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Sumatriptan 4 mg Statdose in the Acute Treatment of Cluster Headache

Primary Purpose

Episodic Cluster Headache, Chronic Cluster Headache

Status
Unknown status
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Sumatriptan 4mg Statdose injection
Sponsored by
Diamond Headache Clinic
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Episodic Cluster Headache focused on measuring cluster headache, sumatriptan

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Subject is between 18 years and 65 years of age.
  • Subject is male or female. If female the subject is:
  • non-childbearing potential or,
  • child-bearing potential, has a negative pregnancy test at screen, and agrees to one of the following: Complete abstinence from intercourse from 2 weeks prior to administration of the study drug, throughout the study, and for a time interval after completion or premature discontinuation from the study to account for elimination of the investigational drug (a minimum of 10 hours); or,
  • Female sterilization; or,
  • Sterilization of male partner; or,
  • Implants of levonorgestrel; or,
  • Injectable progestogen; or,
  • Oral contraceptive (combined or progestin only) or,
  • Any intrauterine device (IUD) with published data showing that the lowest expected failure rate is less than 1% per year; or,
  • Double barrier method; (2 physical barriers or 1 physical barrier plus spermicide).
  • Subject has a diagnosis of cluster headache (IHS).
  • Subject has at least 1 previous cycle of cluster headache if episodic or has been in chronic cluster headache for at least 6 months.
  • Subject taking any medication for chronic cluster headache prevention has been on a stable regimen for at least 1 month prior to screening.
  • Subjects with episodic cluster headache have a history of continuing to have cluster headaches at least once every other day during the first three weeks of treatment with preventive medications.
  • Subject is able and willing to give written informed consent to participate in the study.
  • Subject who have used 6 mg StatDose Imitrex for the treatment of cluster headache must have a history of responding to treatment with this in at least 1 out every 3 attacks.

Exclusion Criteria:

  • Subject has confirmed or suspected ischemic heart disease, Prinzmetal's angina, or signs/symptoms consistent with any of the above.
  • Subject has cardiac arrhythmias requiring medication or a history of a clinically significant electrocardiogram abnormality that, in the investigator's opinion contraindicates participation in this study.
  • Subject has a history of congenital heart disease.
  • Subject has a history of cerebrovascular pathology including stroke.
  • The subject, in the investigator's opinion, is likely to have unrecognized cardiovascular disease.
  • Subject has evidence or history of ischemic abdominal syndromes or peripheral vascular disease.
  • Subject has uncontrolled hypertension at screening.
  • Subject has a history of epilepsy or structural brain lesions which lowers the convulsive threshold.
  • Subject has a history of impaired hepatic or renal function.
  • Subject is currently taking a monoamine oxidase inhibitor (MAO) or has taken a MAOI within the 2 weeks prior to screen
  • Subject is currently taking an ergotamine-containing or ergot-type cluster headache preventive medication like ergotamine tartrate or methylergonovine.
  • Subject has hypersensitivity or contraindication to the use of sumatriptan, any of its components, or any other 5-HT1B1D receptor agonist.
  • Subject is pregnant, actively trying to become pregnant or breast-feeding
  • Subject is of childbearing potential and not using adequate contraceptive measures.
  • Subject has evidence of alcohol or substance abuse within the last year which, in the investigator's judgment, will likely interfere with the study conduct, subject cooperation, or evaluation and interpretation of the study results.
  • Subject has any concurrent medical or psychiatric condition that, in the investigator's opinion, may affect the interpretation of efficacy and safety date or which otherwise contraindicates participation in a clinical trial.
  • Subject has participated in an investigational drug trial within the previous four weeks.
  • Subject is unable or unwilling to self administer subcutaneously administered Imitrex.

Sites / Locations

  • Diamond Headache ClinicRecruiting

Outcomes

Primary Outcome Measures

The primary efficacy parameters will be the percentage of cluster headache attacks that result in the cluster headache pain being reduced to mild or none following a single dose of 4 mg subcutaneous sumatriptan at 15 minutes and at 30 minutes.

Secondary Outcome Measures

The time meaningful relief of cluster headache.
The percentage of attacks that produce a pain free response to a single dose of sumatriptan 4 mg subcutaneous at 15 minutes, 30 minutes and at 1 hour.
The percentage of attacks of migraine that result in resolution of all associated symptoms of cluster headache present at the time of treatment with the study medication as well as achieving a pain free response within 1hour.
The number of patients reporting adverse effects to study medication, the type of adverse event reported and the percentage of attacks that are associate with the adverse effect.
The percentage of patients who achieve pain reduced to mild or none at 15 minutes or at 30 minutes respectively for all three treated headache attacks.
The percentage of patients who achieve pain reduced to mild or none at 15 minutes or at 30 minutes respectively for two out of three treated headaches.
The percentage of patients who become pain free at 15 minutes or 30 minutes or at 1 hour respectively or at any combination of the three time points for all three headache attacks.
Patient evaluation of subcutaneous sumatriptan 4 mg regarding satisfaction with their treatment using the PPMQR assessment.
The percentage of attacks in which the pain was reduced to moderate or mild and for which the patient took a second and or a third dose of the study medication.
The percentage of attacks in which the patient became pain free at or before 1 hour and experienced a recurrence of cluster headache and in which a second or third dose of study medication was taken.
The percentage of cluster headaches in which the patient became free at or before 1 hour and experienced a recurrence of cluster headache.
The mean time to meaningful pain relief across three treated headache attacks.

