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The study consists of a screening visit, out-patient treatment of a moderate or severe migraine attack with a single dose of the study medication within 8 weeks, and End-of-Study Visit 2-7 days after dosing.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Naltrexone and Acetaminophen | Experimental | Patients take one capsule containing naltrexone and one capsule containing acetaminophen together for a qualifying migraine |
|
| Naltrexon/Acetaminophen-High Capsules | Experimental | Patient take one capsule containing naltrexone (high dose) and one capsule containing acetaminophen together for a qualifying migraine |
|
| Naltrexone Alone Capsules | Active Comparator | Patient take one capsule containing naltrexone and one capsule containing placebo together for a qualifying migraine |
|
| Acetaminophen Alone Capsules | Active Comparator | Patient take one capsule containing naltrexone and one capsule containing placebo together for a qualifying migraine |
|
| Placebo Capsules | Placebo Comparator | Patient take two capsule containing placebo together for a qualifying migraine |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Naltrexone and Acetaminophen | Drug | Naltrexone plus acetaminophen |
| |
| Measure | Description | Time Frame |
|---|---|---|
| % of patients reporting no headache pain. | Self-reported headache pain on a four-point Likert scale. | 2 hours post-dose |
| % of patients having absence of most bothersome migraine-associated symptom (MBS). | MBS was prospectively identified at baseline. Self-reported MBS as present or absent. | 2 hours post-dose |
| % of patients who have "sustained pain freedom" | Defined as having no headache pain at 2 hours after dose, with no use of rescue medication and no relapse of headache pain within 24 hours after administration of the investigational drug. | 24-hour post-dose. |
| Measure | Description | Time Frame |
|---|---|---|
| % of patients having absence of nausea, photophobia, phonophobia, and neck/shoulder pain | Self-reported the current status of their associated symptom as present or absent. | 24-hour post-dose. |
| % of patients who used rescue medications |
| Measure | Description | Time Frame |
|---|---|---|
| % of patients who experienced adverse events | treatment related Adverse Events | 48 hours |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Annette C Toledano, M.D. | Allodynic Therapeutics, Inc | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Annette C. Toledano MD | North Miami | Florida | 33181 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26603732 | Result | Wang X, Zhang Y, Peng Y, Hutchinson MR, Rice KC, Yin H, Watkins LR. Pharmacological characterization of the opioid inactive isomers (+)-naltrexone and (+)-naloxone as antagonists of toll-like receptor 4. Br J Pharmacol. 2016 Mar;173(5):856-69. doi: 10.1111/bph.13394. Epub 2016 Feb 4. | |
| 25744676 | Result | Kato J, Svensson CI. Role of extracellular damage-associated molecular pattern molecules (DAMPs) as mediators of persistent pain. Prog Mol Biol Transl Sci. 2015;131:251-79. doi: 10.1016/bs.pmbts.2014.11.014. Epub 2015 Jan 30. |
| Label | URL |
|---|---|
| 2009-2013 Pain Research Advances \| Interagency Pain ...Thus, identifying potential new medications is critical. Recent evidence indicates a pivotal role for the receptor known as toll-like receptor 4 (TLR4 ... | View source |
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| Naltrexone and Acetaminophen-High Dose |
| Drug |
Naltrexon (high dose) plus acetaminophen |
|
| Naltrexone Alone (regular dose) | Drug | Naltrexone Alone plus Placebo |
|
| Acetaminophen Alone | Drug | Acetaminophen Alone plus Placebo |
|
| Matching Placebo | Drug | Two Placebo capsules |
|
| 2-24 hours |
