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This is a a multi-center, randomized, double-blind, parallel group, and placebo controlled, two-arm study of a single oral dose of NXN-188 for the treatment of acute migraine headache without aura. Up to 120 migraineurs will be enrolled. Approximately 60 subjects having a headache history of migraine without aura will complete each of the two treatment arms to evaluate NXN-188 600 mg or placebo.
After study eligibility was confirmed and all screening procedures completed, subjects were randomized at Visit 1 to receive either NXN-188 600 mg or placebo in a 1:1 ratio. Study drug and diaries were dispensed, and subjects were instructed regarding when to dose with study drug. Subjects were also trained regarding the Interactive Voice Response System (IVRS), and made familiar with the study diary and the completion of study diary assessments. Subjects left the clinic to self-administer treatment as an outpatient at the onset of a moderate to severe migraine headache without aura (as rated on a 4-point categorical scale). Dosing with study drug was to take place within 42 days from Randomization (Visit 1). The subject contacted the investigatorI or designee at 14 and 28 days after Randomization if they had not yet treated a migraine headache without aura in order to receive verbal permission from the site personnel to continue in the study as appropriate. If the subject had not treated a migraine headache within 42 days of Visit 1, the subject did not take study drug and returned all materials, including the unused study drug, to the study site. If the subject experienced a qualifying migraine without aura during the treatment period, (s)he recorded headache symptoms in the study diary when first noticed (and menstrual cycle status [female subjects only]). If the subject met dosing requirements as outlined in the protocol, they dosed with the study drug, called the IVRS to report dosing, recorded all assessments and adverse events (AEs) and contacted the study center to schedule a post treatment visit (Visit 2) within 6 days (± 2 days) of treatment. If study drug resulted in insufficient relief at 2 hours p.a., subjects were permitted to use the non-triptan rescue medication recommended by the PI at Visit 1. Within 6 days (± 2 days) of treatment, the subject returned to the study center for Visit 2. The subject had a brief physical examination, a 12-lead electrocardiogram (ECG), and had samples taken for clinical laboratory tests, including a serum pregnancy test for all females. Concomitant medications taken and adverse events (AEs) experienced from time of dosing to Visit 2 were reported to site personnel and recorded. Study diaries were reviewed and information recorded. Discontinuing subjects returned unused study drug and study material. One safety follow-up telephone contact was made within 15 days (± 2 days) post treatment. For those subjects not meeting the Treatment/Enrollment criteria by Day 42 (i.e., not experiencing a qualifying headache) and for other subjects discontinuing the study protocol post Randomization (Visit 1), a second visit, Visit 2, was required and subjects underwent a brief physical examination, had vital signs and ECGs performed, samples collected for clinical labs, concomitant medications and AEs reviewed, and returned all study drug and study materials.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NXN-188 600 mg | Experimental | 3 x 200 mg capsules, PRN |
|
| Placebo | Placebo Comparator | 3 x 0 mg capsules, PRN |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NXN-188 | Drug | 200 mg capsules, 600 mg, PRN |
|
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| Measure | Description | Time Frame |
|---|---|---|
| Headache Relief (Modified LOCF - Efficacy Evaluable Analysis Set) | Headache relief at 2 hours post administration defined as reduction from Baseline moderate or severe score to mild or none. | 2 hours |
| Headache Recurrence (Modified LOCF - Efficacy Evaluable Analysis Set) | Headache recurrence is defined as any subject that experiences headache relief at the given time point (i.e., 2 hours or 4 hours), who did not use rescue medication and who experienced a worsening of their headache to moderate or severe within 24 hours following study drug administration. The denominator is the number of subjects who experienced headache relief at 2 hours/4 hours. | 4 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Headache Relief Based on a 2-Point Reduction From Baseline (Modified LOCF - Efficacy Evaluable Analysis Set) | The Headache Severity Score (HSS) assessment was recorded in the diary by the subject and used the following categories: 0 = no pain; 1 = mild pain; 2 = moderate pain; and, 3 = severe pain | 72 hours |
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Inclusion Criteria:
Exclusion Criteria:
A diagnosis of headaches that is not consistent with migraine without aura as defined in the inclusion criteria. Subjects with a history of migraine with aura are excluded.
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| Name | Affiliation | Role |
|---|---|---|
| Guy Boudreau, MD | Hopital Notre-Dame Du Chum, Montreal | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Comprehensive Neuroscience, Inc. | St. Petersburg | Florida | 33716 | United States | ||
| Comprehensive NeuroScience, Inc. Atlanta |
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Study Period - 6 months. First subject screened 28 July 2009, Last subject completed the study 9 February 2010.
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo | 3 x capsules, PRN |
| FG001 | NXN-188 600 mg | 3 x 200 mg capsules, PRN |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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Of the 195 subjects randomized, 174 subjects received study drug: the 174 subjects constitute the Safety Population.
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| ID | Title | Description |
|---|---|---|
| BG000 | NXN-188 | 3 x 200 mg capsules |
| BG001 | Placebo | 3 x 0 mg capsules |
| BG002 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Headache Relief (Modified LOCF - Efficacy Evaluable Analysis Set) | Headache relief at 2 hours post administration defined as reduction from Baseline moderate or severe score to mild or none. | Modified LOCF - Efficacy Evaluable Analysis Set | Posted | Number | Participants | 2 hours |
|
|
Adverse event data were collected throughout the study beginning with the dosing of study drug and ending 15 days (± 2 days) p.a.
All AE summaries were restricted to TEAEs, which were defined as those AEs that occurred after dosing and those existing AEs that worsened during the study.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | NXN-188 600 mg | 3 x 200 mg capsules, PRN |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Syncope | Nervous system disorders | MedDRA (11.0) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | MedDRA (11.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Thomas Lategan, PhD | NeurAxon, Inc. | 417-673-6697 | tlategan@neuraxon.com |
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| ID | Term |
|---|---|
| D020326 | Migraine without Aura |
| D008881 | Migraine Disorders |
| ID | Term |
|---|---|
| D051270 | Headache Disorders, Primary |
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| Placebo | Drug | 200 mg capsules with no active ingredient designed to match the NXN-188 capsules |
|
| Headache Relief Based on a 1-Point Reduction From Baseline (Modified LOCF - Efficacy Evaluable Analysis Set) |
The Headache Severity Score (HSS) assessment was recorded in the diary by the subject and used the following categories: 0 = no pain; 1 = mild pain; 2 = moderate pain; and, 3 = severe pain |
| 72 hours |
| Complete Headache Relief (Efficacy Evaluable Analysis Set) | 72 hours |
| Time (Hours) to First Use of Rescue Medication (Full Analysis Set) | Subjects who do not require rescue medication are censored at the time of their last diary assessment completed up to 24 hours following study drug administration. | 24 Hours |
| Overall Evaluation of Study Medication at 24 Hours Post Administration (Full Analysis Set) | Overall evaluation of the study drug was measured with a 4-point scale at 24 hours and used the following categories: 1 = Poor; 2 = Moderate; 3 = Good; and,4 = Excellent | 24 hours |
| Atlanta |
| Georgia |
| 30328 |
| United States |
| Elkind Headache Center | Mount Vernon | New York | 10550 | United States |
| Lifetree Clinical Research | Salt Lake City | Utah | 84106 | United States |
| Non-compliance to Study Procedures |
|
| No migraine headache without aura |
|
| Total |
Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Weight | Mean | Standard Deviation | kg |
|
| Height | Mean | Standard Deviation | cm |
|
| Body Mass Index (BMI) | Mean | Standard Deviation | kg/m^2 |
|
| Type of Migraine | Subjects are counted once within each type where at least one migraine is recorded. | Number | Participants |
|
| Number of Previous Migraines | Previous Migraines for each subject was based on the total number of migraine entries reported on the Migraine History CRF | Mean | Standard Deviation | migraine episodes |
|
| Counts |
|---|
| Participants |
|
|