Full Information

First Posted
November 12, 2006
Last Updated
January 29, 2009
Sponsor
Diamond Headache Clinic
Collaborators
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT00399243
Brief Title
Sumatriptan 4 mg Statdose in the Acute Treatment of Cluster Headache
Official Title
4mg StatDose Imitrex for Acute Treatment of Cluster Headache
Study Type
Interventional

2. Study Status

Record Verification Date
January 2009
Overall Recruitment Status
Unknown status
Study Start Date
November 2006 (undefined)
Primary Completion Date
August 2010 (Anticipated)
Study Completion Date
August 2010 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Diamond Headache Clinic
Collaborators
GlaxoSmithKline

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study's hypothesis is the 4mg StatDose sumatriptan is effective for the acute treatment of cluster headache and provides good safety and tolerability across multiple doses of the study medication as well as across multiple attacks of cluster headache. This study seeks to determine the safety and efficacy of the commercially available 4mg StatDose formulation of sumatriptan as an acute treatment of cluster headache. Patients are allowed to use repeated dose of the study medication for a given headache if they have had a partial response to the first dose. They may treat up to 3 attacks of cluster headache with the study medication. Safety assessment will be through adverse event reporting and physical examination. Patients with both episodic cluster headache as well as chronic cluster headache will be studied. Patients must either not have started preventive treatment for cluster headache or be on a stable dose of preventive medication.
Detailed Description
This is an open label trial of sumatriptan 4 mg using the StatDose injector system for the treatment of acute attacks of cluster headache. Patient entering the trial must either be in the first 3 weeks of an episodic cluster headache cycle or have chronic cluster headache. Patients with episodic cluster headache may have not begun taking preventive medications at the time of study or must be on a stable regimen of preventive medications. Patients with chronic cluster headache must be on a stable regimen of preventive medications. Patients must be in good health with no contraindications to the use of sumatriptan such as either having or having increased risk factors for CAD or CVD. They may not take during the time of the study preventive medications that are 5HT1B/1D agonists. Episodic use of triptans, ergotamine, or dihydroergotamine is permitted provided they are not used within 24 hours of use of the study medication. Patients will be required to treat 3 acute attacks of cluster headache with the study medication or to use more than 1 dose of study medication to fully treat an individual attack of cluster headache with a maximum of 3 doses of the study medication within a 24 hour time frame. Efficacy of the study medication will be determined from diary data collected. Safety data will be determined by adverse events reported by the patient.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Episodic Cluster Headache, Chronic Cluster Headache
Keywords
cluster headache, sumatriptan

