MedPath

Acute Treatment Trial in Adult Subjects With Migraines

Phase 2
Completed
Conditions
Migraine
Interventions
Device: Intranasal Aptar Pharma Unit Dose System
Registration Number
NCT03872453
Lead Sponsor
Pfizer
Brief Summary

The purpose of the study is to evaluate the safety and efficacy of three different intranasal dose levels of zavegepant (BHV-3500), relative to placebo, in the acute treatment of moderate to severe migraine.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
2154
Inclusion Criteria

Key Inclusion Criteria:

  1. Participants have at least 1-year history of migraines (with or without aura), consistent with a diagnosis according to the International Classification of Headache Disorder, 3rd Edition, including the following:

  2. Migraine attacks present for more than 1 year with the age of onset prior to 50 years of age.

  3. Migraine attacks, on average, lasting about 4-72 hours if untreated.

  4. Not more than 8 attacks of moderate to severe intensity per month within the last 3 months.

  5. At least 2 consistent migraine headache attacks of moderate or severe intensity in each of the 3 months prior to the Screening Visit and throughout the Screening Period.

  6. Less than 15 days with headache (migraine or non-migraine) per month in each of the 3 months prior to the Screening Visit and throughout the Screening Period.

  7. Participants on prophylactic migraine medication are permitted to remain on therapy provided they have been on a stable dose for at least 3 months prior to Screening Visit and the dose is not expected to change during the course of the study.

  8. Participants with contraindications for use of triptans may be included provided they meet all other study entry criteria.

Exclusion Criteria

Key Exclusion Criteria:

  1. Participant with a history of basilar migraine or hemiplegic migraine.
  2. Participant with a history of human immunodeficiency virus (HIV) disease.
  3. Participant history with current evidence of uncontrolled, unstable or recently diagnosed cardiovascular disease, such as ischemic heart disease, coronary artery vasospasm, and cerebral ischemia. Participants with myocardial infarction, acute coronary syndrome, percutaneous coronary intervention, cardiac surgery, stroke or transient ischemic attack during the 6 months prior to screening.
  4. Uncontrolled hypertension (high blood pressure), or uncontrolled diabetes (however subjects can be included who have stable hypertension and/or diabetes for at least 3 months prior to being enrolled).
  5. Participant has a current diagnosis of major depression, other pain syndromes, psychiatric conditions (for example, schizophrenia), dementia, or significant neurological disorders (other than migraine) that, in the Investigator's opinion might interfere with study assessments.
  6. Participant has a history of gastric, or small intestinal surgery (including gastric bypass, gastric banding, gastric sleeve, gastric balloon, etc.), or has disease that causes malabsorption.
  7. The participant has a history of current or evidence of any significant and/ or unstable medical conditions (for example, history of congenital heart disease or arrhythmia, known suspected infection, hepatitis B or C, or cancer) that, in the Investigator's opinion, would expose them to undue risk of a significant adverse event or interfere with assessments of safety or efficacy during the course of the trial.
  8. History of, treatment for, or evidence of, alcohol or drug abuse within the past 12 months or subjects who have met Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM-V) criteria for any significant substance use disorder within the past 12 months from the date of the Screening Visit.
  9. History of nasal surgery in the 6 months preceding the Screening Visit.
  10. Participation in any other investigational clinical trial while participating in this clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Zavegepant 5 mgIntranasal Aptar Pharma Unit Dose SystemParticipants administered a single intranasal dose of zavegepant 5 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar Unidose System (UDS) liquid spray device.
Zavegepant 10 mgIntranasal Aptar Pharma Unit Dose SystemParticipants administered a single intranasal dose of zavegepant 10 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar UDS liquid spray device.
Zavegepant 20 mgZavegepantParticipants administered a single intranasal dose of zavegepant 20 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar UDS liquid spray device.
Zavegepant 20 mgIntranasal Aptar Pharma Unit Dose SystemParticipants administered a single intranasal dose of zavegepant 20 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar UDS liquid spray device.
PlaceboZavegepant matching placeboParticipants administered a single intranasal dose of zavegepant-matching placebo on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar UDS liquid spray device.
PlaceboIntranasal Aptar Pharma Unit Dose SystemParticipants administered a single intranasal dose of zavegepant-matching placebo on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar UDS liquid spray device.
Zavegepant 5 mgZavegepantParticipants administered a single intranasal dose of zavegepant 5 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar Unidose System (UDS) liquid spray device.
Zavegepant 10 mgZavegepantParticipants administered a single intranasal dose of zavegepant 10 mg on occurrence of migraine that reached moderate or severe intensity within 45 days after randomization. The dose was administered using Aptar UDS liquid spray device.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants With Freedom From Most Bothersome Symptom (MBS) at 2 Hours Post-dose2 hours post-dose

