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A Study of a Melatonin Receptor Agonist to Prevent Migraine

Primary Purpose

Migraine, Migraine With Aura, Migraine Without Aura

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ramelteon
Placebo
Sponsored by
Swedish Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Migraine focused on measuring Migraine, Headache

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female, ages 18 to 65 years, inclusive.
  • An established history of migraine, with or without aura and probable migraine, conforming to the revised IHS criteria (2004) for at least 1 year before screening, sufficient to establish the diagnosis.
  • To be randomized, during the prospective 4-week baseline period (approximately 28 days before Visit 2), subjects must have more than 4 migraine/probable migraine attacks per month (using the 24-hour rule).
  • Must have been less than 50 years of age at the time of initial migraine onset.
  • Must have no clinically significant and relevant abnormalities on physical or neurologic examinations
  • Must have completed a washout of all prophylactic medications for migraine before the start of the 4-week prospective baseline period (ie, 28 days before Visit 2, when randomization occurs).
  • Female subjects must be at least 1 of the following:
  • postmenopausal, or
  • surgically incapable of being children, or
  • practicing a highly effective method of birth control

Exclusion Criteria:

  • Most frequent type of headache does not meet the revised IHS diagnostic criteria for migraine with aura or without aura or probable migraine.
  • Pregnant or lactating women, or sexually active women of childbearing potential who are not using an appropriate method of contraception.
  • Failed adequate trials of prophylactic agents with demonstrated or possible efficacy in the prophylaxis of migraine. These agents include beta-blockers, tricyclic antidepressants, valproate, topiramate, and methysergide.
  • Unable to complete the diary in a timely and accurate manner after each migraine headache attacks, either independently or with assistance.
  • Overuse of analgesics or specific agents for abortive treatment of migraine attacks, which makes the investigator suspect medication overuse headache.
  • Receiving non-pharmacological prophylactic treatments such as acupuncture, chiropractic, or massage, if these were started less than 1 month before the screening visit (Day -28). These therapies may be continued if started before that time.
  • Currently abusing alcohol or other drugs.
  • Have a central nervous system neoplasm or infection, demyelinating disease, degenerative or progressive central nervous system disease, or active epilepsy.
  • History of serious systemic disease, including hepatic insufficiency, renal insufficiency, a malignant neoplasm, any disorder in which prognosis for survival is less than 3 months, or any disorder which in the judgment of the investigator will place the subject at excessive risk by participation in a controlled trial.
  • Have a significant psychiatric disorder, such as acute psychosis, schizophrenia, severe bipolar disorder, or severe unipolar mood disorder, of sufficient severity to preclude safe and effective participation of the subject in the study.
  • Require continued use of any of protocol-defined prohibited medications during the study
  • Have any recent or remote history of suicide attempt or ideation
  • Known or strongly suspected to be non-compliant in administering daily medications.
  • Received an experimental drug or used an experimental device within 30 days before the Screening Visit.
  • Employees of the investigator or study center, with direct involvement in the proposed study or other studies under the direction of that investigator or study center, as well as family members of the employees or the investigator
  • Any reason for which the investigator, upon her evaluation, feels that it is in the subject's best interest not to continue on in the study.

Sites / Locations

  • Swedish Pain and Headache Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Active Treatment

Placebo

Arm Description

Ramelteon once daily (double-blind assignment)

Placebo tablet, once daily (double-blind assignment)

Outcomes

Primary Outcome Measures

T-Test
It was planned to use a simple T-Test or ANoVa for data analysis. No Analysis was made due to insufficient recruitment. Planned primary efficacy variable was the percent reduction in the average monthly miqraine/probable migraine frequency from the baseline period to the entire double-blind treatment phase of the study.

Secondary Outcome Measures

Full Information

First Posted
August 19, 2008
Last Updated
August 22, 2012
Sponsor
Swedish Medical Center
Collaborators
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT00739024
Brief Title
A Study of a Melatonin Receptor Agonist to Prevent Migraine
Official Title
A Randomized, Double-blind Placebo-controlled, Parallel Group Study to Study the Efficacy and Tolerability of Ramelteon (Rozerem) in the Prophylaxis of Migraine
Study Type
Interventional

2. Study Status

Record Verification Date
August 2012
Overall Recruitment Status
Terminated
Why Stopped
Recruitment slow and administrative reasons
Study Start Date
April 2008 (undefined)
Primary Completion Date
April 2009 (Actual)
Study Completion Date
September 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Swedish Medical Center
Collaborators
Takeda

