, Elhacham, Y, Yerushalmi, Z, Hering, . Feverfew in the treatment of migraine: its effect on serotonin uptake and platelet activity. Neurology 1998; 44(Suppl. 2): 293P.Google Scholar
9: Pfaffenrath, V, Fischer, M, Friede, M, Heinneicke, V, Zepelin, HH. Clinical dose–response study for the investigation of efficacy and tolerability of. Tanacetum parthenium in migraine prophylaxis. Proceedings of Deutscher Schmerzkongress 1998.Google Scholar
10: Fetow, CW, Avila, JR. Complementary and Alternative Medicines. Springhouse: Philadelphia, 1999.Google Scholar
11: Boon, H, Smith, M. The Botanical Pharmacy. Kingston, Canada: Quarry Press, 1999.Google Scholar
12: Ernst, E.Possible interactions between synthetic and herbal medicinal products. Part 1: a systematic review of the indirect evidence. Perfusion 2000; 13: 4–15.Google Scholar
13: Lininger, SW. A–Z Guide to Drug–Herb–Vitamin Interactions. Rocklin, CA: Prima Publishing, 1999.Google Scholar
14: Newall, CA, Anderson, LA, Phillipson, JD. Herbal Medicines. London: The Pharmaceutical Press, 1996.Google Scholar
15: Brinker, R. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Medical Publications, 1998.Google Scholar
16: Tfelt-Hansen, P, Nielsen, SL. Patient numbers needed in prophylactic migraine trials. Neuroepidemiology 1997; 6: 214–19.CrossRefGoogle Scholar
17: Heptinstall, S, Groenewegen, WA, Spangenberg, P, Loesche, W.Extracts of feverfew may inhibit platelet behaviour via neutralization of sulphydryl groups. J. Pharm. Pharmacol. 1987; 39: 459–65.CrossRefGoogle ScholarPubMed
18: Pugh, WJ, Sambo, K.Prostaglandin synthetase inhibitors in feverfew. J. Pharm. Pharmacol. 1988; 40: 743–5.CrossRefGoogle ScholarPubMed
19: Makheja, AN, Bailey, JM. A platelet phospholipase inhibitor from the medicinal herb feverfew (Tanacetum parthenium). Prostaglandins Leukotrienes Med. 1982; 8: 653–60.Google ScholarPubMed
20: Awang, DVC. Prescribing therapeutic feverfew (Tanacetum parthenium (L.) Schultz Bip., syn. Chrysanthemum parthenium (L.) Bernh.). Integrative Med. 1998; 1: 11–13.CrossRefGoogle Scholar
21: Goadsby, PJ. How do the currently used prophylactic agents work in migraine?. Cephalalgia 1997; 17: 85–92.CrossRefGoogle ScholarPubMed
22: Brown, AMG, Edwards, CM, Davey, MR, Power, B, Lowe, KC. Pharmacological activity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.): Assessment by inhibition of human polymorphonuclear leucocyte chemiluminescence in-vitro. J. Pharm. Pharmacol. 1998; 49: 558–61.CrossRefGoogle Scholar
23: Hendriks, H, Bos, R, Woerdenbag, HJ. The essential oil of Tanacetum parthenium (L.) Schultz-Bip. Flavour Fragrance J. 1996; 11: 367–71.3.0.CO;2-R>CrossRefGoogle Scholar
24: Murch, SJ, Simmons, CB, Saxena, PK. Melatonin in feverfew and other medicinal plants. Lancet 1997; 350: 1598–9.CrossRefGoogle ScholarPubMed
25: Brun, J, Claustrat, B, Saddier, P, Chazor, G.Nocturnal melatonin excretion is decreased in patients with migraine without aura attacks associated with menses. Cephalalgia 1995; 15: 136–9.CrossRefGoogle ScholarPubMed
26: Willigmann, J, Freudenstein, J. Production of a stable feverfew (Tanacetum parthenium) extract as an active substance for a pharmaceutical product. Scharper Brümmer 1999 (internal document).Google Scholar
27: Anderson, D, Jenkinson, PC, Dewdney, RS, Blowers, SD, Johnson, ES, Kadam, NP. Chromosomal aberrations and sister chromatid exchanges in lymphocytes and urine mutagenicity of migraine patients: a comparison of chronic feverfew users and matched non-users. Hum. Toxicol. 1988; 7: 145–52.CrossRefGoogle ScholarPubMed
28: Burry, JN. Compositae dermatitis in South Australia: Contact dermatitis from Chrysanthemum parthenium. Contact Dermatitis 1980; 6: 445.CrossRefGoogle ScholarPubMed
29: Hausen, BM, Osmundsen, PE. Contact allergy to parthenolide in Tanacetum parthenium (L.) Schulz-Bip. (Feverfew, Asteraceae) and cross-reactions to related sesquiterpene lactone containing compositae species. Acta Derm. Venereol. 1983; 63: 308–14.CrossRefGoogle ScholarPubMed
30: Johnson, ES. Patients who chew chrysanthemum leaves. MIMS Mag. 1983; 15 05: 32–5.Google Scholar
31: Easterbrook, PJ, Berlin, JA, Gopalan, R, Matthews, DR. Publication bias in clinical research. Lancet 1991; 337: 867–72.CrossRefGoogle ScholarPubMed
32: Ernst, E, Pittler, MH. Alternative therapy bias [letter]. Nature 1997; 385: 480.CrossRefGoogle ScholarPubMed
33: Pittler, MH, Abbot, NC, Harkness, EF, Ernst, E.Location bias in controlled clinical trials of complementary medicine. J. Clin. Epidemiol. 2000; 53: 485–9.CrossRefGoogle Scholar
34: Ernst, E, ed. Herbal Medicine. A Concise Overview for Professionals. Oxford: Butterworth-Heinemann, 2000.Google Scholar