MBS was reported as nausea, photophobia, or phonophobia at migraine onset using the eCOA handheld device. Symptom status (absent, present) was assessed post-dose using the eCOA handheld device separately for nausea, photophobia, and phonophobia. Freedom from MBS was defined as MBS reported at on-study migraine attack onset that was absent post-dose.

Percentage of Participants With Freedom From Pain at 2 Hours Post-dose2 hours post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the electronic clinical outcome assessment (eCOA) handheld device. Pain freedom was defined as pain level of none post-dose.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With Pain Relief at 2 Hours Post-dose2 hours post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the eCOA handheld device. Pain relief was defined as pain level of none or mild.

Percentage of Participants Who Were Able to Function Normally at 2 Hours Post-dose2 hours post-dose

Functional disbaility level was assessed on a 4-point scale (normal function, mildly impaired, severely impaired, requires bedrest) using the eCOA handheld device. Normal function was defined as a functional disability level of normal post-dose in the subset of participants with functional disability (mildly impaired, severely impaired, requires bedrest) at on-study migraine attack onset.

Percentage of Participants With Rescue Medication Use Within 24 Hours Post-doseThrough 24 hours post-dose

Participants who did not experience relief of their migraine headache at the end of 2 hours after dosing with study medication (and after the 2-hour assessments had been completed on the eCOA handheld device) were permitted to use the following rescue medications: aspirin, ibuprofen, acetaminophen up to 1000 mg/day (this includes Excedrin® Migraine), naproxen (or any other type of nonsteroidal anti-inflammatory drug), antiemetics (for example, metoclopramide or promethazine), or baclofen. The participant's use of rescue medication was recorded by the site on a case report form.

Percentage of Participants With Freedom From Photophobia at 2 Hours Post-dose2 hours post-dose

Photophobia (sensitivity to light) status was measured as absent or present in the eCOA handheld device. Freedom from photophobia was defined as photophobia absent post-dose in the subset of participants with photophobia present at on-study migraine attack onset.

Percentage of Participants With Freedom From Phonophobia at 2 Hours Post-dose2 hours post-dose

Phonophobia (sensitivity to sound) status was measured as absent or present in the eCOA handheld device. Freedom from phonophobia was defined as phonophobia absent post-dose in the subset of participants with phonophobia present at on-study migraine attack onset.

Percentage of Participants With Pain Relief at 60 Minutes Post-dose60 minutes post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the eCOA handheld device. Pain relief was defined as pain level of none or mild.

Percentage of Participants Who Were Able to Function Normally at 60 Minutes Post-dose60 minutes post-dose

Functional disbaility level was assessed on a 4-point scale (normal function, mildly impaired, severely impaired, requires bedrest) using the eCOA handheld device. Normal function was defined as a functional disability level of normal post-dose in the subset of participants with functional disability (mildly impaired, severely impaired, requires bedrest) at on-study migraine attack onset.

Percentage of Participants With Pain Relief at 30 Minutes Post-dose30 minutes post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the eCOA handheld device. Pain relief was defined as pain level of none or mild.

Percentage of Participants Who Were Able to Function Normally at 30 Minutes Post-dose30 minutes post-dose

Functional disbaility level was assessed on a 4-point scale (normal function, mildly impaired, severely impaired, requires bedrest) using the eCOA handheld device. Normal function was defined as a functional disability level of normal post-dose in the subset of participants with functional disability (mildly impaired, severely impaired, requires bedrest) at on-study migraine attack onset.

