Safety and Efficacy of ZP-Zolmitriptan Intracutaneous Microneedle Systems for the Acute Treatment of Migraine
- Conditions
- Acute Migraine
- Interventions
- Drug: ZP-ZolmitriptanDrug: Placebo
- Registration Number
- NCT02745392
- Lead Sponsor
- Zosano Pharma Corporation
- Brief Summary
This is a randomized, double-blind, multi-center, parallel-group study designed to compare the safety and efficacy of a range of doses of ZP-Zolmitriptan intracutaneous microneedle systems to placebo.
- Detailed Description
This is a randomized, double-blind, multi-center, parallel group study designed to compare the safety and efficacy of a range of doses of ZP-Zolmitriptan intracutaneous microneedle systems to placebo. Subjects who have consented and meet the entry criteria will be randomized to one of four blinded treatment groups. There will be a screening period of up to 1 week, followed by a run-in period to record migraine activity. The run-in period is to determine eligibility for randomization, and is planned to be 4 weeks in duration but may be extended up to an additional 4 weeks to accommodate scheduling. Qualified subjects will randomize to the double-blind treatment period at Day 0 and will have up to 8 weeks to confirm and treat a qualifying migraine. Using the eDiary to confirm they are experiencing a qualified migraine, subjects will self-administer the patch or patches and continue to respond to questions in the eDiary for 48 hours post treatment administration.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 365
-
Greater than 1 year history of episodic, acute migraine (with or without aura) with onset prior to 50 years of age. Diagnosis must comply with International Headache Society (IHS) diagnostic criteria. Diagnostic criteria must include a history of at least five attacks not attributed to any other disorder that include all of the following criteria:
- Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)
- Headache has at least two of the following characteristics:
(i) unilateral location (ii) pulsating quality (iii) moderate or severe pain intensity (iv) aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs) c) During headache at least one of the following: (i) nausea and/or vomiting (ii) both photophobia and phonophobia
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Migraine history during the 6-month period prior to the run-in period must include: 2-8 migraines per month and no more than 10 headache days per month
-
Women of child-bearing potential must not be pregnant, must agree to avoid pregnancy during the trial, and must use an acceptable methods of birth control for the duration of the trial.
-
No significant ECG findings, defined by:
- ischemic changes
- Q-waves in at least two contiguous leads,
- clinically significant intra-ventricular conduction abnormalities (left bundle branch block or Wolf-Parkinson-White syndrome), or
- clinically significant arrhythmias (e.g., current atrial fibrillation)
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Able to understand the operation of the electronic diary and is able to apply the demo study drug patch.
-
Contraindication to triptans
-
Use of any prohibited concomitant medications within 10 days of the Run-in Period
-
History of hemiplegic or basilar migraine
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Participation in another investigational trial during the 30 days prior to the Run-in Period or during this study
-
Previous participation in a clinical trial of ZP-Zolmitriptan
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Diagnosis of cancer (other than non-invasive skin cancer) within the 5 years prior to the Run-in Period
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History of unstable psychiatric illness requiring medication or hospitalization in the 12 months prior to the Run-in Period
-
Subjects who have known allergy or sensitivity to zolmitriptan or its derivatives or formulations
-
Subjects who have known allergy or sensitivity to adhesives
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Planned participation in activities which cause inflammation, irritation, sunburn, lesions, or tattoos at the intended application site from two weeks prior to screening through the last day of study participation
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Use of opiate analgesics or barbiturates more frequently than one day/week
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Women who are pregnant, breast-feeding or plan a pregnancy during this study
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Clinically significant liver disease
-
Clinically significant kidney disease
-
History of coronary artery disease (CAD), coronary vasospasm (including Prinzmetal's angina), aortic aneurysm, peripheral vascular disease or other ischemic diseases (e.g., ischemic bowel syndrome or Raynaud's syndrome)
-
Three or more of the following CAD risk factors:
- Current tobacco use
- Hypertension or receiving anti-hypertensive medication for treatment of hypertension
- Hyperlipidemia or on prescribed anti-cholesterol treatment
- Family history of premature coronary artery disease (< 55 years of age in male first degree relatives or < 65 years of age in female first degree relatives)
- Diabetes mellitus
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History of cerebral vascular accident, transient ischemic attacks, or seizures
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Hospitalization within the 30 days prior to the Run-in Period
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Any other household member currently participating in a ZP-Zolmitriptan study or relatives of site staff
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Any reason to believe that compliance with the study requirements and completion of evaluations required for this study will not be possible
-
History or current abuse or dependence on alcohol or drugs that would interfere with adherence to study requirements
-
Any clinically relevant abnormal findings in the physical exam, vital signs or laboratory tests that, in the opinion of the Investigator, may put the subject at risk
To be eligible for Treatment, subjects must continue to meet all eligibility criteria and the following criteria observed during the Run-in Period:
- An average of at least two qualifying migraines per 28-day period
- No more than 10 headache days in the last 28 days prior to randomization
- Demonstrated ability to properly use the eDiary and apply the demo study drug patch
- Confirmation of continuing good general health, or stable non-serious disease that in the opinion of the Investigator will not place the subject at risk.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description ZP-Zolmitriptan 3.8 mg ZP-Zolmitriptan ZP-Zolmitriptan 3.8 mg (1.9 mg x 2 patches) single administration ZP-Zolmitriptan 1 mg ZP-Zolmitriptan ZP-Zolmitriptan 1 mg patch single administration ZP-Zolmitriptan 1.9 mg ZP-Zolmitriptan ZP-Zolmitriptan 1.9 mg patch single administration Placebo Placebo Placebo (either single or double patch) single administration
- Primary Outcome Measures
Name Time Method Proportion of Subjects With Freedom From Most Bothersome Pre-specified Other Symptom (Nausea, Photophobia, or Phonophobia Pre-specified by Subject) 2 hours The proportion of subjects with freedom from the subject's pre-specified most bothersome symptom at 2 hours is one of two parts of the co-primary efficacy endpoint. This endpoint will be evaluated separately but both endpoints have to be met statistically for the study to be considered a success.