| % of patients who had headache pain relapse. | Defined as the return of headache of any severity within 48 hours after administration of the investigational drug, when the patient was pain-free at 2 hours after the administration of the investigational drug. | 2-48 hours |
| 22520687 | Result | Lewis SS, Loram LC, Hutchinson MR, Li CM, Zhang Y, Maier SF, Huang Y, Rice KC, Watkins LR. (+)-naloxone, an opioid-inactive toll-like receptor 4 signaling inhibitor, reverses multiple models of chronic neuropathic pain in rats. J Pain. 2012 May;13(5):498-506. doi: 10.1016/j.jpain.2012.02.005. Epub 2012 Apr 20. |
| 17175134 | Result | Watkins LR, Hutchinson MR, Ledeboer A, Wieseler-Frank J, Milligan ED, Maier SF. Norman Cousins Lecture. Glia as the "bad guys": implications for improving clinical pain control and the clinical utility of opioids. Brain Behav Immun. 2007 Feb;21(2):131-46. doi: 10.1016/j.bbi.2006.10.011. Epub 2006 Dec 18. |
| 18662331 | Result | Hutchinson MR, Zhang Y, Brown K, Coats BD, Shridhar M, Sholar PW, Patel SJ, Crysdale NY, Harrison JA, Maier SF, Rice KC, Watkins LR. Non-stereoselective reversal of neuropathic pain by naloxone and naltrexone: involvement of toll-like receptor 4 (TLR4). Eur J Neurosci. 2008 Jul;28(1):20-9. doi: 10.1111/j.1460-9568.2008.06321.x. |
| 28322750 | Result | Wieseler J, Ellis A, McFadden A, Stone K, Brown K, Cady S, Bastos LF, Sprunger D, Rezvani N, Johnson K, Rice KC, Maier SF, Watkins LR. Supradural inflammatory soup in awake and freely moving rats induces facial allodynia that is blocked by putative immune modulators. Brain Res. 2017 Jun 1;1664:87-94. doi: 10.1016/j.brainres.2017.03.011. Epub 2017 Mar 16. |
| 29310498 | Result | Su M, Ran Y, He Z, Zhang M, Hu G, Tang W, Zhao D, Yu S. Inhibition of toll-like receptor 4 alleviates hyperalgesia induced by acute dural inflammation in experimental migraine. Mol Pain. 2018 Jan-Dec;14:1744806918754612. doi: 10.1177/1744806918754612. Epub 2018 Jan 8. |
| 20548058 | Result | Dewall CN, Macdonald G, Webster GD, Masten CL, Baumeister RF, Powell C, Combs D, Schurtz DR, Stillman TF, Tice DM, Eisenberger NI. Acetaminophen reduces social pain: behavioral and neural evidence. Psychol Sci. 2010 Jul;21(7):931-7. doi: 10.1177/0956797610374741. Epub 2010 Jun 14. |
| 19453963 | Result | Younger J, Mackey S. Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study. Pain Med. 2009 May-Jun;10(4):663-72. doi: 10.1111/j.1526-4637.2009.00613.x. Epub 2009 Apr 22. |
| 11112243 | Result | Lipton RB, Baggish JS, Stewart WF, Codispoti JR, Fu M. Efficacy and safety of acetaminophen in the treatment of migraine: results of a randomized, double-blind, placebo-controlled, population-based study. Arch Intern Med. 2000 Dec 11-25;160(22):3486-92. doi: 10.1001/archinte.160.22.3486. |
| 16135345 | Result | Kaki AM, El-Yaski AZ, Youseif E. Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale. Reg Anesth Pain Med. 2005 Sep-Oct;30(5):422-8. doi: 10.1016/j.rapm.2005.05.013. |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Feb 2, 2024 | Feb 28, 2024 | 24 | ||
| Mar 10, 2024 | Apr 1, 2024 | 25 |
| ID | Term |
|---|---|
| D008881 | Migraine Disorders |
| D020773 | Headache Disorders |
| D020325 | Migraine with Aura |
| D020326 | Migraine without Aura |
| ID | Term |
|---|---|
| D051270 | Headache Disorders, Primary |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D009271 | Naltrexone |
| D000082 | Acetaminophen |
| ID | Term |
|---|---|
| D009270 | Naloxone |
| D009019 | Morphinans |
| D053610 | Opiate Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D006572 | Heterocyclic Compounds, Bridged-Ring |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D010616 | Phenanthrenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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