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Low-Dose Naltrexone and Acetaminophen Combination and Its Components in the Acute Treatment of Migraine (ANODYNE-1)

Primary Purpose

Migraine With or Without Aura

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Naltrexone and Acetaminophen
Naltrexone and Acetaminophen-High Dose
Naltrexone Alone (regular dose)
Acetaminophen Alone
Matching Placebo
Sponsored by
Allodynic Therapeutics, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Migraine With or Without Aura focused on measuring Migraine Disorders, Headache Disorders, Migraine with Aura, Migraine without Aura

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female 18 years of age or older.
  2. History of migraine with or without aura according to the International Classification of Headache Disorders (ICHD)-3rd edition (beta version) for at least one-year with first migraine prior to age 50.
  3. Migraine-associated nausea with ≥half of migraine attacks.
  4. 2 - 8 migraines per month in each of the previous 3 months.
  5. The patient is able to complete study questionnaires, comply with the study requirements and restrictions, and willing to provide written informed consent and authorize HIPAA.
  6. The female patient who is premenopausal or postmenopausal less than 1 year, or have not had surgical sterilization (i.e., tubal ligation, partial or complete hysterectomy) must have a negative urine pregnancy test, be non-lactating, and commit to using adequate and reliable contraception throughout the study (e.g., barrier with additional spermicidal, intra-uterine device, hormonal contraception). The male patient must be surgically sterile or commit to the use of 2 different methods of birth control during the study and for 28 days after taking the study drug.

Exclusion Criteria:

  1. The patient in the opinion of the investigator, may have medication-overuse headache pain (as defined by ICHD - 3 beta criteria for medication-overuse headache), (analgesic, opioid, ergotamine or triptan overuse) during the 3 months preceding screening.
  2. The patient in the opinion of the investigator has chronic migraine (as defined by ICHD - 3 beta criteria for chronic migraine).
  3. History of cluster headache or neurologically complicated migraine (hemiplegic, basilar, retinal, ophthalmoplegic migraine).
  4. Initiation or change in medications with possible migraine prophylactic effects during 3 months before inclusion into the trial (E.g., calcium channel blockers, tricyclic antidepressants, beta-blockers, selective serotonin re-uptake inhibitors (SSRIs), serotonin-norepinephrine re-uptake inhibitors (SNRIs), or Botox).
  5. Any concurrent medical or psychiatric condition, this includes, but is not limited to chronic unstable debilitating diseases, significant renal or hepatic impairment.
  6. A history within the previous 3 years of abuse of any drug, prescription, illicit, or alcohol.
  7. The Female patient is pregnant or breast-feeding. The Male patient is not practicing 2 different methods of birth control with their partner during the study, and for 28 days after the investigational drug last dose or will not remain abstinent during the study, and for 28 days after the last dose.
  8. Use of opiates or barbiturates more than 3 days per month.
  9. Known-hypersensitivity reaction to any of the components of the investigational drug.
  10. Consumption of analgesic medication for other conditions on a regular basis, (nonsteroidal anti-inflammatory drugs, or acetaminophen, or muscle relaxants).
  11. Use of emergency care treatment more than 3 times in the previous 6 months.
  12. Participation in another study with an investigational drug within 30 days prior to randomization and/or a plan to participate during the study.

Sites / Locations

  • Annette C. Toledano MD

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

Naltrexone and Acetaminophen

Naltrexon/Acetaminophen-High Capsules

Naltrexone Alone Capsules

Acetaminophen Alone Capsules

Placebo Capsules

Arm Description

Patients take one capsule containing naltrexone and one capsule containing acetaminophen together for a qualifying migraine

Patient take one capsule containing naltrexone (high dose) and one capsule containing acetaminophen together for a qualifying migraine

Patient take one capsule containing naltrexone and one capsule containing placebo together for a qualifying migraine

Patient take one capsule containing naltrexone and one capsule containing placebo together for a qualifying migraine

Patient take two capsule containing placebo together for a qualifying migraine

Outcomes

Primary Outcome Measures

% of patients reporting no headache pain.
Self-reported headache pain on a four-point Likert scale.
% of patients having absence of most bothersome migraine-associated symptom (MBS).
MBS was prospectively identified at baseline. Self-reported MBS as present or absent.
% 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.

Secondary Outcome Measures

% 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.
% of patients who used rescue medications
% 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.

Full Information

First Posted
February 17, 2017
Last Updated
April 11, 2021
Sponsor
Allodynic Therapeutics, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03061734
Brief Title
Low-Dose Naltrexone and Acetaminophen Combination and Its Components in the Acute Treatment of Migraine
Acronym
ANODYNE-1
Official Title
A Clinical Trial to Assess a Single Dose of Low-Dose Naltrexone and Acetaminophen Combination and Its Components in the Acute Treatment of Migraine
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
February 18, 2017 (Actual)
Primary Completion Date
February 8, 2018 (Actual)
Study Completion Date
February 8, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Allodynic Therapeutics, LLC

4. Oversight

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

5. Study Description

Brief Summary
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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Migraine With or Without Aura
Keywords
Migraine Disorders, Headache Disorders, Migraine with Aura, Migraine without Aura

