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Low-Dose Naltrexone and Acetaminophen Combination and Sumatriptan in the Acute Treatment of Migraine With Nausea

Primary Purpose

Migraine With and Without Aura

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Naltrexone and Acetaminophen Combination
Sumatriptan 100 mg
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 and Without Aura

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female 18 to 65 years of age.
  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 the 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 2 methods of adequate and reliable contraception throughout the study and for 28 days after taking the last dose of the study drug (e.g., barrier with additional spermicidal, intra-uterine device, hormonal contraception). Male patients must be surgically sterile or commit to the use of 2 different methods of birth control during the study and for 28 days after the study.ice, hormonal contraception).

Exclusion Criteria:

  1. The patient in the opinion of the investigator may have medication-overuse headaches (as defined by ICHD - 3 beta criteria for medication-overuse headache) during the preceding 3 months.
  2. The patient in the opinion of the investigator has chronic migraine (as defined by ICHD - 3 beta criteria for chronic migraine) during the preceding 3 months.
  3. History of cluster headaches or neurologically complicated migraine (hemiplegic, basilar, retinal, ophthalmoplegic).
  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, or Botox).
  5. Use of opiates or barbiturates more than 3 days per month.
  6. Any concurrent medical or psychiatric condition, this includes, but is not limited to chronic unstable debilitating diseases, significant renal or hepatic impairment.
  7. The patient has a history within the previous 3 years of abuse of any drug, prescription, illicit, or alcohol.
  8. 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.
  9. The patient has known-hypersensitivity reaction to any of the components of the investigational drug.
  10. Consumption of analgesic medication or muscle relaxants (including all benzodiazepines) for other conditions on a regular basis.
  11. The patient has used emergency care treatment more than 3 times in the previous 6 months.
  12. The patient has participated in another study with an investigational drug within 30 days prior to randomization and/or plan to participate during the study.
  13. The patient has a history of congenital heart disease, cardiac arrhythmias, or cardiovascular disease, e.g., ischemic heart disease (e.g., stable angina pectoris, unstable angina, vasospastic angina, myocardial infarction or silent myocardial ischemia), cerebrovascular syndromes (e.g., strokes of any type or transient ischemic attacks), peripheral vascular disease, ischemic bowel disease, or Raynaud syndrome.
  14. Uncontrolled hypertension (sitting >160 mmHg systolic pressure or >95mmHg diastolic pressure).
  15. The patient, in the investigator's opinion, is likely to have unrecognized cardiovascular or cerebrovascular disease.
  16. History of epilepsy. Allergy to sulfonamides.
  17. Consumption of monoamine oxidase inhibitor (MAOI) drug, tricyclic antidepressant, selective serotonin reuptake inhibitor (SSRI) or Serotonin Noradrenaline Reuptake Inhibitor (SNRI).

Sites / Locations

  • Annette C. Toledano, M.D.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

Naltrexone and Acetaminophen Combination

Sumatriptan 100 mg

Placebo

Arm Description

Outcomes

Primary Outcome Measures

The proportion of patients having no headache pain at 2 hours.
Measured by asking the patients to self-report the current status of their headache pain on a four-point Likert scale (i.e., 0=none, 1=mild, 2=moderate, 3=severe).
The proportion of patients having the absence of the most bothersome migraine-associated symptom at 2 hours.
The most bothersome migraine-associated symptom is prospectively identified at baseline. It is measured by asking the patients to self-report the current status of their associated symptom as present or absent.

Secondary Outcome Measures

The proportion of patients having the absence of nausea, photophobia, phonophobia, and neck/shoulder pain at 2 hours.
Measured by asking the patients to self-report the current status of their associated symptoms as present or absent.
The proportion of patients who used rescue medications within 24 hours.
The proportion of patients who are "sustained pain-free" at 24-hours and 48-hours.
Defined as having no headache pain at 2 hours after the dose, with no use of rescue medication and no relapse of headache pain within 24 hours (24-hour sustained pain-free) or 48 hours (48-hour sustained pain-free) after administration of the investigational drug.
The proportion of patients who had headache pain relapse within 48 hours
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.
The proportion of patients who experienced adverse events

Full Information

First Posted
June 8, 2017
Last Updated
April 11, 2021
Sponsor
Allodynic Therapeutics, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03185143
Brief Title
Low-Dose Naltrexone and Acetaminophen Combination and Sumatriptan in the Acute Treatment of Migraine With Nausea
Official Title
Randomized, Double-Blind, and Placebo-Controlled Study to Assess a Single Dose of Low-Dose Naltrexone and Acetaminophen Combination Versus Sumatriptan in the Acute Treatment of Migraine With Nausea
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
June 27, 2017 (Actual)
Primary Completion Date
May 7, 2018 (Actual)
Study Completion Date
May 7, 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
This proof-of-concept study compares side-by-side low-dose naltrexone and acetaminophen combination to sumatriptan in the acute treatment of migraine.
Detailed Description
The study consists of a screening visit, outpatient treatment of a moderate or severe migraine attack with a single dose of the study drug 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 and Without Aura

