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Safety and Efficacy of ZP-Zolmitriptan Intracutaneous Microneedle Systems for the Acute Treatment of Migraine (Zotrip)

Primary Purpose

Acute Migraine

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
ZP-Zolmitriptan
Placebo
Sponsored by
Zosano Pharma Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Migraine focused on measuring migraine, migraine headache, acute migraine, acute migraine headache

Eligibility Criteria

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

Inclusion Criteria:

  • Greater than 1 year history of episodic, acute migraine (with or without aura) with onset prior to 50 years of age. Diagnosis must comply with International Headache Society (IHS) diagnostic criteria. Diagnostic criteria must include a history of at least five attacks not attributed to any other disorder that include all of the following criteria:

    1. Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)
    2. Headache has at least two of the following characteristics:

    (i) unilateral location (ii) pulsating quality (iii) moderate or severe pain intensity (iv) aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs) c) During headache at least one of the following: (i) nausea and/or vomiting (ii) both photophobia and phonophobia

  • Migraine history during the 6-month period prior to the run-in period must include: 2-8 migraines per month and no more than 10 headache days per month
  • Women of child-bearing potential must not be pregnant, must agree to avoid pregnancy during the trial, and must use an acceptable methods of birth control for the duration of the trial.
  • No significant ECG findings, defined by:

    1. ischemic changes
    2. Q-waves in at least two contiguous leads,
    3. clinically significant intra-ventricular conduction abnormalities (left bundle branch block or Wolf-Parkinson-White syndrome), or
    4. clinically significant arrhythmias (e.g., current atrial fibrillation)
  • Able to understand the operation of the electronic diary and is able to apply the demo study drug patch.

Exclusion Criteria:

  • Contraindication to triptans
  • Use of any prohibited concomitant medications within 10 days of the Run-in Period
  • History of hemiplegic or basilar migraine
  • Participation in another investigational trial during the 30 days prior to the Run-in Period or during this study
  • Previous participation in a clinical trial of ZP-Zolmitriptan
  • Diagnosis of cancer (other than non-invasive skin cancer) within the 5 years prior to the Run-in Period
  • History of unstable psychiatric illness requiring medication or hospitalization in the 12 months prior to the Run-in Period
  • Subjects who have known allergy or sensitivity to zolmitriptan or its derivatives or formulations
  • Subjects who have known allergy or sensitivity to adhesives
  • Planned participation in activities which cause inflammation, irritation, sunburn, lesions, or tattoos at the intended application site from two weeks prior to screening through the last day of study participation
  • Use of opiate analgesics or barbiturates more frequently than one day/week
  • Women who are pregnant, breast-feeding or plan a pregnancy during this study
  • Clinically significant liver disease
  • Clinically significant kidney disease
  • History of coronary artery disease (CAD), coronary vasospasm (including Prinzmetal's angina), aortic aneurysm, peripheral vascular disease or other ischemic diseases (e.g., ischemic bowel syndrome or Raynaud's syndrome)
  • Three or more of the following CAD risk factors:

    • Current tobacco use
    • Hypertension or receiving anti-hypertensive medication for treatment of hypertension
    • Hyperlipidemia or on prescribed anti-cholesterol treatment
    • Family history of premature coronary artery disease (< 55 years of age in male first degree relatives or < 65 years of age in female first degree relatives)
    • Diabetes mellitus
  • History of cerebral vascular accident, transient ischemic attacks, or seizures
  • Hospitalization within the 30 days prior to the Run-in Period
  • Any other household member currently participating in a ZP-Zolmitriptan study or relatives of site staff
  • Any reason to believe that compliance with the study requirements and completion of evaluations required for this study will not be possible
  • History or current abuse or dependence on alcohol or drugs that would interfere with adherence to study requirements
  • Any clinically relevant abnormal findings in the physical exam, vital signs or laboratory tests that, in the opinion of the Investigator, may put the subject at risk

To be eligible for Treatment, subjects must continue to meet all eligibility criteria and the following criteria observed during the Run-in Period:

  1. An average of at least two qualifying migraines per 28-day period
  2. No more than 10 headache days in the last 28 days prior to randomization
  3. Demonstrated ability to properly use the eDiary and apply the demo study drug patch
  4. Confirmation of continuing good general health, or stable non-serious disease that in the opinion of the Investigator will not place the subject at risk.

Sites / Locations

  • Clinical Research Advantage, Inc./Thunderbird Internal Medicine
  • The Research Center of Southern California
  • Allergy and Asthma Specialists Medical Group and Research Center
  • