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This is a randomized, multicenter, double-blind, placebo-controlled, parallel-group study to evaluate the safety and efficacy of a single dose of TNX-201 (140 mg) for the treatment of a single qualifying Tension-Type-Headache (TTH).
The study will be conducted in 4 periods (the Screening Period, the Run-In Period, the Double-Blind Treatment Period and the Follow-up Period) and 4 visits (the Screening Visit, Enrollment Visit, Randomization Visit and End-of-Study Visit).
Screening Period- Eligible subjects who provide written informed consent to participate will have study assessments performed at the Screening.
Run-In Period- The Run-In Period will last for at least 28 days. During the Run-In period, subjects will be assessed for frequency of headache, study compliance and to ensure they meet all required study criteria for randomization.
Double-Blind Treatment Period- The Double-Blind Treatment Period (Treatment Period) will last up to 4 weeks or until a qualifying headache episode has occurred and been treated using the study drug, whichever occurs first.
Follow-up Period- All subjects will return to the investigational site for this visit, regardless of whether they have treated a qualifying TTH with study medication. Subjects who have not treated a qualifying TTH with study drug during the Treatment Period will be asked to return study materials and undergo safety evaluations at the End-of-Study Visit and will be discharged from the study. Subjects who have treated a qualifying TTH with study drug during the Treatment Period will ingest a 140 mg dose of open-label TNX-201 at this visit and undergo urine and blood sample collection for 3 hours post-dose to characterize each subject's genetic metabolism and PK profile.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TNX-201 | Experimental | 4 X 35 mg capsules to be taken when qualifying tension-type headache occurs |
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| Placebo | Placebo Comparator | 4 X placebo capsules to be taken when qualifying tension-type headache occurs |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TNX-201 | Drug | TNX-201 capsule |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects Pain Free | Number of subjects pain free at 2 hours post-dose (Pain assessed by 4-point NRS, VAS, and binary yes/no question). 4-point NRS grades: 0=none, 1=mild, 2=moderate, 3=severe; "pain-free" defined as score = 0. VAS: 0-100 scale, anchored by verbal anchors of No Pain (0) vs. Worst Imaginable Headache Pain (100). "Pain-free" was defined as a score <= 5 | 2 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Subjects Pain Free at 15, 30, 60, 90 Minutes and 4 Hours Post-dose (Pain Will be Assessed by 4-point NRS, VAS, and Binary Yes/no Question) | 4-point NRS grades: 0=none, 1=mild, 2=moderate, 3=severe. VAS: 0-100 scale, No Pain vs. Worst Imaginable Headache Pain | 15, 30, 60, 90 minutes and 4 hours post-dose |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tracie Ruther, M.S | 1 513 579 9911 ext 2214 | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| James D. Wolfe, MD | San Jose | California | 95117 | United States | ||
| Avail Clinical Research LLC. |
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| ID | Title | Description |
|---|---|---|
| FG000 | TNX-201 | 4 X 35 mg capsules to be taken orally with a minimum of 4 ounces of water when qualifying tension-type headache occurs TNX-201: TNX-201 capsule |
| FG001 | Placebo | 4 X placebo capsules to be taken orally with a minimum of 4 ounces of water when qualifying tension-type headache occurs Placebo: Placebo capsule |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Placebo | Drug | Placebo capsule |
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| Number of Subjects Using Rescue Medication During the 24-hour Post-dose Period |
| 24-hour post-dose period |
| Number of Subjects With at Least a Two-category Improvement From Baseline at 2 Hours Post-dose in VAS Severity Category (Carvalho Responders) | The Carvalho Responder analysis refers to subjects with at least 2 categories of improvement in their VAS severity category (0-100 scale). VAS severity categories were defined as "severe" if between 52-100 inclusive, "moderate" between 31-51 inclusive, "mild" between 6-30 inclusive, and pain-free if less than 6. Therefore, a Carvalho responder was either a subject who had a VAS response classified as 'severe' at baseline and 'mild' or pain-free at the post-dose assessment time point, or a subject who had a VAS response classified as 'moderate' at baseline and pain-free at the post-dose assessment time point. | 2 hours |
| DeLand |
| Florida |
| 32720 |
| United States |
| Nathan Segall, MD, CPI | Stockbridge | Georgia | 30281 | United States |
| Michigan Head-Pain Neurological Institute | Ann Arbor | Michigan | 48104 | United States |
| Gary D. Berman, MD | Minneapolis | Minnesota | 55402 | United States |
| John Rubino, MD | Raleigh | North Carolina | 27609 | United States |
| PMG Research of Winston-Salem, LLC. | Winston-Salem | North Carolina | 27103 | United States |
| Rapid Medical Research, Inc. | Cleveland | Ohio | 44122 | United States |
| Stephan C. Sharp, MD | Nashville | Tennessee | 37203 | United States |
| Duane G. Wombolt, MD | Norfolk | Virginia | 23507 | United States |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | TNX-201 | 4 X 35 mg capsules to be taken orally with a minimum of 4 ounces of water when qualifying tension-type headache occurs TNX-201: TNX-201 capsule |
| BG001 | Placebo | 4 X placebo capsules to be taken orally with a minimum of 4 ounces of water when qualifying tension-type headache occurs Placebo: Placebo capsule |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| 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 | Number of Subjects Pain Free | Number of subjects pain free at 2 hours post-dose (Pain assessed by 4-point NRS, VAS, and binary yes/no question). 4-point NRS grades: 0=none, 1=mild, 2=moderate, 3=severe; "pain-free" defined as score = 0. VAS: 0-100 scale, anchored by verbal anchors of No Pain (0) vs. Worst Imaginable Headache Pain (100). "Pain-free" was defined as a score <= 5 | LOCF Analysis 8 subjects in the TNX-201 group and 10 subjects in the placebo group who did not take a dose during the double-blind treatment period and/or did not report data 2-hour post-dose were excluded from analyses. | Posted | Count of Participants | Participants | 2 hours |
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| Secondary | Number of Subjects Pain Free at 15, 30, 60, 90 Minutes and 4 Hours Post-dose (Pain Will be Assessed by 4-point NRS, VAS, and Binary Yes/no Question) | 4-point NRS grades: 0=none, 1=mild, 2=moderate, 3=severe. VAS: 0-100 scale, No Pain vs. Worst Imaginable Headache Pain | LOCF Analysis 8 subjects in the TNX-201 group and 10 subjects in the placebo group who did not take a dose during the double-blind treatment period and/or did not report data 2-hour post-dose were excluded from analyses. | Posted | Count of Participants | Participants | 15, 30, 60, 90 minutes and 4 hours post-dose |
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| Secondary | Number of Subjects Using Rescue Medication During the 24-hour Post-dose Period | 8 subjects in the TNX-201 group and 10 subjects in the placebo group who did not take a dose during the double-blind treatment period and/or did not report data 2-hour post-dose were excluded from analyses. | Posted | Count of Participants | Participants | 24-hour post-dose period |
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| Secondary | Number of Subjects With at Least a Two-category Improvement From Baseline at 2 Hours Post-dose in VAS Severity Category (Carvalho Responders) | The Carvalho Responder analysis refers to subjects with at least 2 categories of improvement in their VAS severity category (0-100 scale). VAS severity categories were defined as "severe" if between 52-100 inclusive, "moderate" between 31-51 inclusive, "mild" between 6-30 inclusive, and pain-free if less than 6. Therefore, a Carvalho responder was either a subject who had a VAS response classified as 'severe' at baseline and 'mild' or pain-free at the post-dose assessment time point, or a subject who had a VAS response classified as 'moderate' at baseline and pain-free at the post-dose assessment time point. | Only subjects who were categorized as "severe" or "moderate" at baseline and have data reported at 2 hours were included in this analysis. All subjects who took rescue medication at or before 2 hours were considered non-responders. | Posted | Count of Participants | Participants | 2 hours |
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5 subjects in the TNX-201 group and 9 subjects in the placebo group did not take a dose of study drug during the double-blind treatment period; therefore, these subjects were not included in the analyses.
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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 | TNX-201 | 4 X 35 mg capsules to be taken orally with a minimum of 4 ounces of water when qualifying tension-type headache occurs TNX-201: TNX-201 capsule | 0 | 78 | 5 | 78 | ||
| EG001 | Placebo | 4 X placebo capsules to be taken orally with a minimum of 4 ounces of water when qualifying tension-type headache occurs Placebo: Placebo capsule | 0 | 73 | 6 | 73 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Dizziness | Nervous system disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Abdominal discomfort | Gastrointestinal disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Chills | General disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Dry Mouth | Gastrointestinal disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Malaise | General disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Pyrexia | General disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Somnolence | Nervous system disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Upper Respiratory Tract Infection | Infections and infestations | MedDRA 16.0 | Non-systematic Assessment |
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| Feeling Hot | General disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Flushing | Vascular disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA 16.0 | Non-systematic Assessment |
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| Palpitations | Cardiac disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Sinus Congestion | Respiratory, thoracic and mediastinal disorders | MedDRA 16.0 | Non-systematic Assessment |
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| Sinusitis | Infections and infestations | MedDRA 16.0 | Non-systematic Assessment |
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An industry standard NDA in place with all study investigators.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Judith Gendreau, Senior Medical Director | Tonix Pharmaceuticals | 858-433-5574 | judy.gendreau@tonixpharma.com |
| ID | Term |
|---|---|
| D018781 | Tension-Type Headache |
| ID | Term |
|---|---|
| D051270 | Headache Disorders, Primary |
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| >=65 years |
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| Male |
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| VAS |
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