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Study of Oral Atogepant When Added to OnabotulinumtoxinA (BOTOX) to Assess Adverse Events and Change in Disease Activity in Adult Participants With Chronic Migraine

Phase 3
Active, not recruiting
Conditions
Chronic Migraine
Interventions
Registration Number
NCT05216263
Lead Sponsor
AbbVie
Brief Summary

Migraine is characterized by attacks of throbbing, moderate or severe headache, often associated with nausea, vomiting, and/or sensitivity to light and/or sound. The study will assess safety and tolerability of atogepant when added to BOTOX, as well as prospectively evaluate the efficacy of add-on atogepant for migraine prevention. Adverse events and change in disease activity will be monitored.

Atogepant is an investigational drug being developed to prevent chronic migraine. Approximately 75 adult participants will be enrolled at approximately 30 sites in the United States.

All participants will receive atogepant oral tablet once a day (QD) during the 24-week treatment period, in addition to their standard of care Botox.

There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
75
Inclusion Criteria
  • At least a 1-year history of chronic migraine (CM), with or without aura, consistent with a diagnosis according to International Classification of Headache Disorders 3rd edition (ICHD-3 2018) and with or without acute medication overuse as defined in the protocol.
  • Must be currently treated with BOTOX for CM: treated with >= 2 treatment cycles in the 8 months prior to Visit 2 (Day 1) with documentation of payer authorization or written attestation of self-pay to support continued use of BOTOX.
  • Must have 8 to 23 (inclusive) migraine days in the electronic diary [eDiary] screening/baseline period (eDiary data must have been collected for at least 20 days).
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Exclusion Criteria
  • Use of opioid-containing products for more than 4 days per month for acute treatment of headache in the 3 months prior to Screening or during the screening/baseline period.
  • Treatment of study target muscles using acupuncture, transcutaneous electrical nerve stimulation (TENS), cranial traction, dental splints for headache, or head and/or neck injections of anesthetics/steroids within 4 weeks prior to Screening and throughout the study.
  • Concurrent use of any migraine prevention treatment other than BOTOX (required concomitant medication; or topiramate <=100mg daily) including use of oral gepants in the 4 weeks prior to screening nor during the screening/baseline period.
  • Current use or use within the 6 months (24 weeks) prior to Screening, of mAbs blocking the CGRP pathway.
  • Concurrent use of oral gepants for acute migraine treatment in the 4 weeks prior to screening nor during the screening/baseline period.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
AtogepantAtogepantParticipants will receive atogepant once a day (QD) during the 24-week treatment period.
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Monthly Migraine DaysBaseline (Week 0) through 24 Weeks

Change from Baseline in monthly migraine days, defined by International Headache Society (IHS) Guidelines 2018 will be assessed.

Number of Participants With Adverse Events (AEs)Up to approximately 28 Weeks

An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study. A serious adverse event (SAE) is an event that results in death, is life-threatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event that, based on medical judgment, may jeopardize the participant and may require medical or surgical intervention to prevent any of the outcomes listed above.

Change from Baseline in Monthly Headache Days, Moderate or Severe Headache Days, Cumulative Hours of Headache, Acute Treatment Medication Use Days, Headache Free Days, and Migraine Symptom-Free DaysBaseline (Week 0) through 24 Weeks

Change from baseline in monthly headache days, moderate or severe headache days, cumulative hours of headache, acute treatment medication use days, headache free days, and migraine symptom-free days, defined by IHS Guidelines 2018 will be assessed.

Responder Status of at least 25% Reduction in the Frequency of Monthly Migraine Days Collected via Daily Electronic Diary (eDiary)Baseline (Week 0) through 24 Weeks

Percentage of participants achieving at least 25% reduction from baseline in the frequency of monthly migraine days will be assessed.

Change from Baseline in Monthly Activity Impairment in Migraine - Diary (AIM-D)Baseline (Week 0) through 24 Weeks

The AIM-D is an 11-item daily diary measure that assesses the impact of migraine and is comprised of two domains that evaluate performance of daily activities (7 items) and physical impairment (4 items).

Responder Status of at least 30% Reduction in the Frequency of Monthly Migraine Days Collected via eDiaryBaseline (Week 0) through 24 Weeks

Percentage of participants achieving at least 30% reduction from baseline in the frequency of monthly migraine days will be assessed.