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Sumatriptan 4mg Statdose injection
Intervention Description
4mg Sumatriptan Statdose injection for use as acute therapy in a cluster headache. Consistency of response in three attacks will be measured
Primary Outcome Measure Information:
Title
The primary efficacy parameters will be the percentage of cluster headache attacks that result in the cluster headache pain being reduced to mild or none following a single dose of 4 mg subcutaneous sumatriptan at 15 minutes and at 30 minutes.
Time Frame
15 minutes and 30 minutes
Secondary Outcome Measure Information:
Title
The time meaningful relief of cluster headache.
Time Frame
Meaningful Relief
Title
The percentage of attacks that produce a pain free response to a single dose of sumatriptan 4 mg subcutaneous at 15 minutes, 30 minutes and at 1 hour.
Time Frame
30 minutes and 1 Hour
Title
The percentage of attacks of migraine that result in resolution of all associated symptoms of cluster headache present at the time of treatment with the study medication as well as achieving a pain free response within 1hour.
Time Frame
1 hour
Title
The number of patients reporting adverse effects to study medication, the type of adverse event reported and the percentage of attacks that are associate with the adverse effect.
Time Frame
Length of study
Title
The percentage of patients who achieve pain reduced to mild or none at 15 minutes or at 30 minutes respectively for all three treated headache attacks.
Time Frame
15 minutes and 30 minutes
Title
The percentage of patients who achieve pain reduced to mild or none at 15 minutes or at 30 minutes respectively for two out of three treated headaches.
Time Frame
15 minutes and 30 minutes
Title
The percentage of patients who become pain free at 15 minutes or 30 minutes or at 1 hour respectively or at any combination of the three time points for all three headache attacks.
Time Frame
15 minutes, 30 minutes, and 1 hour
Title
Patient evaluation of subcutaneous sumatriptan 4 mg regarding satisfaction with their treatment using the PPMQR assessment.
Time Frame
End of treatment
Title
The percentage of attacks in which the pain was reduced to moderate or mild and for which the patient took a second and or a third dose of the study medication.
Time Frame
Length of study
Title
The percentage of attacks in which the patient became pain free at or before 1 hour and experienced a recurrence of cluster headache and in which a second or third dose of study medication was taken.
Time Frame
1 hour
Title
The percentage of cluster headaches in which the patient became free at or before 1 hour and experienced a recurrence of cluster headache.
Time Frame
1 hour
Title
The mean time to meaningful pain relief across three treated headache attacks.
Time Frame
Length of study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subject is between 18 years and 65 years of age. Subject is male or female. If female the subject is: non-childbearing potential or, child-bearing potential, has a negative pregnancy test at screen, and agrees to one of the following: Complete abstinence from intercourse from 2 weeks prior to administration of the study drug, throughout the study, and for a time interval after completion or premature discontinuation from the study to account for elimination of the investigational drug (a minimum of 10 hours); or, Female sterilization; or, Sterilization of male partner; or, Implants of levonorgestrel; or, Injectable progestogen; or, Oral contraceptive (combined or progestin only) or, Any intrauterine device (IUD) with published data showing that the lowest expected failure rate is less than 1% per year; or, Double barrier method; (2 physical barriers or 1 physical barrier plus spermicide). Subject has a diagnosis of cluster headache (IHS). Subject has at least 1 previous cycle of cluster headache if episodic or has been in chronic cluster headache for at least 6 months. Subject taking any medication for chronic cluster headache prevention has been on a stable regimen for at least 1 month prior to screening. Subjects with episodic cluster headache have a history of continuing to have cluster headaches at least once every other day during the first three weeks of treatment with preventive medications. Subject is able and willing to give written informed consent to participate in the study. Subject who have used 6 mg StatDose Imitrex for the treatment of cluster headache must have a history of responding to treatment with this in at least 1 out every 3 attacks. Exclusion Criteria: Subject has confirmed or suspected ischemic heart disease, Prinzmetal's angina, or signs/symptoms consistent with any of the above. Subject has cardiac arrhythmias requiring medication or a history of a clinically significant electrocardiogram abnormality that, in the investigator's opinion contraindicates participation in this study. Subject has a history of congenital heart disease. Subject has a history of cerebrovascular pathology including stroke. The subject, in the investigator's opinion, is likely to have unrecognized cardiovascular disease. Subject has evidence or history of ischemic abdominal syndromes or peripheral vascular disease. Subject has uncontrolled hypertension at screening. Subject has a history of epilepsy or structural brain lesions which lowers the convulsive threshold. Subject has a history of impaired hepatic or renal function. Subject is currently taking a monoamine oxidase inhibitor (MAO) or has taken a MAOI within the 2 weeks prior to screen Subject is currently taking an ergotamine-containing or ergot-type cluster headache preventive medication like ergotamine tartrate or methylergonovine. Subject has hypersensitivity or contraindication to the use of sumatriptan, any of its components, or any other 5-HT1B1D receptor agonist. Subject is pregnant, actively trying to become pregnant or breast-feeding Subject is of childbearing potential and not using adequate contraceptive measures. Subject has evidence of alcohol or substance abuse within the last year which, in the investigator's judgment, will likely interfere with the study conduct, subject cooperation, or evaluation and interpretation of the study results. Subject has any concurrent medical or psychiatric condition that, in the investigator's opinion, may affect the interpretation of efficacy and safety date or which otherwise contraindicates participation in a clinical trial. Subject has participated in an investigational drug trial within the previous four weeks. Subject is unable or unwilling to self administer subcutaneously administered Imitrex.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Fred G Freitag, DO
Phone
773 388 6390
Email
research@diamondheadache.com
First Name & Middle Initial & Last Name or Official Title & Degree
George Nissan, DO
Phone
773 388 6390
Email
research@diamondheadache.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Seymour Diamond, MD
Organizational Affiliation
Diamond Headache Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Diamond Headache Clinic
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60614
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nancy Caldwell, RN
Phone
773-388-6390
Email
ncaldwell@diamondheadache.com
First Name & Middle Initial & Last Name & Degree
Fred G Freitag, DO
First Name & Middle Initial & Last Name & Degree
George Nissan, DO
First Name & Middle Initial & Last Name & Degree
Merle Diamond, MD
First Name & Middle Initial & Last Name & Degree
George Urban, MD
First Name & Middle Initial & Last Name & Degree
Betsy Pepper, MD

12. IPD Sharing Statement

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Sumatriptan 4 mg Statdose in the Acute Treatment of Cluster Headache

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