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MLD10 in the Prevention of Migraine in Adults

Primary Purpose

Migraine

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
MLD10
Placebo
Sponsored by
Pharmalyte Solutions LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Migraine

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. male or female, in otherwise good health, 18 to 65 years of age.
  2. history of frequent episodic migraine (3-14 migraine days per month) (with or without aura) according to the International Classification of Headache Disorders-3beta for at least 3 months.
  3. onset of migraine before age 50.
  4. stable history of migraine at least 3 months prior to screening.
  5. not currently taking a migraine preventive or has been taking preventive for at least 30 days prior to screening and agrees to not start, stop, or change medication and/or dosage during the study period.
  6. if female of childbearing potential, has a negative urine pregnancy test at Visits 1-5 and uses, or agrees to use, for the duration of the study, a medically acceptable form of contraception as listed:

    • complete abstinence from intercourse from 2 weeks prior to administration of study drug, throughout the study, and for 7 days after completion or premature discontinuation from the study; surgically sterile (hysterectomy or tubal ligation or otherwise incapable of pregnancy); sterilization of male partner when in a monogamous relationship; intrauterine device with published data showing lowest expected failure rate is less than 1% per year; double barrier method (i.e., 2 physical barriers OR 1 physical barrier plus spermicide) for a least 1 month prior to Visit 1 and throughout study; or hormonal contraceptives for at least 3 months prior to Visit 1 and throughout study.
  7. completion of online diary must be ≥ 80% compliance, unless otherwise approved by the Sponsor and/or Clinvest.

Exclusion Criteria:

  1. unable to understand the study requirements, the informed consent, or complete headache records as required per protocol.
  2. pregnant, actively trying to become pregnant, or breast-feeding.
  3. diagnosed with International Classification of Headache Disorders-3beta criteria for Chronic Migraine within 3 months prior to screening, at the time of screening, and/or during the baseline period.
  4. experienced the following migraine variants: basilar migraine, aura without headache, familial hemiplegic migraine, complicated migraine, ophthalmoplegic migraine and retinal migraine within the last year.
  5. history of medication overuse headache (MOH) (Appendix II) in the 3 months prior to study enrollment or during the baseline phase.
  6. history of medication overuse (MO) of ergotamines, triptans, opioids, analgesics, NSAIDS and combination therapies, as defined by ICHD-3beta criteria and/or MO during baseline period.
  7. history of substance abuse and/or dependence, in the opinion of the Investigator.
  8. history of impaired renal function that, in the investigator's opinion, contraindicates participation in this study.
  9. unstable neurological condition or a significantly abnormal neurological examination with focal signs or signs of increased intracranial pressure.
  10. suffers from a serious illness, or an unstable medical condition, one that could require hospitalization, or could increase the risk of adverse events.
  11. has significant risk of suicide, defined as a "yes" answer to any of the following questions on the Columbia-Suicide Severity Rating Scale (C-SSRS), either at the screening visit (when assessing the prior 12 months) or at visit 2 (when assessing time since the screening visit):

    1. Questions 4 or 5 on the suicidal ideation section
    2. Any question on any item in the suicidal behavior section
  12. any psychiatric disorder with psychotic features, and/or any other psychiatric disorder not stable or well controlled, that would interfere in their ability to complete study activities.
  13. hypersensitivity, intolerance, or contraindication to the use of magnesium L-lactate dehydrate or any of its components.
  14. received any investigational agents within 30 days prior to Visit 1.
  15. plans to participate in another clinical study at any time during this study.

Sites / Locations

  • The Research Center of Southern California
  • San Francisco Clinical Research Center
  • Physician Associates of Florida Research Department
  • Dr. B. Abraham, P.C.
  • Westside Family Medical Center, P.C.
  • StudyMetrix Research
  • Clinvest Research, LLC
  • Baptist Memorial Hospital
  • Nashville Neuroscience Group

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

MLD10

Placebo

Arm Description

Subjects randomized to MLD10 will be dispensed a 28 day supply of magnesium L-lactate dehydrate for daily treatment. A total of 120 caplets will be given each time at Visit 2, 3, and 4. Additional overage will be given to account for the 3 day window. Subjects will be instructed to take two caplets of study medication BID (twice a day) at about the same time each day. Subjects will be instructed regarding storage requirements and will be asked to return all used/partially used/unused medication containers at the next office visit.

Subjects randomized to placebo will be dispensed a 28 day supply of matching placebo for daily treatment. A total of 120 caplets will be given each time at Visit 2, 3, and 4. Additional overage will be given to account for the 3 day window. Subjects will be instructed to take two caplets of study medication BID (twice a day) at about the same time each day. Subjects will be instructed regarding storage requirements and will be asked to return all used/partially used/unused medication containers at the next office visit.

