{"id":"39f36f6d-2fb1-55ef-b0e5-325561bc0f88","stable_key":"548ab9d6-3a9b-5bed-879c-17d03813b636:b2-migraine-child-positive","predicate":"reduced_attacks_in_second_child_trial","statement":"In the 90-child three-arm study,>=50% frequency reduction occurred in 24/30 on 200 mg/day versus 4/30 placebo; 100 mg/day did not show a significant benefit.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"negative","is_public":true,"mechanism_event_id":"aad20d3e-ed9c-563a-81b0-2a1a39aa5eec","mechanism_event_label":"A later pediatric trial reported benefit at the same 200 mg daily exposure used in the earlier negative study.","subject":{"id":"86eb1eee-a8d1-539c-8c17-0911f69b6f1b","slug":"riboflavin","display_name":"Riboflavin (vitamin B2)","entity_type_key":"small_molecule"},"object":{"id":"b7c15223-a4df-5d22-806a-01d8bc86b2a9","slug":"migraine-attack-frequency","display_name":"Migraine attack frequency","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"aad20d3e-ed9c-563a-81b0-2a1a39aa5eec","stable_key":"548ab9d6-3a9b-5bed-879c-17d03813b636:b2-migraine-child-positive-event","event_type":"observed_intervention","label":"A later pediatric trial reported benefit at the same 200 mg daily exposure used in the earlier negative study.","description":"In the 90-child three-arm study,>=50% frequency reduction occurred in 24/30 on 200 mg/day versus 4/30 placebo; 100 mg/day did not show a significant benefit.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"86eb1eee-a8d1-539c-8c17-0911f69b6f1b","slug":"riboflavin","display_name":"Riboflavin (vitamin B2)","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"b7c15223-a4df-5d22-806a-01d8bc86b2a9","slug":"migraine-attack-frequency","display_name":"Migraine attack frequency","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""}]},"contexts":[{"dimension":"experimental_model","value_text":"90 children ages 5-13 randomized equally to placebo, 100 mg or 200 mg riboflavin; 12-week trial.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"100 or 200 mg/day riboflavin versus placebo; missing follow-up values carried forward from baseline; pharmacological exposure.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Single-center study, small arms and baseline values carried forward for missing follow-up; genotype and deficiency did not establish the reason for discordance.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Riboflavin research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"riboflavin","display_name":"Riboflavin (vitamin B2)","entity_type_key":"small_molecule"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"A later pediatric trial reported benefit at the same 200 mg daily exposure used in the earlier negative study.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[b2-talebian2018] Prophylactic effect of riboflavin on pediatric migraine: a randomized, double-blind, placebo-controlled trial (2018). https://pubmed.ncbi.nlm.nih.gov/29629048/ DOI: 10.19082/6279","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Children with migraine","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"4146eb31-c980-5534-851c-3c1638f06a7a","evidence_kind":"source_excerpt","locator":"Lines 1741-1751","start_line":1741,"end_line":1751,"excerpt":"### b2-migraine-child-positive\nIn the 90-child three-arm study,>=50% frequency reduction occurred in 24/30 on 200 mg/day versus 4/30 placebo; 100 mg/day did not show a significant benefit.\nCondition category: normal\nnutrient_topic: Riboflavin research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A later pediatric trial reported benefit at the same 200 mg daily exposure used in the earlier negative study.\norganism: Homo sapiens\ntissue_or_cell_type: Children with migraine\nexperimental_model: 90 children ages 5-13 randomized equally to placebo, 100 mg or 200 mg riboflavin; 12-week trial.\nlimitations: Single-center study, small arms and baseline values carried forward for missing follow-up; genotype and deficiency did not establish the reason for discordance.\nexposure: 100 or 200 mg/day riboflavin versus placebo; missing follow-up values carried forward from baseline; pharmacological exposure.\n[b2-talebian2018] Prophylactic effect of riboflavin on pediatric migraine: a randomized, double-blind, placebo-controlled trial (2018). https://pubmed.ncbi.nlm.nih.gov/29629048/ DOI: 10.19082/6279","model_system":"90 children ages 5-13 randomized equally to placebo, 100 mg or 200 mg riboflavin; 12-week trial.