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Naltrexone and Acetaminophen Combination
Arm Type
Experimental
Arm Title
Sumatriptan 100 mg
Arm Type
Active Comparator
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Naltrexone and Acetaminophen Combination
Intervention Description
Treat a single Qualified Migraine attack.
Intervention Type
Drug
Intervention Name(s)
Sumatriptan 100 mg
Intervention Description
One capsule contains Sumatriptan 100 mg and one capsule contains a sham for component B taken together to treat a single Qualified Migraine attack.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
One capsule contains a sham for component A and one capsule contains a sham for component B taken together to treat a single Qualified Migraine attack.
Primary Outcome Measure Information:
Title
The proportion of patients having no headache pain at 2 hours.
Description
Measured by asking the patients to self-report the current status of their headache pain on a four-point Likert scale (i.e., 0=none, 1=mild, 2=moderate, 3=severe).
Time Frame
2 hours
Title
The proportion of patients having the absence of the most bothersome migraine-associated symptom at 2 hours.
Description
The most bothersome migraine-associated symptom is prospectively identified at baseline. It is measured by asking the patients to self-report the current status of their associated symptom as present or absent.
Time Frame
2 hours
Secondary Outcome Measure Information:
Title
The proportion of patients having the absence of nausea, photophobia, phonophobia, and neck/shoulder pain at 2 hours.
Description
Measured by asking the patients to self-report the current status of their associated symptoms as present or absent.
Time Frame
24 and 48 hours
Title
The proportion of patients who used rescue medications within 24 hours.
Time Frame
24 hours
Title
The proportion of patients who are "sustained pain-free" at 24-hours and 48-hours.
Description
Defined as having no headache pain at 2 hours after the dose, with no use of rescue medication and no relapse of headache pain within 24 hours (24-hour sustained pain-free) or 48 hours (48-hour sustained pain-free) after administration of the investigational drug.
Time Frame
48 hours.
Title
The proportion of patients who had headache pain relapse within 48 hours
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
48 hours
Title
The proportion of patients who experienced adverse events
Time Frame
48 hours

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 18 to 65 years of age. 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 the 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 2 methods of adequate and reliable contraception throughout the study and for 28 days after taking the last dose of the study drug (e.g., barrier with additional spermicidal, intra-uterine device, hormonal contraception). Male patients must be surgically sterile or commit to the use of 2 different methods of birth control during the study and for 28 days after the study.ice, hormonal contraception). Exclusion Criteria: The patient in the opinion of the investigator may have medication-overuse headaches (as defined by ICHD - 3 beta criteria for medication-overuse headache) during the preceding 3 months. The patient in the opinion of the investigator has chronic migraine (as defined by ICHD - 3 beta criteria for chronic migraine) during the preceding 3 months. History of cluster headaches or neurologically complicated migraine (hemiplegic, basilar, retinal, ophthalmoplegic). 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, or Botox). Use of opiates or barbiturates more than 3 days per month. Any concurrent medical or psychiatric condition, this includes, but is not limited to chronic unstable debilitating diseases, significant renal or hepatic impairment. The patient has 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. The patient has known-hypersensitivity reaction to any of the components of the investigational drug. Consumption of analgesic medication or muscle relaxants (including all benzodiazepines) for other conditions on a regular basis. The patient has used emergency care treatment more than 3 times in the previous 6 months. The patient has participated in another study with an investigational drug within 30 days prior to randomization and/or plan to participate during the study. The patient has a history of congenital heart disease, cardiac arrhythmias, or cardiovascular disease, e.g., ischemic heart disease (e.g., stable angina pectoris, unstable angina, vasospastic angina, myocardial infarction or silent myocardial ischemia), cerebrovascular syndromes (e.g., strokes of any type or transient ischemic attacks), peripheral vascular disease, ischemic bowel disease, or Raynaud syndrome. Uncontrolled hypertension (sitting >160 mmHg systolic pressure or >95mmHg diastolic pressure). The patient, in the investigator's opinion, is likely to have unrecognized cardiovascular or cerebrovascular disease. History of epilepsy. Allergy to sulfonamides. Consumption of monoamine oxidase inhibitor (MAOI) drug, tricyclic antidepressant, selective serotonin reuptake inhibitor (SSRI) or Serotonin Noradrenaline Reuptake Inhibitor (SNRI).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Annette C. Toledano, M.D.
Organizational Affiliation
Allodynic Therapeutics, LLC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Annette C. Toledano, M.D.
City
North Miami
State/Province
Florida
ZIP/Postal Code
33181
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Low-Dose Naltrexone and Acetaminophen Combination and Sumatriptan in the Acute Treatment of Migraine With Nausea

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