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
92 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Naltrexone and Acetaminophen
Arm Type
Experimental
Arm Description
Patients take one capsule containing naltrexone and one capsule containing acetaminophen together for a qualifying migraine
Arm Title
Naltrexon/Acetaminophen-High Capsules
Arm Type
Experimental
Arm Description
Patient take one capsule containing naltrexone (high dose) and one capsule containing acetaminophen together for a qualifying migraine
Arm Title
Naltrexone Alone Capsules
Arm Type
Active Comparator
Arm Description
Patient take one capsule containing naltrexone and one capsule containing placebo together for a qualifying migraine
Arm Title
Acetaminophen Alone Capsules
Arm Type
Active Comparator
Arm Description
Patient take one capsule containing naltrexone and one capsule containing placebo together for a qualifying migraine
Arm Title
Placebo Capsules
Arm Type
Placebo Comparator
Arm Description
Patient take two capsule containing placebo together for a qualifying migraine
Intervention Type
Drug
Intervention Name(s)
Naltrexone and Acetaminophen
Intervention Description
Naltrexone plus acetaminophen
Intervention Type
Drug
Intervention Name(s)
Naltrexone and Acetaminophen-High Dose
Intervention Description
Naltrexon (high dose) plus acetaminophen
Intervention Type
Drug
Intervention Name(s)
Naltrexone Alone (regular dose)
Intervention Description
Naltrexone Alone plus Placebo
Intervention Type
Drug
Intervention Name(s)
Acetaminophen Alone
Intervention Description
Acetaminophen Alone plus Placebo
Intervention Type
Drug
Intervention Name(s)
Matching Placebo
Intervention Description
Two Placebo capsules
Primary Outcome Measure Information:
Title
% of patients reporting no headache pain.
Description
Self-reported headache pain on a four-point Likert scale.
Time Frame
2 hours post-dose
Title
% of patients having absence of most bothersome migraine-associated symptom (MBS).
Description
MBS was prospectively identified at baseline. Self-reported MBS as present or absent.
Time Frame
2 hours post-dose
Title
% of patients who have "sustained pain freedom"
Description
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.
Time Frame
24-hour post-dose.
Secondary Outcome Measure Information:
Title
% of patients having absence of nausea, photophobia, phonophobia, and neck/shoulder pain
Description
Self-reported the current status of their associated symptom as present or absent.
Time Frame
24-hour post-dose.
Title
% of patients who used rescue medications
Time Frame
2-24 hours
Title
% of patients who had headache pain relapse.
Description
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.
Time Frame
2-48 hours
Other Pre-specified Outcome Measures:
Title
% of patients who experienced adverse events
Description
treatment related Adverse Events
Time Frame
48 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female 18 years of age or older. History of migraine with or without aura according to the International Classification of Headache Disorders (ICHD)-3rd edition (beta version) for at least one-year with first migraine prior to age 50. Migraine-associated nausea with ≥half of migraine attacks. 2 - 8 migraines per month in each of the previous 3 months. The patient is able to complete study questionnaires, comply with the study requirements and restrictions, and willing to provide written informed consent and authorize HIPAA. The female patient who is premenopausal or postmenopausal less than 1 year, or have not had surgical sterilization (i.e., tubal ligation, partial or complete hysterectomy) must have a negative urine pregnancy test, be non-lactating, and commit to using adequate and reliable contraception throughout the study (e.g., barrier with additional spermicidal, intra-uterine device, hormonal contraception). The male patient must be surgically sterile or commit to the use of 2 different methods of birth control during the study and for 28 days after taking the study drug. Exclusion Criteria: The patient in the opinion of the investigator, may have medication-overuse headache pain (as defined by ICHD - 3 beta criteria for medication-overuse headache), (analgesic, opioid, ergotamine or triptan overuse) during the 3 months preceding screening. The patient in the opinion of the investigator has chronic migraine (as defined by ICHD - 3 beta criteria for chronic migraine). History of cluster headache or neurologically complicated migraine (hemiplegic, basilar, retinal, ophthalmoplegic migraine). Initiation or change in medications with possible migraine prophylactic effects during 3 months before inclusion into the trial (E.g., calcium channel blockers, tricyclic antidepressants, beta-blockers, selective serotonin re-uptake inhibitors (SSRIs), serotonin-norepinephrine re-uptake inhibitors (SNRIs), or Botox). Any concurrent medical or psychiatric condition, this includes, but is not limited to chronic unstable debilitating diseases, significant renal or hepatic impairment. A history within the previous 3 years of abuse of any drug, prescription, illicit, or alcohol. The Female patient is pregnant or breast-feeding. The Male patient is not practicing 2 different methods of birth control with their partner during the study, and for 28 days after the investigational drug last dose or will not remain abstinent during the study, and for 28 days after the last dose. Use of opiates or barbiturates more than 3 days per month. Known-hypersensitivity reaction to any of the components of the investigational drug. Consumption of analgesic medication for other conditions on a regular basis, (nonsteroidal anti-inflammatory drugs, or acetaminophen, or muscle relaxants). Use of emergency care treatment more than 3 times in the previous 6 months. Participation in another study with an investigational drug within 30 days prior to randomization and/or a plan to participate during the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Annette C Toledano, M.D.
Organizational Affiliation
Allodynic Therapeutics, LLC
Official's Role
Study Director
Facility Information:
Facility Name
Annette C. Toledano MD
City
North Miami
State/Province
Florida
ZIP/Postal Code
33181
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
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Links:
URL
https://search.usa.gov/search?utf8=%E2%9C%93&affiliate=iprcc&query=tlr4&x=0&y=0
Description
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 ...

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Low-Dose Naltrexone and Acetaminophen Combination and Its Components in the Acute Treatment of Migraine

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