Responder Status of at least 75% Reduction in the Frequency of Monthly Migraine Days Collected via eDiaryBaseline (Week 0) through 24 Weeks

Percentage of participants achieving at least 75% reduction from baseline in the frequency of monthly migraine days will be assessed.

Responder Status of at least 50% Reduction in the Frequency of Monthly Migraine Days Collected via eDiaryBaseline (Week 0) through 24 Weeks

Percentage of participants achieving at least 50% reduction from baseline in the frequency of monthly migraine days will be assessed.

Responder Status of at least 100% Reduction in the Frequency of Monthly Migraine Days Collected via eDiaryBaseline (Week 0) through 24 Weeks

Percentage of participants achieving at least 100% reduction from baseline in the frequency of monthly migraine days will be assessed.

Change from Baseline in Monthly days with Non-Headache Migraine SymptomsBaseline (Week 0) through 24 Weeks

Change from baseline in monthly days with non-headache migraine symptoms such as photophobia, phonophobia, nausea and/or vomiting, dizziness, neck pain, tiredness, mood change, yawning, thirst, cravings, urinary frequency, cranial autonomic symptoms

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (29)

Michigan Headache & Neurological Institute (MHNI) /ID# 241784

🇺🇸

Ann Arbor, Michigan, United States

Minneapolis Clinic of Neurology - Burnsville /ID# 241994

🇺🇸

Burnsville, Minnesota, United States

Albany Medical College /ID# 242757

🇺🇸

Albany, New York, United States

Dent Neurosciences Research Center, Inc. /ID# 241776

🇺🇸

Amherst, New York, United States

Neurology and Neurodiagnostics of Alabama /ID# 242538

🇺🇸

Hoover, Alabama, United States

Barrow Neurological Institute - Dignity Health St. Joseph's Hosp and Medical Ctr /ID# 241812

🇺🇸

Phoenix, Arizona, United States

Arkansas Clinical Research /ID# 241789

🇺🇸

Little Rock, Arkansas, United States

Hope Clinical Research /ID# 241772

🇺🇸

Canoga Park, California, United States

Profound Research LLC /ID# 244084

🇺🇸

Carlsbad, California, United States

Neuro Pain Medical Center /ID# 241992

🇺🇸

Fresno, California, United States

Neurological Research Institute /ID# 242688

🇺🇸

Santa Monica, California, United States

Neurology Offices of South Florida, PLLC /ID# 242693

🇺🇸

Boca Raton, Florida, United States

Coastal Clinical Research Specialists /ID# 247992

🇺🇸

Jacksonville Beach, Florida, United States

University of Miami /ID# 252230

🇺🇸

Miami, Florida, United States

First Physicians Group - Waldemere /ID# 242861

🇺🇸

Sarasota, Florida, United States

Kansas Institute of Research /ID# 241796

🇺🇸

Overland Park, Kansas, United States

Ochsner Clinic Foundation /ID# 241803

🇺🇸

Covington, Louisiana, United States

Beth Israel Deaconess Medical Center /ID# 241800

🇺🇸

Boston, Massachusetts, United States

Headache Wellness Center /ID# 241791

🇺🇸

Greensboro, North Carolina, United States

Jefferson Hospital for Neuroscience /ID# 243712

🇺🇸

Philadelphia, Pennsylvania, United States

Preferred Primary Care Physicians - Jacob Murphy /ID# 241798

🇺🇸

Uniontown, Pennsylvania, United States

Chattanooga Medical Research /ID# 253295

🇺🇸

Chattanooga, Tennessee, United States

Nashville Neuroscience Group /ID# 243592

🇺🇸

Nashville, Tennessee, United States

Texas Neurology /ID# 241795

🇺🇸

Dallas, Texas, United States

Inova Health System /ID# 252242

🇺🇸

Falls Church, Virginia, United States

Integrated Neurology Services - Falls Church /ID# 244747

🇺🇸

Falls Church, Virginia, United States

Puget Sound Neurology /ID# 241787

🇺🇸

Tacoma, Washington, United States

Frontier Clinical Research - Kingwood /ID# 242928

🇺🇸

Kingwood, West Virginia, United States

West Virginia Univ School Med /ID# 252869

🇺🇸

Morgantown, West Virginia, United States

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