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [b2-talebian2018] Prophylactic effect of riboflavin on pediatric migraine: a randomized, double-blind, placebo-controlled trial (2018). https://pubmed.ncbi.nlm.nih.gov/29629048/ DOI: 10.19082/6279","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"4f7c9578-82bf-5e2d-b5c4-72a79fb4f6af","stable_key":"import-548ab9d6-3a9b-5bed-879c-17d03813b636","title":"Riboflavin: mechanisms, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"680cb6bc8249877f2410f551807f10d390fdd719014137d7414ba3420e29228d","revision_id":"7a61e299-908d-5372-860b-99ed190f9d7a","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[{"id":"038d5db9-5470-5f31-9a92-51033f4c9ebd","title":"Pediatric migraine: 200 mg/day trials reported opposing preventive outcomes","kind":"contradiction","status":"open","why":"Two randomized pediatric trials at 200 mg/day disagree about migraine-frequency prevention: the 2008 study found no benefit, while the 2018 study reported a large responder advantage. This is an unresolved research discrepancy, not an editorial correction or a comparison of adult and child biology.","resolution":"Retain both outcomes. Baseline status, age distribution, placebo response, recruitment, measurement, missing-data handling and population genetics are candidates to investigate; none has been shown to explain this difference.","created_at":"2026-09-17 10:23:30","record_type":"conflict","display_label":"Recorded conflict","record_url":"/conflicts/038d5db9-5470-5f31-9a92-51033f4c9ebd","sides":[{"conflict_id":"038d5db9-5470-5f31-9a92-51033f4c9ebd","ordinal":0,"label":"2008 pediatric randomized trial: no advantage over placebo","revision_id":"7a61e299-908d-5372-860b-99ed190f9d7a","start_line":1729,"end_line":1739,"quote":"### b2-migraine-child-null\nIn the 48-child trial,>=50% attack reduction occurred in 12/27 riboflavin versus 14/21 placebo participants; no primary or secondary endpoint differed significantly.\nCondition category: normal\nnutrient_topic: Riboflavin research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: One pediatric trial found no preventive advantage over placebo.\norganism: Homo sapiens\ntissue_or_cell_type: Children with migraine\nexperimental_model: Randomized double-blind placebo-controlled trial in 48 children with migraine.\nlimitations: High placebo response and modest sample; null evidence does not prove impossibility of benefit in every child.\nexposure: 200 mg/day riboflavin versus placebo; primary endpoint>=50% reduction in attack frequency; pharmacological exposure.\n[b2-maclennan2008] High-dose riboflavin for migraine prophylaxis in children: a double-blind, randomized, placebo-controlled trial (2008). https://pubmed.ncbi.nlm.nih.gov/18984840/ DOI: 10.1177/0883073808318053","source_key":"import-548ab9d6-3a9b-5bed-879c-17d03813b636","source_title":"Riboflavin: mechanisms, deficiency and nutrient interactions (2026-09-17)","claim_ids":["9c2f7cfb-1ab0-5dbb-843a-31949f6c6dcb"]},{"conflict_id":"038d5db9-5470-5f31-9a92-51033f4c9ebd","ordinal":1,"label":"2018 pediatric randomized trial: frequency benefit at 200 mg/day","revision_id":"7a61e299-908d-5372-860b-99ed190f9d7a","start_line":1741,"end_line":1751,"quote":"### b2-migraine-child-positive\nIn the 90-child three-arm study,>=50% frequency reduction occurred in 24/30 on 200 mg/day versus 4/30 placebo; 100 mg/day did not show a significant benefit.\nCondition category: normal\nnutrient_topic: Riboflavin research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: A later pediatric trial reported benefit at the same 200 mg daily exposure used in the earlier negative study.\norganism: Homo sapiens\ntissue_or_cell_type: Children with migraine\nexperimental_model: 90 children ages 5-13 randomized equally to placebo, 100 mg or 200 mg riboflavin; 12-week trial.\nlimitations: Single-center study, small arms and baseline values carried forward for missing follow-up; genotype and deficiency did not establish the reason for discordance.\nexposure: 100 or 200 mg/day riboflavin versus placebo; missing follow-up values carried forward from baseline; pharmacological exposure.\n[b2-talebian2018] Prophylactic effect of riboflavin on pediatric migraine: a randomized, double-blind, placebo-controlled trial (2018). https://pubmed.ncbi.nlm.nih.gov/29629048/ DOI: 10.19082/6279","source_key":"import-548ab9d6-3a9b-5bed-879c-17d03813b636","source_title":"Riboflavin: mechanisms, deficiency and nutrient interactions (2026-09-17)","claim_ids":["39f36f6d-2fb1-55ef-b0e5-325561bc0f88"]}]}],"corrections":[],"research":null}