Outcomes

Primary Outcome Measures

Migraine Headache Days
Comparison of the mean change from baseline in the frequency of migraine headache days per 28-day period ending with the cessation of treatment period month 3 in subjects treated with MLD10 versus placebo. A migraine headache day will be defined as a calendar day (00:00 to 23:59) with 4 or more hours of migraine headache, fulfilling International Classification of Headache Disorders-3beta criteria, and/or any headache of any duration with the use of migraine-specific acute medications(s) (i.e. ergot alkaloids, ergot combinations, opioids, triptans, combination analgesics [simple analgesics combined with opioids or barbiturate with or without caffeine]).

Secondary Outcome Measures

Headache Days
Comparison of the change from baseline of subjects treated with MLD10 versus placebo in the frequency of headache days during the 3 month treatment period. A headache day will be defined as any day not classified as a migraine day, but recorded headache of any severity and/or duration.
Headache Duration
Change from baseline (28 day period) in the total cumulative minutes of headache during each 28-day treatment period month 1, 2, & 3 in subjects treated with MLD10 versus placebo. All headaches and/or migraines will be including in this outcome analysis.
Pain Severity
Change from baseline (28 day period) in the average pain severity at time of onset compared to each 28-day treatment period month 1, 2, & 3 in subjects treated with MLD10 versus placebo. Headache pain severity was measured on a scale 1 = Mild, 2 = Moderate, 3 = Severe.
Acute Medication Usage
Change from baseline (28 day period) in the total number of acute headache pain medications used during each 28 day treatment period month 1, 2, & 3 in subjects treated with MLD10 versus placebo.
Migraine Disability Assessment Scale (MIDAS)
Change from Visit 2 to Visit 5 in the total MIDAS score in subjects treated with MLD10 versus placebo. The MIDAS test determines how severely migraines affect daily functioning. The responses of a variety of questions will be scored according to the questionnaire's scoring guide. A total score will be calculated ranging from 0-93. A score of 0-5 indicates little or no disability, 6-10 mild disability, 11-20, moderate disability, 21+ severe disability.
Subject Global Impression of Change (SGIC)
Comparison of SGIC at Visit 5 in subjects treated with MLD10 versus placebo. Global impression of change rated by the subject will be assessed using a 7-point Likert scale ranging from -3 to 3 with -3 = very much worse, -2 = much worse, -1 = minimally worse, 0 = no change, 1 = minimally improved, 2 = much improved, 3 = very much improved.
Physician Global Impression of Change (PGIC)
Comparison of PGIC at Visit 5 in subjects treated with MLD10 versus placebo. The PGIC will be an impression of change rated by the investigator using a 7-point Likert scale ranging from -3 to 3 with -3 = very much worse, -2 = much worse, -1 = minimally worse, 0 = no change, 1 = minimally improved, 2 = much improved, 3 = very much improved.

Full Information

First Posted
December 17, 2014
Last Updated
September 16, 2020
Sponsor
Pharmalyte Solutions LLC
Collaborators
Clinvest
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1. Study Identification

Unique Protocol Identification Number
NCT02322333
Brief Title
MLD10 in the Prevention of Migraine in Adults
Official Title
A Multicenter, Randomized, Double-blind, Placebo-controlled Study Evaluating the Efficacy and Safety of MLD10 in the Prevention of Migraine Headache in Adults
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
March 2015 (Actual)
Primary Completion Date
June 2017 (Actual)
Study Completion Date
June 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pharmalyte Solutions LLC
Collaborators
Clinvest