Percentage of Participants With Sustained Pain Relief From 2 to 24 Hours Post-doseFrom 2 hours up to 24 hours post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the eCOA handheld device. Sustained pain relief was defined as pain level of none or mild at 2 hours up to 24 hours post-dose.

Percentage of Participants With Sustained Pain Freedom From 2 to 24 Hours Post-doseFrom 2 hours up to 24 hours post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the eCOA handheld device. Sustained pain freedom was defined as pain level of none at 2 hours up to 24 hours post-dose.

Percentage of Participants With Sustained Pain Relief From 2 to 48 Hours Post-doseFrom 2 hours up to 48 hours post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the eCOA handheld device. Sustained pain relief was defined as pain level of none or mild at 2 hours up to 48 hours post-dose.

Percentage of Participants With Sustained Pain Freedom From 2 to 48 Hours Post-doseFrom 2 hours up to 48 hours post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the eCOA handheld device. Sustained pain freedom was defined as pain level of none at 2 hours up to 48 hours post-dose.

Percentage of Participants With Freedom From Nausea at 2 Hours Post-dose2 hours post-dose

Nausea status was measured as absent or present in the eCOA handheld device. Freedom from nausea was defined as nausea absent post-odse in the subset of participants with nausea present at on-study migraine attack onset.

Percentage of Participants With Pain Relapse From 2 to 48 Hours Post-doseFrom 2 hours up to 48 hours post-dose

Pain levels were assessed on a 4-point scale (none, mild, moderate, severe) using the eCOA handheld device. Pain relapse was defined as pain level of mild, moderate, or severe after 2 hours up to 48 hours post-dose in the subset of participants with pain level of none at 2 hours post-dose.

Trial Locations

Locations (75)

CT Clinical Research

🇺🇸

Cromwell, Connecticut, United States

Elite Clinical Studies

🇺🇸

Phoenix, Arizona, United States

Optimus Medical Group

🇺🇸

San Francisco, California, United States

Clinical Research Associates, Inc.

🇺🇸

Nashville, Tennessee, United States

Wasatch Clinical Research, LLC

🇺🇸

Salt Lake City, Utah, United States

eStudySite

🇺🇸

La Mesa, California, United States

National Research Institute

🇺🇸

Panorama City, California, United States

Clinical Neuroscience Solutions, Inc.

🇺🇸

Orlando, Florida, United States

Center for Pharmaceutical Research, LLC

🇺🇸

Kansas City, Missouri, United States

Multi-Specialty Research Associates, Inc.

🇺🇸

Lake City, Florida, United States

Meridien Research

🇺🇸

Tampa, Florida, United States

Phoenix Medical Research

🇺🇸

Prairie Village, Kansas, United States

Center for Emotional Fitness

🇺🇸

Cherry Hill, New Jersey, United States

Family Medicine Specialists/CIS

🇺🇸

Wauconda, Illinois, United States

Ki Health Partners, LLC, dba New England Institute for Clinical Research

🇺🇸

Stamford, Connecticut, United States

Crescent City Headache and Neurology Center, LLC

🇺🇸

Chalmette, Louisiana, United States

Premiere Research Institute

🇺🇸

West Palm Beach, Florida, United States

Ormond Medical Arts Pharmaceutical Research Center

🇺🇸

Ormond Beach, Florida, United States

Meridian Clinical Research

🇺🇸

Dakota Dunes, South Dakota, United States

Clinical Trials of South Carolina

🇺🇸

Charleston, South Carolina, United States

Sundance Clinical Research, LLC

🇺🇸

Saint Louis, Missouri, United States

Rochester Clinical Research, Inc.

🇺🇸

Rochester, New York, United States

Meritas Health Neurology

🇺🇸

North Kansas City, Missouri, United States

Wilmington Health, PLLC

🇺🇸

Wilmington, North Carolina, United States

PharmQuest

🇺🇸

Greensboro, North Carolina, United States

Hightower Clinical

🇺🇸

Oklahoma City, Oklahoma, United States

PMG Research of Charlotte, LLC

🇺🇸

Charlotte, North Carolina, United States

Hometown Urgent Care and Research

🇺🇸

Dayton, Ohio, United States

Upstate Clinical Research Associates, LLC

🇺🇸

Williamsville, New York, United States

FutureSearch Trials of Neurology

🇺🇸

Austin, Texas, United States

FutureSearch Trials of Dallas

🇺🇸

Dallas, Texas, United States

Clinical Investigation Specialists, Inc.