Proportion of Subjects With Pain Freedom 2 hours Pain Freedom at 2 hours post study drug administration is one of the co-primary endpoints. Subjects were queried via their eDiary about their level of migraine pain (none, mild, moderate, or severe) at various intervals post-dose. Subjects who answered none at 2 hours post study drug were considered pain free at 2 hours.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (36)
Dartmouth-Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States
Novex Medical Research
🇺🇸New Bedford, Massachusetts, United States
Clinvest/A Division of Banyan Group Inc.
🇺🇸Springfield, Missouri, United States
The Research Center of Southern California
🇺🇸Carlsbad, California, United States
Coastal Carolina Research Center
🇺🇸Mount Pleasant, South Carolina, United States
California Medical Clinic for Headache
🇺🇸Santa Monica, California, United States
Ki Health Partners
🇺🇸Stamford, Connecticut, United States
Boston Clinical Trials
🇺🇸Boston, Massachusetts, United States
Allergy and Asthma Specialists Medical Group and Research Center
🇺🇸Huntington Beach, California, United States
Avail Clinical Research, LLC
🇺🇸DeLand, Florida, United States
Clinical Research Atlanta
🇺🇸Stockbridge, Georgia, United States
Headache Wellness Center, PC
🇺🇸Greensboro, North Carolina, United States
Meridien Research
🇺🇸Tampa, Florida, United States
Michigan Head Pain &Neurological Institute
🇺🇸Ann Arbor, Michigan, United States
The Clinical Research Center, LLC
🇺🇸Saint Louis, Missouri, United States
Westside Family Medical Center, P.C
🇺🇸Kalamazoo, Michigan, United States
Downtown LA Research Center
🇺🇸Los Angeles, California, United States
Clinical Research Advantage, Inc./Thunderbird Internal Medicine
🇺🇸Glendale, Arizona, United States
Allergy and Asthma Associates of Santa Clara Valley Research Center
🇺🇸San Jose, California, United States
Empire Clinical Research
🇺🇸Upland, California, United States
MedVadis Research Corporation
🇺🇸Watertown, Massachusetts, United States
North Carolina Clinical Research
🇺🇸Raleigh, North Carolina, United States
Allergy & Asthma Associates of Southern California
🇺🇸Mission Viejo, California, United States
Nebraska Medical Research Institute
🇺🇸Bellevue, Nebraska, United States
Central Texas Health Research
🇺🇸New Braunfels, Texas, United States
Northeast Medical Research Associates, Inc.
🇺🇸North Dartmouth, Massachusetts, United States
Peters Medical Research LLC
🇺🇸High Point, North Carolina, United States
Colorado Allergy & AsthmaCenters, PC
🇺🇸Denver, Colorado, United States
Clinical Research Institute, Inc.
🇺🇸Minneapolis, Minnesota, United States
CTI Clinical Research Center
🇺🇸Cincinnati, Ohio, United States
Nashville Neurosciences Group
🇺🇸Nashville, Tennessee, United States
Sylvana Research Associates
🇺🇸San Antonio, Texas, United States
Medical Research Group of Central Florida
🇺🇸Orange City, Florida, United States
Princeton Center for Clinical Research
🇺🇸Skillman, New Jersey, United States
Charlottesville Medical Research Center LLC
🇺🇸Charlottesville, Virginia, United States
PMG Research of Raleigh
🇺🇸Raleigh, North Carolina, United States