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a double-blind, placebo-controlled, randomized, multi-center study. Subjects agreeing to participate in the study and meet the entry criteria assessed at the screening visit, will begin a 28 day baseline period to confirm their diagnosis, as well as establish baseline migraine characteristics. During this baseline period, subjects will continue treating their migraines as usual, simply recording the information in a daily headache diary. Subjects who, after completing the baseline, continue to meet entrance criteria will be eligible to enter into the treatment phase and be randomized according to the Clinvest generated randomization schedule. Approximately 142 subjects (71 subjects per arm) will be randomized and enter the treatment phase receiving MLD10 or placebo in a 1:1 design at 6 United States sites. Diary assessments will collect study medication adherence, pain severity, headache symptoms, acute medication usage, and unusual symptoms. Serum samples will be collected and analyzed for ionized magnesium, electrolytes, and creatinine.
Detailed Description
This is a multi-center, double-blind, randomized, placebo-controlled, parallel study of MLD10 for the prevention of migraine headache. The study population will consist of approximately 142 male and female subjects between 18 and 65 years of age with frequent episodic migraine as defined by International Classification of Headache Disorders-3beta criteria. Two MLD10 (243 mg (milligrams) of elemental magnesium) or placebo caplets will be taken twice daily for a total daily dose of 486 mg. VISIT 1 - SCREENING The following will be completed at Visit 1: Obtain written Informed Consent. The informed consent will be obtained in accordance with Good Clinical Practices (GCP) and all applicable regulatory requirements from each subject prior to participation in the study. Verify Inclusion/Exclusion Criteria. Subjects will meet all the inclusion and none of the exclusion criteria. Obtain demographics (race, ethnicity, sex, date of birth) Obtain medical, medication, and headache history. Data collected will include medical history and diagnoses, age at onset of migraine and other pertinent migraine/headache history, history of acute and prophylactic headache medications within the past 30 days, and history of other recent/concomitant medications. Obtain date of last menstrual cycle and perform urine pregnancy test, if appropriate. Results of the pregnancy test must be negative to continue in study. Perform physical and neurological examinations. Measure vital signs (height, weight, resting heart rate, and blood pressure). Review Baseline Headache Diary. Subjects will be instructed to complete a daily online headache diary. Assessments to be captured are start/stop time, severity, associated symptoms, use of rescue medications, and unusual symptoms. Administer Columbia-Suicide Severity Rating Scale (C-SSRS). Schedule Visit 2. VISIT 2 - RANDOMIZATION Verify Inclusion/Exclusion Criteria. Subjects must continue to meet all inclusion (including ≥ 3 days of migraine during baseline) and none of the exclusion criteria. Perform urine pregnancy test, if appropriate. Results of the pregnancy test must be negative to continue in study. Measure vital signs (weight, resting heart rate, and blood pressure). Record any changes to concomitant medications. Record any Serious Adverse Events (SAE) since signing the Informed Consent. Review Baseline Headache Diary for completeness and continuing eligibility. Randomize subject Review Month 1 Headache Diary instructions (same instructions as those discussed for Baseline Headache Diary). Dispense Month 1 study medication. Subjects will be instructed how to take study medication, prohibited medications/foods, dosage limitations of study medication, and storage requirements. Subjects will be instructed to return all used/partially used/unused study medication at next office visit and medications reconciliation will be performed to ensure a compliance of at least 80%. Subjects not complying at an 80% level will be withdrawn, unless otherwise approved by the Sponsor and/or Clinvest. (Estimated to be < 10%) Administer C-SSRS. Administer MIDAS. Collect serum samples for electrolytes, creatinine, and ionized Mg. Schedule Visit 3. VISIT 3 - END OF TREATMENT PERIOD MONTH 1 Record any changes to concomitant medications. Record any Non-Serious Adverse Events (NSAE) and/or SAEs. Perform urine pregnancy test, if appropriate. Results of the pregnancy test must be negative to continue in study. Measure vital signs (weight, resting heart rate, and blood pressure). Review Month 1 Headache Diary for completeness. Review instructions for Month 2 Headache Diary (same instructions as those discussed for Month 1 Headache Diary). Collect Month 1 unused study medication and used packaging. Confirm 85% compliance of medication usage per study protocol. Dispense Month 2 study medication and review the dosage limitations of study medication, storage requirements, and to return all used/partially used/unused study medication at next office visit. Perform drug accountability. Administer C-SSRS. Collect serum samples for electrolytes, creatinine, and ionized Mg. Schedule Visit 4. VISIT 4 - END OF TREATMENT PERIOD MONTH 2 Record any changes to concomitant medications. Record any NSAEs/SAEs. Perform urine pregnancy test, if appropriate. Results of the pregnancy test must be negative to continue in study. Measure vital signs (weight, resting heart rate, and blood pressure). Review Month 2 Headache Diary for completeness. Review instructions for Month 3 Headache Diary (same instructions as those discussed for Month 2 Headache Diary). Collect Month 2 unused study medication and used packaging. Confirm 85% compliance for medication usage per study protocol. Dispense Month 3 study medication and review the dosage limitations of study medication, storage requirements, and to return all used/partially used/unused study medication at next office visit. Perform drug accountability. Administer C-SSRS. Collect serum samples for electrolytes, creatinine, and ionized Mg. Schedule Visit 5. VISIT 5 - END OF TREATMENT PERIOD MONTH 3 Record any changes to concomitant medications. Record any NSAEs/SAEs. Perform urine pregnancy test, if appropriate. Measure vital signs (weight, resting heart rate, and blood pressure) Perform physical/neurological examinations. Collect Month 4 unused study medication and used packaging. Perform drug accountability. Administer SGIC & complete PGIC. Administer MIDAS. Administer C-SSRS. Collect serum samples for electrolytes, creatinine, and ionized Mg. Exit subject.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Migraine

