Erenumab - Comprehensive Assessment of Efficacy in (High-Frequency) Episodic Migraine (EMBRACE)
Migraine
About this trial
This is an interventional prevention trial for Migraine
Eligibility Criteria
Key inclusion criteria include:
- Age greater than or equal to 18 years upon entry into initial screening.
- Documented history of migraine with or without aura according to the International Headache Society (IHS) International Classification of Headache Disorders, Third Edition (ICHD-III) for greater than or equal to 12 months.
- Have high-frequency episodic migraine (HFEM): Defined as history of ≥ 7 to < 15 migraine days and < 15 headache days per month on average during the 3 months prior to screening.
- History of ≥ 4 migraine attacks of at least moderate severity per month on average during the 3 months prior to screening.
- History of treatment failure with at least 1 preventive treatment for migraine. Failure of preventive treatment for migraine is defined as treatment discontinuation due to lack of efficacy, adverse event, or general poor tolerability.
- Regular use of an oral triptan (using only eletriptan, rizatriptan, sumatriptan, or zolmitriptan) for acute migraine treatment, and typically initiating acute treatment with an oral triptan on > 50% of attacks of at least moderate pain intensity. Regular use is defined as ≥ 4 days of oral triptan use per month during the 3 months prior to screening.
Key exclusion criteria include:
- History of hemiplegic migraine, cluster headache, or other trigeminal autonomic cephalalgia.
- Has any medical contraindication to the use of an oral triptan.
- Previously treated with erenumab.
Previously treated with a gepant (small molecule calcitonin gene related peptide receptor [CGRP-R] antagonist) in a preventive fashion in a manner consistent with migraine prevention that either:
- In the opinion of the investigator, did not offer any evidence of a therapeutic response or
- Was discontinued for less than 12 weeks from the date of initial screening or
- Was previously discontinued due to a known adverse drug reaction
- Currently being treated with lasmiditan and/or a gepant in the acute setting.
- No therapeutic response with greater than 4 of the defined medication categories after an adequate therapeutic trial.
- Currently has a history of consistent excellent response to oral triptans, defined as achievement of pain-freedom in ≤ 1 hour for ≥ 50% of treated attacks of at least moderate pain intensity during the 3 months prior to screening.
- Use of triptans administered via a non-oral (e.g. subcutaneous [SC] or intranasal delivery systems) or sublingual route at the time of screening, during the run-in and baseline periods, and throughout the study duration.
Sites / Locations
- Long Beach Clinical Trials Services Inc
- Clinical Research Institute, LLC
- Mountain Neurological Research Center
- Denver Neurological Clinic
- Summit Headache and Neurologic Institute
- JEM Research Institute
- Jacksonville Center for Clinical Research
- Visionary Investigators Network
- Renstar Medical Research
- Heuer Medical Doctor Research LLC
- Neurology Associates of Ormond Beach
- Visionary Investigators Network
- Saint Lukes Clinic
- Chicago Headache Center and Research Institute
- Boston Clinical Trials
- New England Regional Headache Center Inc
- Michigan Head Pain and Neurological Institute
- Mercy Health Research
- StudyMetrix Research
- Clinvest Research LLC
- Papillion Research Center
- Forte Family Practice
- Dent Neurosciences Research Center
- American Clinical Research Institute LLC
- University of Cincinnati
- Cleveland Clinic
- Summit Research Network
- Palmetto Clinical Trial Services
- Nashville Neuroscience Group
- FutureSearch Trials of Neurology
- North Texas Institute of Neurology and Headache
- University Multiprofile Hospital for Active Treatment - Dr Georgi Stranski EAD
- University Multiprofile Hospital for Active Treatment Sveti Georgi EAD
- Multiprofile Hospital for Active Treatment in neurology and psychiatry Sveti Naum EAD
- University First Multiprofile Hospital for Active Treatment - Sofia Sveti Yoan Krastitel EAD
- Medical Center Excelsior OOD
- University Multiprofile Hospital for Active Treatment Alexandrovska EAD
- Medical Center New Rehabilitation Center EOOD
- Neurologie Brno sro
- Fakultni nemocnice u svate Anny v Brne
- Poliklinika Chocen, Neurohk sro
- Brain-soultherapy sro
- Dado Medical sro
- FORBELI sro
- Institut Neuropsychiatricke pece
- NeuroMed Zlin sro
- Obudai Egeszsegugyi Centrum Kft
- High Tech Medical Kft
- Uno Medical Trials Kft
- S-Medicon Kutatasi Centrum
- Orszagos Mentalis, Ideggyogyaszati es Idegsebeszeti Intezet
- Obudai Egeszsegugyi Centrum Kft
- Ospedale Bellaria Carlo Alberto Pizzardi
- Azienda Socio Sanitaria Teritoriale Spedali Civili di Brescia
- Azienda Ospedaliera Universitaria Renato Dulbecco
- Ospedale Policlinico San Martino IRCCS
- IRCCS Ospedale San Raffaele
- Fondazione IRCCS Istituto Neurologico Carlo Besta
- Fondazione Istituto Neurologico Nazionale C Mondino IRCCS
- Policlinico Universitario Campus Biomedico
- IRCCS San Raffaele Pisana
- Azienda della scienza di Torino
- Centrum Badan Klinicznych PI-House Spzoo
- Gabinet Diagnostyki i Leczenia Osteoporozy Prof Wojciech Pluskiewicz
- Care Clinic Spzoo Care Clinic Centrum Medyczne
- Vita Longa Spzoo
- NZOZ Neuromed M i M Nastaj Spolka Partnerska
- AppleTreeClinics Network Spzoo
- M-Zdrowie
- NZOZ Neuromed M i M Nastaj Spolka Partnerska
- Instytut Zdrowia Dr Boczarska-Jedynak Spzoo SpKom
- Osrodek Badan Klinicznych Cromed
- Prywatny Gabinet Neurologiczny Iwona Rosciszewska-Zukowska
- Migre Polskie Centrum Leczenia Migreny Anna Gryglas-Dworak
- Centrum Medyczne Oporow
- Vistamed and Vertigo Sp z o o
- Hospital da Luz, SA
- Centro Hospitalar Universitario de Lisboa Norte, EPE - Hospital de Santa Maria
- Hospital Cuf Sintra
- Campus Neurologico Senior
- Spitalul Universitar de Urgenta Militar Central Dr. Carol Davila
- Spitalul Universitar de Urgenta Bucuresti
- Spitalul Clinic Judetean de Urgenta Pius Brinzeu Timisoara
- Hospital Universitario Virgen del Rocio
- Hospital Clinico Universitario Lozano Blesa
- Hospital Universitario Marques de Valdecilla
- Hospital Clinico Universitario de Valladolid
- Hospital Universitari Vall d Hebron
- Hospital Clinico Universitario de Valencia
- Hospital Universitari i Politecnic La Fe
- Clinica Universidad de Navarra
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Erenumab
Placebo
The 4-month DBTP has 2 phases: Main double-blind treatment phase (M-DBTP, months 1 to 3) that will assess the effect of erenumab on metrics such as time spent in at least moderate pain, peak migraine severity, and functional impairment. Exploratory DBTP (E-DBTP, month 4) that will assess the impact of erenumab on the acute response to treatment with oral triptan therapy as well as non-ictal burden.
The 4-month DBTP has 2 phases: Main DBTP (M-DBTP, months 1 to 3) that will assess the effect of erenumab on metrics such as time spent in at least moderate pain, peak migraine severity, and functional impairment. Exploratory DBTP (E-DBTP, month 4) that will assess the impact of erenumab on the acute response to treatment with oral triptan therapy as well as non-ictal burden.