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Cefalium® Compared to Tylenol® in the Treatment of Migraine Attacks

Primary Purpose

Migraine

Status
Suspended
Phase
Phase 3
Locations
Brazil
Study Type
Interventional
Intervention
Acetaminophen+Caffeine+Dihydroergotamine+Metoclopramide.
Acetaminophen
Sponsored by
Ache Laboratorios Farmaceuticos S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Migraine focused on measuring Headache, Aura, Migraine, Moderate to Severe

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects of both gender;
  • Age older or equal to 18 and younger than 66 years if they have symptoms of migraine headache before 50 years of age;
  • Presence of migraine headache with or without aura symptoms, at least 03 months prior to the study, the criteria defined by International Classification of Headache Disorders(ICHD)-II, 2004 (IHS International Headache Society) - Annex I;
  • Subjects which are experiencing 2-6 migraine attacks per month with mild to moderate pain intensity in the last 3 months prior to screening visit;
  • Participants which are able to distinguish migraine attacks to any other type of headache;
  • Ability to understand and consent to participate in this clinical research, expressed by signing the Informed Consent Form (ICF).

Exclusion Criteria:

  • Any clinical finding (clinical evaluation / physical) that is interpreted by the Investigator as a risk to the subject in the clinical trial;
  • Subjects which had recent episodes of headache, with frequency equal or higher than 15 daily episodes per month, 3 months prior to the screening visit;
  • Subjects with headache history defined by the ICHD-II criteria, 2004 IHS (International Headache Society) rated as:

    • Typical aura with non-migraine headache;
    • Typical aura without headache;
    • Familial Hemiplegic Migraine (FHM);
    • Sporadic Hemiplegic Migraine;
    • Basilar type Migraine;
  • Any laboratorial finding that the Investigator consider a risk to subject of the study;
  • Hypersensitivity to the drug components used during the study;
  • Women in pregnancy or nursing period;
  • Women in reproductive age who do not agree to use contraception acceptable [oral contraceptives, injectable contraceptives, intrauterine device (IUD), hormonal implants, barrier methods, hormonal patch and tubal ligation]; other than surgically sterile (bilateral oophorectomy or hysterectomy), postmenopausal for at least one (01) years or sexual abstinence;
  • Inability to understand and answer to the functional categorical scale of the study, diary of symptoms, and not having accompanying to assist him/her;
  • History of abuse, according to the principal investigator, of the alcohol, opioids, barbiturates, benzodiazepines and illicit drugs in the last 02 years, or abuse of drugs for headache including ergotamines or narcotics in the last 03 months;
  • Subjects with prolonged hypotension, shock, sepsis, pheochromocytoma, hemorrhage, mechanical obstruction or perforation of the gastrointestinal tract
  • Participants with glucose-6-phosphate dehydrogenase(G6PD) deficiency due to increased risk of hemolysis associated with the use of paracetamol;
  • Subjects with history of epilepsy or presence of psychiatric illness of any kind, in the opinion of the investigator, that may interfere with adherence to treatment;
  • Subjects with a malignant disease less than five years, or for more than five years, but without documentation about the remission/cure. As example: melanoma, leukemia, lymphoma, myeloproliferative diseases and renal cell carcinoma of any length should be excluded. Exceptions: Participants with basal cell skin cancers, squamous cell, and cervical cancer in situ may be eligible;
  • Subjects which uses a preventive treatment and changed the dose in the last 02 weeks before the screening visit (V0);
  • Subjects with hepatic or renal failure;
  • Subjects that has participated in clinical trial protocols in the last twelve (12) months (National Board of Health- Resolution 251 of 07 August 1997, Part III, sub-item J), unless the investigator considers that there may be a direct benefit to it;
  • Subjects who are in prohibited medication as described in item 10.2 of the Protocol.

Sites / Locations

  • Centro de Pesquisa Clínica - CPEC / Associação Obras Sociais Irmã Dulce
  • Centro de Pesquisa Clínica Hospital São Lucas da PUCRS
  • Centro de Desenvolvimento em Estudos Clínicos Brasil - CDEC Brasil
  • Cepic - Centro Paulista de Investigação Clínica
  • CPCLIN - Centro de Pesquisas Clinicas Ltda
  • Universidade Federal de São Paulo - Núcleo de Gestão de Pesquisa/HU/FAP

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Cefalium®

Tylenol®

Arm Description

Acetaminophen+Caffeine+Dihydroergotamine+Metoclopramide.