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
157 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MLD10
Arm Type
Active Comparator
Arm Description
Subjects randomized to MLD10 will be dispensed a 28 day supply of magnesium L-lactate dehydrate for daily treatment. A total of 120 caplets will be given each time at Visit 2, 3, and 4. Additional overage will be given to account for the 3 day window. Subjects will be instructed to take two caplets of study medication BID (twice a day) at about the same time each day. Subjects will be instructed regarding storage requirements and will be asked to return all used/partially used/unused medication containers at the next office visit.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Subjects randomized to placebo will be dispensed a 28 day supply of matching placebo for daily treatment. A total of 120 caplets will be given each time at Visit 2, 3, and 4. Additional overage will be given to account for the 3 day window. Subjects will be instructed to take two caplets of study medication BID (twice a day) at about the same time each day. Subjects will be instructed regarding storage requirements and will be asked to return all used/partially used/unused medication containers at the next office visit.
Intervention Type
Drug
Intervention Name(s)
MLD10
Other Intervention Name(s)
elemental magnesium
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Migraine Headache Days
Description
Comparison of the mean change from baseline in the frequency of migraine headache days per 28-day period ending with the cessation of treatment period month 3 in subjects treated with MLD10 versus placebo. A migraine headache day will be defined as a calendar day (00:00 to 23:59) with 4 or more hours of migraine headache, fulfilling International Classification of Headache Disorders-3beta criteria, and/or any headache of any duration with the use of migraine-specific acute medications(s) (i.e. ergot alkaloids, ergot combinations, opioids, triptans, combination analgesics [simple analgesics combined with opioids or barbiturate with or without caffeine]).
Time Frame
Day 1(Screening) - Day 116 (Visit 5 End of Study)
Secondary Outcome Measure Information:
Title
Headache Days
Description
Comparison of the change from baseline of subjects treated with MLD10 versus placebo in the frequency of headache days during the 3 month treatment period. A headache day will be defined as any day not classified as a migraine day, but recorded headache of any severity and/or duration.
Time Frame
Day 1(Screening) - Day 116 (Visit 5 End of Study)
Title
Headache Duration
Description
Change from baseline (28 day period) in the total cumulative minutes of headache during each 28-day treatment period month 1, 2, & 3 in subjects treated with MLD10 versus placebo. All headaches and/or migraines will be including in this outcome analysis.
Time Frame
Day 1(Screening) - Day 116 (Visit 5 End of Study)
Title
Pain Severity
Description
Change from baseline (28 day period) in the average pain severity at time of onset compared to each 28-day treatment period month 1, 2, & 3 in subjects treated with MLD10 versus placebo. Headache pain severity was measured on a scale 1 = Mild, 2 = Moderate, 3 = Severe.
Time Frame
Day 1(Screening) - Day 116 (Visit 5 End of Study)
Title
Acute Medication Usage
Description
Change from baseline (28 day period) in the total number of acute headache pain medications used during each 28 day treatment period month 1, 2, & 3 in subjects treated with MLD10 versus placebo.
Time Frame
Day 1(Screening) - Day 116 (Visit 5 End of Study)
Title
Migraine Disability Assessment Scale (MIDAS)
Description
Change from Visit 2 to Visit 5 in the total MIDAS score in subjects treated with MLD10 versus placebo. The MIDAS test determines how severely migraines affect daily functioning. The responses of a variety of questions will be scored according to the questionnaire's scoring guide. A total score will be calculated ranging from 0-93. A score of 0-5 indicates little or no disability, 6-10 mild disability, 11-20, moderate disability, 21+ severe disability.
Time Frame
Day 29 (Randomization) & Day 116 (Visit 5 End of Study)
Title
Subject Global Impression of Change (SGIC)
Description
Comparison of SGIC at Visit 5 in subjects treated with MLD10 versus placebo. Global impression of change rated by the subject will be assessed using a 7-point Likert scale ranging from -3 to 3 with -3 = very much worse, -2 = much worse, -1 = minimally worse, 0 = no change, 1 = minimally improved, 2 = much improved, 3 = very much improved.
Time Frame
Day 116 (Visit 5 End of Study)
Title
Physician Global Impression of Change (PGIC)
Description
Comparison of PGIC at Visit 5 in subjects treated with MLD10 versus placebo. The PGIC will be an impression of change rated by the investigator using a 7-point Likert scale ranging from -3 to 3 with -3 = very much worse, -2 = much worse, -1 = minimally worse, 0 = no change, 1 = minimally improved, 2 = much improved, 3 = very much improved.
Time Frame