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to see if ramelteon will reduce the number of migraine headaches over a 12 week period. The safety and tolerability of ramelteon will also be evaluated. Ramelteon has been approved by the U.S. Food and Drug Administration (FDA) for insomnia (trouble sleeping); however; ramelteon has not been approved for the prevention of migraines.
Detailed Description
Sleep has played an important role in migraine. Younger migraine sufferers usually report relief of migraine after sleep. In older migraine sufferers migraine is sometimes triggered with sleep changes. Occurrence of migraine in the early morning is very common. Therefore in these individuals regulation of sleep may improve the frequency of migraine. Recent PET studies done during migraine demonstrated activation of hypothalamus during migraine. In light of this new data and the known action of ramelteon on the melatonin receptors it may theoretically provide an insight on a possible mechanism of action in migraine.

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Active Treatment
Arm Type
Active Comparator
Arm Description
Ramelteon once daily (double-blind assignment)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo tablet, once daily (double-blind assignment)
Intervention Type
Drug
Intervention Name(s)
Ramelteon
Other Intervention Name(s)
Rozerem
Intervention Description
8 mg tablet, oral, once daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo tablet, oral, once daily
Primary Outcome Measure Information:
Title
T-Test
Description
It was planned to use a simple T-Test or ANoVa for data analysis. No Analysis was made due to insufficient recruitment. Planned primary efficacy variable was the percent reduction in the average monthly miqraine/probable migraine frequency from the baseline period to the entire double-blind treatment phase of the study.
Time Frame
4 weeks

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, ages 18 to 65 years, inclusive. An established history of migraine, with or without aura and probable migraine, conforming to the revised IHS criteria (2004) for at least 1 year before screening, sufficient to establish the diagnosis. To be randomized, during the prospective 4-week baseline period (approximately 28 days before Visit 2), subjects must have more than 4 migraine/probable migraine attacks per month (using the 24-hour rule). Must have been less than 50 years of age at the time of initial migraine onset. Must have no clinically significant and relevant abnormalities on physical or neurologic examinations Must have completed a washout of all prophylactic medications for migraine before the start of the 4-week prospective baseline period (ie, 28 days before Visit 2, when randomization occurs). Female subjects must be at least 1 of the following: postmenopausal, or surgically incapable of being children, or practicing a highly effective method of birth control Exclusion Criteria: Most frequent type of headache does not meet the revised IHS diagnostic criteria for migraine with aura or without aura or probable migraine. Pregnant or lactating women, or sexually active women of childbearing potential who are not using an appropriate method of contraception. Failed adequate trials of prophylactic agents with demonstrated or possible efficacy in the prophylaxis of migraine. These agents include beta-blockers, tricyclic antidepressants, valproate, topiramate, and methysergide. Unable to complete the diary in a timely and accurate manner after each migraine headache attacks, either independently or with assistance. Overuse of analgesics or specific agents for abortive treatment of migraine attacks, which makes the investigator suspect medication overuse headache. Receiving non-pharmacological prophylactic treatments such as acupuncture, chiropractic, or massage, if these were started less than 1 month before the screening visit (Day -28). These therapies may be continued if started before that time. Currently abusing alcohol or other drugs. Have a central nervous system neoplasm or infection, demyelinating disease, degenerative or progressive central nervous system disease, or active epilepsy. History of serious systemic disease, including hepatic insufficiency, renal insufficiency, a malignant neoplasm, any disorder in which prognosis for survival is less than 3 months, or any disorder which in the judgment of the investigator will place the subject at excessive risk by participation in a controlled trial. Have a significant psychiatric disorder, such as acute psychosis, schizophrenia, severe bipolar disorder, or severe unipolar mood disorder, of sufficient severity to preclude safe and effective participation of the subject in the study. Require continued use of any of protocol-defined prohibited medications during the study Have any recent or remote history of suicide attempt or ideation Known or strongly suspected to be non-compliant in administering daily medications. Received an experimental drug or used an experimental device within 30 days before the Screening Visit. Employees of the investigator or study center, with direct involvement in the proposed study or other studies under the direction of that investigator or study center, as well as family members of the employees or the investigator Any reason for which the investigator, upon her evaluation, feels that it is in the subject's best interest not to continue on in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sheena K Aurora, MD
Organizational Affiliation
Swedish Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Swedish Pain and Headache Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Study of a Melatonin Receptor Agonist to Prevent Migraine

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