| Secondary | Headache Relief Based on a 2-Point Reduction From Baseline (Modified LOCF - Efficacy Evaluable Analysis Set) | The Headache Severity Score (HSS) assessment was recorded in the diary by the subject and used the following categories: 0 = no pain; 1 = mild pain; 2 = moderate pain; and, 3 = severe pain | Posted | Number | Participants | 72 hours |
|
|
|
| Secondary | Headache Relief Based on a 1-Point Reduction From Baseline (Modified LOCF - Efficacy Evaluable Analysis Set) | The Headache Severity Score (HSS) assessment was recorded in the diary by the subject and used the following categories: 0 = no pain; 1 = mild pain; 2 = moderate pain; and, 3 = severe pain | Posted | Number | Participants | 72 hours |
|
|
|
| Secondary | Complete Headache Relief (Efficacy Evaluable Analysis Set) | Posted | Number | Participants | 72 hours |
|
|
|
| Primary | Headache Recurrence (Modified LOCF - Efficacy Evaluable Analysis Set) | Headache recurrence is defined as any subject that experiences headache relief at the given time point (i.e., 2 hours or 4 hours), who did not use rescue medication and who experienced a worsening of their headache to moderate or severe within 24 hours following study drug administration. The denominator is the number of subjects who experienced headache relief at 2 hours/4 hours. | 30 and 42 placebo and NXN-188 subjects, respectivley, experienced headache relief at 2 hours. 41 and 55 placebo and NXN-188 subjects, respectively, experienced headache relief at 4 hours. | Posted | Number | Participants | 4 hours |
|
|
|
| Secondary | Time (Hours) to First Use of Rescue Medication (Full Analysis Set) | Subjects who do not require rescue medication are censored at the time of their last diary assessment completed up to 24 hours following study drug administration. | Full Analysis Set includes all subjects in the Safety Population who had at least one post-dose observation for headache severity recorded in his or her diary. | Posted | Median | 95% Confidence Interval | Participants who required rescue | 24 Hours |
|
|
|
| Secondary | Overall Evaluation of Study Medication at 24 Hours Post Administration (Full Analysis Set) | Overall evaluation of the study drug was measured with a 4-point scale at 24 hours and used the following categories: 1 = Poor; 2 = Moderate; 3 = Good; and,4 = Excellent | Full Analysis Set includes all subjects in the Safety Population who had at least one post-dose observation for headache severity recorded in his or her diary. | Posted | Number | Participants | 24 hours |
|
|
|
| Post-Hoc | Sustained Complete Headache Relief (Efficacy Evaluable Analysis Set) | Exploratory Post-hoc Analysis: Sustained complete headache relief is defined as a reduction in headache severity from moderate or severe to absent over all indicated time points. | Efficacy Evaluable Analysis Set includes all subjects in the Full Analysis Set with an observed or imputed HSS (using rules predefined in the Statistical Analysis Plan [SAP]) at both the 2-hour time point and the 4-hour time point when using the modified LOCF approach | Posted | Number | Participants | 2 - 48 hours |
|
|
|
| 0 |
| 86 |
| 17 |
| 86 |
| EG001 | Placebo | 3 x 0 mg capsules, PRN | 1 | 88 | 13 | 88 |
| Abdominal pain upper | Gastrointestinal disorders | MedDRA (11.0) | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (11.0) | Systematic Assessment |
|
| Somnolence | Nervous system disorders | MedDRA (11.0) | Systematic Assessment |
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| Chills | General disorders | MedDRA (11.0) | Systematic Assessment |
|
| Sensation of heaviness | Musculoskeletal and connective tissue disorders | MedDRA (11.0) | Systematic Assessment |
|
| Proteinuria | Renal and urinary disorders | MedDRA (11.0) | Systematic Assessment |
|
Sponsor may request Investigator or Institution not to publish or disclose information related to the clinical study.
| D009422 | Nervous System Diseases |
| Headache Relief - 24 hours |
|
| Headache Relief - 72 hours |
|
| Headache Relief - 24 hours |
|
| Headache Relief - 72 hours |
|
| Complete Headache Relief - 24 hours |
|
| Complete Headache Relief - 72 hours |
|
| 3 = Good |
|
| 4 = Excellent |
|
| 2-48 hours |
|
| 4-48 hours |
|