Acetaminophen

Outcomes

Primary Outcome Measures

Pain relief of Cefalium® compared to Tylenol®
Relief of pain 2 hours after taking medication, being considered to reduce the intensity from strong(3) or moderate(2), at baseline, to mild(1) or absent(0) 2 hours after taking the medication, according to the functional and behavioral debilitating categorical scale without use of rescue medication as annotations the diary of symptoms

Secondary Outcome Measures

Pain decrease after use of investigational product, without a rescue medication
Number of participants with pain decrease in 2 hours and 4 hours after the use of the investigational product,at the first migraine attack with mild or moderate pain, with remission defined as no pain (0) in categorical scale debilitating functional and behavioral (4 point-scale), without use of a rescue medication
Pain decrease after use of the investigational product, without a rescue medication
Number of participants with pain relief in 4 hours after the use of the investigational product, in the first migraine attack with mild or moderate pain,and is considered the relief reduction of at least 01 point in pain intensity from baseline, according to functional and behavioral debilitating categorical scale without use of a rescue medication;
Pain relief maintenance during the period 4-24 hours after use of investigational product
The maintenance will be observed if the relief reached the first 4 hours will remain at 24 hours after use of the investigational product, according to functional and behavioral debilitating categorical scale (4 point scale) without use of rescue medication during this period;
Nausea/vomiting Symptoms Free
Participants free of nausea/vomiting symptoms 2 and 4 hours after use of investigational product,at the first migraine attack of moderate to severe pain intensity, defined as the proportion of subjects with no symptoms of both among the participants have at least one symptom at baseline of migraine without use of a rescue medication during this period.
Photophobia/Phonophobia Symptoms Free
Participants free of photophobia/phonophobia symptoms 2 and 4 hours after use of investigational product, at the first migraine attack of moderate to severe pain intensity, defined as the proportion of subjects with no symptoms of both among the participants have at least one symptom at baseline of migraine without use of a rescue medication during this period.
Need of a rescue medication
Number of participants who use at least once the rescue medication in a 2-24 hours period after use of the investigational product.

Full Information

First Posted
March 31, 2015
Last Updated
April 9, 2019
Sponsor
Ache Laboratorios Farmaceuticos S.A.
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1. Study Identification

Unique Protocol Identification Number
NCT02582996
Brief Title
Cefalium® Compared to Tylenol® in the Treatment of Migraine Attacks
Official Title
National, Phase III, Multicenter, Randomized, Open, Parallel, to Evaluate the Efficacy, Safety and Superiority of Cefalium® Compared to the Tylenol® in the Treatment of Migraine Attacks
Study Type
Interventional

2. Study Status

Record Verification Date
April 2019
Overall Recruitment Status
Suspended
Why Stopped
Strategic reasons of the company
Study Start Date
April 2020 (Anticipated)
Primary Completion Date
April 2021 (Anticipated)
Study Completion Date
June 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ache Laboratorios Farmaceuticos S.A.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
National clinical trials, phase III, randomized, open, parallel, study of superiority, in which three hundred thirty-six (336) participants of both sexes, aged between 18 and 65 years will be randomly allocated to one of two treatment groups. The Group 01 will use Cefalium® and group 02 will use Tylenol®.
Detailed Description
Cefalium® is a combination of Caffeine + Paracetamol + dihydroergotamine mesylate + metoclopramide hydrochloride. The dihydroergotamine mesylate interacts with the serotonergic, dopaminergic and noradrenergic receptors, but it's mechanism is not totally known. The caffeine presents mechanisms that are not totally clear, but it may relieves the pain by activating of the central noradenosine pathway (pain suppressing system). The Metoclopramide hydrochloride presents an anti-emetic action and prokinetic action in the gastrointestinal tract.One of its properties is the inhibition of nausea and vomiting triggered by drugs such as ergotamine.Paracetamol, also called acetaminophen is an effective agent analgesic and antipyretic with weak anti-inflammatory activity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Migraine
Keywords
Headache, Aura, Migraine, Moderate to Severe