Day 116 (Visit 5 End of Study)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: male or female, in otherwise good health, 18 to 65 years of age. history of frequent episodic migraine (3-14 migraine days per month) (with or without aura) according to the International Classification of Headache Disorders-3beta for at least 3 months. onset of migraine before age 50. stable history of migraine at least 3 months prior to screening. not currently taking a migraine preventive or has been taking preventive for at least 30 days prior to screening and agrees to not start, stop, or change medication and/or dosage during the study period. if female of childbearing potential, has a negative urine pregnancy test at Visits 1-5 and uses, or agrees to use, for the duration of the study, a medically acceptable form of contraception as listed: complete abstinence from intercourse from 2 weeks prior to administration of study drug, throughout the study, and for 7 days after completion or premature discontinuation from the study; surgically sterile (hysterectomy or tubal ligation or otherwise incapable of pregnancy); sterilization of male partner when in a monogamous relationship; intrauterine device with published data showing lowest expected failure rate is less than 1% per year; double barrier method (i.e., 2 physical barriers OR 1 physical barrier plus spermicide) for a least 1 month prior to Visit 1 and throughout study; or hormonal contraceptives for at least 3 months prior to Visit 1 and throughout study. completion of online diary must be ≥ 80% compliance, unless otherwise approved by the Sponsor and/or Clinvest. Exclusion Criteria: unable to understand the study requirements, the informed consent, or complete headache records as required per protocol. pregnant, actively trying to become pregnant, or breast-feeding. diagnosed with International Classification of Headache Disorders-3beta criteria for Chronic Migraine within 3 months prior to screening, at the time of screening, and/or during the baseline period. experienced the following migraine variants: basilar migraine, aura without headache, familial hemiplegic migraine, complicated migraine, ophthalmoplegic migraine and retinal migraine within the last year. history of medication overuse headache (MOH) (Appendix II) in the 3 months prior to study enrollment or during the baseline phase. history of medication overuse (MO) of ergotamines, triptans, opioids, analgesics, NSAIDS and combination therapies, as defined by ICHD-3beta criteria and/or MO during baseline period. history of substance abuse and/or dependence, in the opinion of the Investigator. history of impaired renal function that, in the investigator's opinion, contraindicates participation in this study. unstable neurological condition or a significantly abnormal neurological examination with focal signs or signs of increased intracranial pressure. suffers from a serious illness, or an unstable medical condition, one that could require hospitalization, or could increase the risk of adverse events. has significant risk of suicide, defined as a "yes" answer to any of the following questions on the Columbia-Suicide Severity Rating Scale (C-SSRS), either at the screening visit (when assessing the prior 12 months) or at visit 2 (when assessing time since the screening visit): Questions 4 or 5 on the suicidal ideation section Any question on any item in the suicidal behavior section any psychiatric disorder with psychotic features, and/or any other psychiatric disorder not stable or well controlled, that would interfere in their ability to complete study activities. hypersensitivity, intolerance, or contraindication to the use of magnesium L-lactate dehydrate or any of its components. received any investigational agents within 30 days prior to Visit 1. plans to participate in another clinical study at any time during this study.
Facility Information:
Facility Name
The Research Center of Southern California
City
Carlsbad
State/Province
California
ZIP/Postal Code
92011
Country
United States
Facility Name
San Francisco Clinical Research Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94109
Country
United States
Facility Name
Physician Associates of Florida Research Department
City
Oviedo
State/Province
Florida
ZIP/Postal Code
32765
Country
United States
Facility Name
Dr. B. Abraham, P.C.
City
Snellville
State/Province
Georgia
ZIP/Postal Code
30039
Country
United States
Facility Name
Westside Family Medical Center, P.C.
City
Kalamazoo
State/Province
Michigan
ZIP/Postal Code
49009
Country
United States
Facility Name
StudyMetrix Research
City
Saint Peters
State/Province
Missouri
ZIP/Postal Code
63303
Country
United States
Facility Name
Clinvest Research, LLC
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65807
Country
United States
Facility Name
Baptist Memorial Hospital
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38020
Country
United States
Facility Name
Nashville Neuroscience Group
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States

12. IPD Sharing Statement

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MLD10 in the Prevention of Migraine in Adults

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