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Background: Propranolol is one of the most commonly prescribed drugs for migraine prophylaxis., Objectives: We aimed to determine whether there is evidence that propranolol is more effective than placebo and as effective as other drugs for the interval (prophylactic) treatment of patients with migraine., Search Methods: Potentially eligible studies were identified by searching MEDLINE/PubMed (1966 to May 2003) and the Cochrane Central Register of Controlled Trials (Issue 2, 2003), and by screening bibliographies of reviews and identified articles., Selection Criteria: We included randomised and quasi-randomised clinical trials of at least 4 weeks duration comparing clinical effects of propranolol with placebo or another drug in adult migraine sufferers., Data Collection and Analysis: Two reviewers extracted information on patients, methods, interventions, outcomes measured, and results using a pre-tested form. Study quality was assessed using two checklists (Jadad scale and Delphi list). Due to the heterogeneity of outcome measures and insufficient reporting of the data, only selective quantitative meta-analyses were performed. As far as possible, effect size estimates were calculated for single trials. In addition, results were summarised descriptively and by a vote count among the reviewers., Main Results: A total of 58 trials with 5072 participants met the inclusion criteria. The 58 selected trials included 26 comparisons with placebo and 47 comparisons with other drugs. The methodological quality of the majority of trials was unsatisfactory. The principal shortcomings were high dropout rates and insufficient reporting and handling of this problem in the analysis. Overall, the 26 placebo-controlled trials showed clear short-term effects of propranolol over placebo. Due to the lack of studies with long-term follow up, it is unclear whether these effects are stable after stopping propranolol. The 47 comparisons with calcium antagonists, other beta-blockers, and a variety of other drugs did not yield any clear-cut differences. Sample size was, however, insufficient in most trials to establish equivalence., Authors' Conclusions: Although many trials have relevant methodological shortcomings, there is clear evidence that propranolol is more effective than placebo in the short-term interval treatment of migraine. Evidence on long-term effects is lacking. Propranolol seems to be as effective and safe as a variety of other drugs used for migraine prophylaxis.

Aim: The objective of this systematic review was to present and evaluate the current evidence for the clinical effectiveness of treatment with rosehip powder in patients with osteoarthritis., Method: A systematic search of the literature (Medline, EMBASE, Cochrane Collaboration Library) of all publications up to February 2006 was conducted. The terms searched for were rose hip, rosehip, Rosa canina, Hagebutte and osteoarthritis, arthritis and arthrosis. The studies turned up were subjected to a standardized assessment of method and content., Results: Two double-blind randomized studies were analysed: both were relatively small (N = 100 and 112) and had a Jadad score of 5. In both studies, the rosehip powder LitoZin was employed. In the first study (parallel design; endpoint after 4 months), it was found that rosehip powder, in comparison with placebo, significantly improved hip flexion (p < 0.05), but no significant change was observed for internal and external rotation of the hips or in flexion of the knee. In the second study (crossover design, endpoints after 3 and 6 months) 66% of the patients receiving the test substance, and 35% of the patients on placebo reported a reduction in pain after3 months (p < 0.0128). A comparison of the consumption of analgesics after 3 months revealed no significant difference between the two groups. A comparison after 6 months showed no difference in the two endpoints, which, however, might be due to a possible carryover effect., Conclusion: In both studies rosehip powder had a moderate effect in patients with osteoarthritis.