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
336 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cefalium®
Arm Type
Experimental
Arm Description
Acetaminophen+Caffeine+Dihydroergotamine+Metoclopramide.
Arm Title
Tylenol®
Arm Type
Active Comparator
Arm Description
Acetaminophen
Intervention Type
Drug
Intervention Name(s)
Acetaminophen+Caffeine+Dihydroergotamine+Metoclopramide.
Other Intervention Name(s)
Cefalium
Intervention Description
The subject must manage 02 tablets of Cefalium right after a moderate to severe migraine.
Intervention Type
Drug
Intervention Name(s)
Acetaminophen
Other Intervention Name(s)
Tylenol
Intervention Description
The subject must manage 02 tablets of Tylenol right after a moderate to severe migraine.
Primary Outcome Measure Information:
Title
Pain relief of Cefalium® compared to Tylenol®
Description
Relief of pain 2 hours after taking medication, being considered to reduce the intensity from strong(3) or moderate(2), at baseline, to mild(1) or absent(0) 2 hours after taking the medication, according to the functional and behavioral debilitating categorical scale without use of rescue medication as annotations the diary of symptoms
Time Frame
2 hours
Secondary Outcome Measure Information:
Title
Pain decrease after use of investigational product, without a rescue medication
Description
Number of participants with pain decrease in 2 hours and 4 hours after the use of the investigational product,at the first migraine attack with mild or moderate pain, with remission defined as no pain (0) in categorical scale debilitating functional and behavioral (4 point-scale), without use of a rescue medication
Time Frame
Up to 4 hours
Title
Pain decrease after use of the investigational product, without a rescue medication
Description
Number of participants with pain relief in 4 hours after the use of the investigational product, in the first migraine attack with mild or moderate pain,and is considered the relief reduction of at least 01 point in pain intensity from baseline, according to functional and behavioral debilitating categorical scale without use of a rescue medication;
Time Frame
4 hours
Title
Pain relief maintenance during the period 4-24 hours after use of investigational product
Description
The maintenance will be observed if the relief reached the first 4 hours will remain at 24 hours after use of the investigational product, according to functional and behavioral debilitating categorical scale (4 point scale) without use of rescue medication during this period;
Time Frame
Up to 24 hours
Title
Nausea/vomiting Symptoms Free
Description
Participants free of nausea/vomiting symptoms 2 and 4 hours after use of investigational product,at the first migraine attack of moderate to severe pain intensity, defined as the proportion of subjects with no symptoms of both among the participants have at least one symptom at baseline of migraine without use of a rescue medication during this period.
Time Frame
Up to 4 hours
Title
Photophobia/Phonophobia Symptoms Free
Description
Participants free of photophobia/phonophobia symptoms 2 and 4 hours after use of investigational product, at the first migraine attack of moderate to severe pain intensity, defined as the proportion of subjects with no symptoms of both among the participants have at least one symptom at baseline of migraine without use of a rescue medication during this period.
Time Frame
Up to 4 hours
Title
Need of a rescue medication
Description
Number of participants who use at least once the rescue medication in a 2-24 hours period after use of the investigational product.
Time Frame
Up to 24 hours
Other Pre-specified Outcome Measures:
Title
Variation in laboratory exams ratings
Description
Number of participants with any relevant variation in laboratory exams from baseline visit until 30 days after the end of the treatment
Time Frame
From baseline visit until 30 days after the end of the treatment
Title
Variation in clinical exams ratings
Description
Number of participants with any relevant variation in clinical exams from baseline visit until 30 days after the end of the treatment
Time Frame
From baseline visit until 30 days after the end of the treatment
Title
Variation in physical exams ratings
Description
Number of participants with any relevant variation in physical exams from baseline visit until 30 days after the end of the treatment
Time Frame
From baseline visit until 30 days after the end of the treatment
Title
Participants with adverse events
Description
Number of participants with any adverse events from baseline visit until 30 days after the end of the treatment
Time Frame
From baseline visit until 30 days after the end of the treatment

