Systematic review and meta-analysis of <i>Tanacetum parthenium</i> : evaluating its efficacy in migraine relief

Feverfew (<i>Tanacetum parthenium</i>) has been evaluated in multiple clinical studies for migraine management, with earlier meta-analyses suggesting therapeutic potential. Given recent randomised controlled trials (RCTs), this updated systematic review and meta-analysis aimed to assess feverfew's efficacy in reducing migraine frequency, severity, and associated symptoms. A comprehensive search of PubMed, EMBASE, and Google Scholar up to August 2025 identified nine double-masked, placebo-controlled RCTs involving 899 participants. Feverfew significantly reduced migraine attack frequency (IV: -1.11 [-1.23 to -0.99], <i>p</i> < 0.00001; <i>I</i>² = 28%), migraine duration (IV: -4.43 [-7.63, -1.23] at 95% CI, p = 0.007; <i>I²</i> = 98% and showed a non-significant trend towards reduced pain severity (IV: -0.63 [-1.48 to 0.21], <i>p</i> = 0.14; <i>I</i>² = 85%). No significant effects were observed on migraine associated symptoms such as nausea, vomiting, photophobia, and phonophobia. Moderate heterogeneity, risks of selection, and attrition bias limited the overall quality of the evidence. Feverfew may offer modest benefits in migraine prevention, warranting further high-quality, large-scale RCTs with standardised protocols.