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PACAP38 Induced Headache, Migraine and Flushing in Patients With Migraine

Not Applicable
Completed
Conditions
Migraine Without Aura
Interventions
Other: Isotonic Saline
Other: Pituitary adenylate cyclase-activating peptide-38
Registration Number
NCT03881644
Lead Sponsor
Danish Headache Center
Brief Summary

The aim is to investigate the incidence of headache, migraine attacks and flushing after pituitary adenylate cyclase-activating peptide-38 (PACAP38) with and without treatment with sumatriptan in patients with migraine

Detailed Description

Pituitary adenylate cyclase-activating peptide-38 (PACAP38) plays a role in migraine pathophysiology. Infusions of PACAP38 can trigger migraine-like attacks in some migraine patients and will induce flushing in all patients. We are investigating whether treatment with sumatriptan has an effect on the PACAP38-induced flushing and on whether headache and migraine is induced.

The purpose of this study is to investigate PACAP38-induced headache and migraine in patients with migraine who have been treated with either sumatriptan or placebo using purpose-developed standardized interview. The study will be conducted with a double-blind, placebo-controlled crossover study design.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
37
Inclusion Criteria
  • diagnosis of migraine, according to IHS criteria
  • weight between 50 - 100 kilograms
  • women in fertile age must not be pregnant and must use adequate contraception
Exclusion Criteria
  • migraine more than 5 days per month in average over the past year
  • any primary headache other than migraine, apart from tension-type headache which must be less than 5 days per month
  • headache < 48 hours before experimental day
  • migraine < 72 hours before each experimental day
  • daily / frequent use of any medication apart from contraceptive medication
  • use of any drug less than 5 times the half-life of the drug at the time of the experiment
  • women who are pregnant or breast-feeding at the time of the experiment
  • anamnestic or clinical signs of hypertension (systolic blood pressure > 150 mmHg and/or
  • diastolic blood pressure > 100 mmHg) or hypotension (systolic blood pressure < 90 mmHg and/or diastolic blood pressure < 50 mmHg)
  • anamnestic or clinical signs of mental illness, or abuse of alcohol / drugs
  • patients with glaucoma or prostate hyperplasia
  • anamnestic or clinical symptoms of any sort that the investigating doctor deemed unfit for participating in the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
PACAP38 + ImigranImigranPituitary adenylate cyclase-activating peptide-38 infusion (10 picomol/kg/min) for 20 mins AND Imigran infusion (0.4 mg/min) for 10 mins
PACAP38 + Isotonic SalineIsotonic SalinePituitary adenylate cyclase-activating peptide-38 infusion (10 picomol/kg/min) for 20 mins AND Isotonic saline for 10 mins (placebo)
PACAP38 + ImigranPituitary adenylate cyclase-activating peptide-38Pituitary adenylate cyclase-activating peptide-38 infusion (10 picomol/kg/min) for 20 mins AND Imigran infusion (0.4 mg/min) for 10 mins
PACAP38 + Isotonic SalinePituitary adenylate cyclase-activating peptide-38Pituitary adenylate cyclase-activating peptide-38 infusion (10 picomol/kg/min) for 20 mins AND Isotonic saline for 10 mins (placebo)
Primary Outcome Measures
NameTimeMethod
Incidence of migraineFrom 0 to 12 hours after infusion

Incidence of migraine after PACAP38-infusion will be estimated through a standardized interview based on the international headache classification for migraine

Effect of SumatriptanFrom 0 to 12 hours after infusion

Severity of PACAP38-induced headache and migraine after pretreatment with sumatriptan in migraine patients measured by numerical rating scale for pain from 0 ("no pain") to 10 ("worst pain imaginable")

Secondary Outcome Measures
NameTimeMethod
Severity of headacheFrom 0 to 12 hours after infusion

Severity of PACAP38-induced headache will be rated on a numerical rating scale for pain from 0 ("no pain") to 10 ("worst pain imaginable")

Facial temperatureFrom 0 to 4 hours after infusion

PACAP38-induced temperature changes with and without sumatriptan-treatment measured by infrared thermography

Superficial temporal artery diameterFrom 0 to 4 hours after infusion

Superficial temporal artery diameter after PACAP38 with and without sumatriptan-treatment measured by ultrasound

Severity of flushingFrom 0 to 4 hours after infusion

Facial skin blood flow (flushing) will be measured by laser doppler flowmetry to evaluate the severity of PACAP38-induced flushing with and without sumatriptan-treatment

Trial Locations

Locations (1)

DanishHC

🇩🇰

Glostrup, Denmark

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