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Safety and Efficacy of NPS 1776 in the Acute Treatment of Migraine Headaches

Phase 2
Completed
Conditions
Migraine Headache
Interventions
Drug: NPS 1776 (400 mg)
Drug: PLACEBO
Drug: NPS 1776 (800 mg)
Registration Number
NCT00172094
Lead Sponsor
Shire
Brief Summary

The purpose of this study was to evaluate the effectiveness and safety of a single oral dose of NPS 1776 in the acute treatment of migraine pain and associated symptoms.

Detailed Description

Migraine, the most common cause of recurrent severe or disabling headache, is diagnosed on the basis of a clinical history of intermittent headache with autonomic, constitutional, and neurologic disturbances.

Many antiepileptic drugs (AEDs) have demonstrated efficacy as acute and/or prophylaxis therapy for migraine, even though the mechanism of action of the various AEDs is poorly understood.

NPS 1776, isovaleramide, is a neutral aliphatic amide. The mechanism by which NPS 1776 exerts its therapeutic actions in nonclinical animal models of disease is unclear. The same is true for many antiepileptics on the market today. NPS 1776 does not appear to bind directly to various CNS receptor centers, although it shows a broad range of anticonvulsant activity in multiple animal models of seizures. This broad profile of anticonvulsant activity is similar to that of valproic acid (VPA), and may also predict NPS 1776 efficacy in the treatment of migraine.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
189
Inclusion Criteria
  1. Diagnosis of migraine for at least a year prior to screening.
  2. Experiences 2-10 migraine headaches per month (with at least 24 hours between episodes) and no more than 15 headache days per month in the 3 months prior to screening.
  3. Ability and willingness to arrive at the investigator's center within 1 hour (±5 min) of migraine pain onset (defined as pain that is consistent with the subject's usual migraine and is of at least moderate severity).
  4. Ability and willingness to abstain from taking medications not allowed by the protocol and to meet phone and check-in criteria.
  5. Ability and willingness to undergo a comprehensive urine toxicology screen for both licit and illicit drugs.
  6. Ability and willingness to complete a migraine-history diary from screening to treatment with study drug and a migraine-treatment diary from discharge through the remainder of the 24-hour period following study-drug treatment.
Exclusion Criteria
  1. Unstable or uncontrolled significant metabolic, hepatic, renal, hematological, pulmonary, gastrointestinal, urological, neurological (except migraine headaches), or psychiatric disorders.
  2. Severe or acute cardiovascular or cerebrovascular disease, uncontrolled hypertension, or basilar or hemiplegic migraines.
  3. History of hypersensitivity, allergies, or nonresponse to valproic acid.
  4. Have taken VPA or other AED in the 30 days prior to screening, or are taking a migraine prophylaxis treatment other than a stable dose of propranolol or tricyclic antidepressant.
  5. Migraine attacks that in the investigator's opinion are associated with intractable nausea and/or vomiting.
  6. Any acute or chronic condition that in the investigator's opinion would limit the subject's ability to complete and/or participate in this clinical study or would place the subject at increased risk.
  7. Have newly started or changed the dose of either feverfew or magnesium (above 200 mg, the amount in common daily supplements) within 3 months prior to screening.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2NPS 1776 (400 mg)400 mg 1776 powder
1PLACEBOPLACEBO
3NPS 1776 (800 mg)1776 (800 mg)
Primary Outcome Measures
NameTimeMethod
The response rate at 2 hours post-dose such that the percentage of subjects whose migraine pain-intensity score is none [0] or mild [1] at 2 hours post-dose, after a baseline pain intensity of moderate [2] or severe [3]2 hours post-dose
Secondary Outcome Measures
NameTimeMethod
Pain-free rate at 2 hours post-dose2 hours post-dose
Response rate up to 48 (±24) hours post-dose48 hours post-dose
Recurrence rate of migraine headache within 24 hours post dose24 hours post-dose
Time to recurrence of migraine within 24 hours post-dose24 hours post-dose
Area under the migraine pain curve in visual analogue scale (VAS) 0 4 hours post-dose4 hours post-dose
VAS pain reduction: peak pain reduction in VAS score 0-4 hours post-dose4 hours post-dose
Presence of nausea/vomiting, sensitivity to sound/light, skin sensitivity (cutaneous allodynia), intracranial sensitivity24 hours post-dose
Brush allodynia24 hours post-dose
Muscle tenderness24 hours post-dose
Functional disability24 hours post-dose
Use of rescue medication4 hours post-dose
Time to meaningful pain relief2 hours post-dose
Global Subject Impression (GSI)24 hours post-dose

Trial Locations

Locations (22)

Neuroscience Center of Northern New Jersey

🇺🇸

Morristown, New Jersey, United States

The New England Center for Headache

🇺🇸

Stamford, Connecticut, United States

Mercy Health Research

🇺🇸

Chesterfield, Missouri, United States

University Clinical Research, Inc

🇺🇸

Pembroke Pines, Florida, United States

Headache Wellness Center

🇺🇸

Greensboro, North Carolina, United States

Clinical Study Centers, LLC

🇺🇸

Little Rock, Arkansas, United States

North County Neurological Associates

🇺🇸

Oceanside, California, United States

San Francisco Clinical Research Center

🇺🇸

San Francisco, California, United States

Clinical Innovations

🇺🇸

Santa Ana, California, United States

California Medical Clinic for Headache

🇺🇸

Santa Monica, California, United States

Diamond Headache Clinic

🇺🇸

Chicago, Illinois, United States

MedTrial Boston

🇺🇸

Wellesley Hills, Massachusetts, United States

Headache Care Center/ Clinvest

🇺🇸

Springfield, Missouri, United States

University of Medicine and Dentistry, New Jersey School of Osteopathic Medicine

🇺🇸

Moorestown, New Jersey, United States

Michigan Head-Pain & Neurological Institute

🇺🇸

Ann Arbor, Michigan, United States

Piedmont Medical Research Associates

🇺🇸

Winston-Salem, North Carolina, United States

Neurology Ctr. of Ohio

🇺🇸

Toledo, Ohio, United States

The Neurology Clinic

🇺🇸

Portland, Oregon, United States

Thomas Jefferson University Hospital/ Jefferson Headache Center

🇺🇸

Philadelphia, Pennsylvania, United States

Houston Headache Clinic

🇺🇸

Houston, Texas, United States

Medical Affiliated Research Center

🇺🇸

Huntsville, Alabama, United States

Neurology & Neurosurgery Associates of Tacoma, Inc., PS

🇺🇸

Tacoma, Washington, United States

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