🇺🇸

Kenosha, Wisconsin, United States

Ventavia Research Group

🇺🇸

Fort Worth, Texas, United States

Charlottesville Medical Research Center, LLC

🇺🇸

Charlottesville, Virginia, United States

Northwest Clinical Research

🇺🇸

Bellevue, Washington, United States

Denver Neurological Research, LLC

🇺🇸

Denver, Colorado, United States

Summit Research Network (Oregon) Inc.

🇺🇸

Portland, Oregon, United States

StudyMetrix Research

🇺🇸

Saint Peters, Missouri, United States

Texas Center for Drug Development, Inc.

🇺🇸

Houston, Texas, United States

Dynamed Clinical Research

🇺🇸

Tomball, Texas, United States

Advanced Pharmaceutical Development Clinical Research

🇺🇸

Magnolia, Texas, United States

Coastal Clinical Research, Inc.

🇺🇸

Mobile, Alabama, United States

Baptist Health Center for Clinical Research

🇺🇸

Little Rock, Arkansas, United States

Collaborative Neuroscience Network, LLC

🇺🇸

Long Beach, California, United States

Pharmacology Research Institute

🇺🇸

Newport Beach, California, United States

Synergy San Diego

🇺🇸

Lemon Grove, California, United States

Neurological Research Institute

🇺🇸

Santa Monica, California, United States

MD Clinical

🇺🇸

Hallandale Beach, Florida, United States

Diablo Clinical Research, Inc.

🇺🇸

Walnut Creek, California, United States

AGA Clinical Trials

🇺🇸

Miami, Florida, United States

iResearch Atlanta, LLC

🇺🇸

Decatur, Georgia, United States

Boston Clinical Trials

🇺🇸

Boston, Massachusetts, United States

Community Clinical Research Network

🇺🇸

Marlborough, Massachusetts, United States

DelRicht Research

🇺🇸

New Orleans, Louisiana, United States

New Orleans Center for Clinical Research

🇺🇸

New Orleans, Louisiana, United States

Regeneris Medical

🇺🇸

North Attleboro, Massachusetts, United States

Michigan Head Pain & Neurological Institute

🇺🇸

Ann Arbor, Michigan, United States

QPS Bio-Kinetic Clinical Applications, LLC

🇺🇸

Springfield, Missouri, United States

Clinvest Research LLC

🇺🇸

Springfield, Missouri, United States

Headache Wellness Center

🇺🇸

Greensboro, North Carolina, United States

Clinical Neuroscience Solutions DBA CNS Healthcare

🇺🇸

Memphis, Tennessee, United States

Coastal Carolina Research Center

🇺🇸

Mount Pleasant, South Carolina, United States

Tidewater Integrated Medical Research

🇺🇸

Virginia Beach, Virginia, United States

Victorium Clinical Research

🇺🇸

San Antonio, Texas, United States

PMG Research of Raleigh, LLC

🇺🇸

Raleigh, North Carolina, United States

Dent Neurosciences Research Center

🇺🇸

Amherst, New York, United States

Qps Mra, Llc

🇺🇸

Miami, Florida, United States

Clinical Research Institute, Inc.

🇺🇸

Plymouth, Minnesota, United States

Red Star Research, LLC

🇺🇸

Lake Jackson, Texas, United States

Albuquerque Clinical Trials, Inc.

🇺🇸

Albuquerque, New Mexico, United States

Oregon Center for Clinical Investigations, Inc. (OCCI, Inc.)

🇺🇸

Salem, Oregon, United States

Alliance for Multispecialty Research/New Orleans Center for Clinical Research/Volunteer Research

🇺🇸

Knoxville, Tennessee, United States

Montefiore Medical Center: Headache Center

🇺🇸

Bronx, New York, United States

MedPharmics, LLC

🇺🇸

Biloxi, Mississippi, United States

MedVadis Research Corporation

🇺🇸

Watertown, Massachusetts, United States

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