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: Subjects of both gender; Age older or equal to 18 and younger than 66 years if they have symptoms of migraine headache before 50 years of age; Presence of migraine headache with or without aura symptoms, at least 03 months prior to the study, the criteria defined by International Classification of Headache Disorders(ICHD)-II, 2004 (IHS International Headache Society) - Annex I; Subjects which are experiencing 2-6 migraine attacks per month with mild to moderate pain intensity in the last 3 months prior to screening visit; Participants which are able to distinguish migraine attacks to any other type of headache; Ability to understand and consent to participate in this clinical research, expressed by signing the Informed Consent Form (ICF). Exclusion Criteria: Any clinical finding (clinical evaluation / physical) that is interpreted by the Investigator as a risk to the subject in the clinical trial; Subjects which had recent episodes of headache, with frequency equal or higher than 15 daily episodes per month, 3 months prior to the screening visit; Subjects with headache history defined by the ICHD-II criteria, 2004 IHS (International Headache Society) rated as: Typical aura with non-migraine headache; Typical aura without headache; Familial Hemiplegic Migraine (FHM); Sporadic Hemiplegic Migraine; Basilar type Migraine; Any laboratorial finding that the Investigator consider a risk to subject of the study; Hypersensitivity to the drug components used during the study; Women in pregnancy or nursing period; Women in reproductive age who do not agree to use contraception acceptable [oral contraceptives, injectable contraceptives, intrauterine device (IUD), hormonal implants, barrier methods, hormonal patch and tubal ligation]; other than surgically sterile (bilateral oophorectomy or hysterectomy), postmenopausal for at least one (01) years or sexual abstinence; Inability to understand and answer to the functional categorical scale of the study, diary of symptoms, and not having accompanying to assist him/her; History of abuse, according to the principal investigator, of the alcohol, opioids, barbiturates, benzodiazepines and illicit drugs in the last 02 years, or abuse of drugs for headache including ergotamines or narcotics in the last 03 months; Subjects with prolonged hypotension, shock, sepsis, pheochromocytoma, hemorrhage, mechanical obstruction or perforation of the gastrointestinal tract Participants with glucose-6-phosphate dehydrogenase(G6PD) deficiency due to increased risk of hemolysis associated with the use of paracetamol; Subjects with history of epilepsy or presence of psychiatric illness of any kind, in the opinion of the investigator, that may interfere with adherence to treatment; Subjects with a malignant disease less than five years, or for more than five years, but without documentation about the remission/cure. As example: melanoma, leukemia, lymphoma, myeloproliferative diseases and renal cell carcinoma of any length should be excluded. Exceptions: Participants with basal cell skin cancers, squamous cell, and cervical cancer in situ may be eligible; Subjects which uses a preventive treatment and changed the dose in the last 02 weeks before the screening visit (V0); Subjects with hepatic or renal failure; Subjects that has participated in clinical trial protocols in the last twelve (12) months (National Board of Health- Resolution 251 of 07 August 1997, Part III, sub-item J), unless the investigator considers that there may be a direct benefit to it; Subjects who are in prohibited medication as described in item 10.2 of the Protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thais Villa
Organizational Affiliation
Federal University of São Paulo
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centro de Pesquisa Clínica - CPEC / Associação Obras Sociais Irmã Dulce
City
Salvador
State/Province
Bahia
Country
Brazil
Facility Name
Centro de Pesquisa Clínica Hospital São Lucas da PUCRS
City
Porto Alegre
State/Province
Rio Grande Do Sul
Country
Brazil
Facility Name
Centro de Desenvolvimento em Estudos Clínicos Brasil - CDEC Brasil
City
São Paulo
Country
Brazil
Facility Name
Cepic - Centro Paulista de Investigação Clínica
City
São Paulo
Country
Brazil
Facility Name
CPCLIN - Centro de Pesquisas Clinicas Ltda
City
São Paulo
Country
Brazil
Facility Name
Universidade Federal de São Paulo - Núcleo de Gestão de Pesquisa/HU/FAP
City
São Paulo
Country
Brazil

12. IPD Sharing Statement

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Cefalium® Compared to Tylenol® in the Treatment of Migraine Attacks

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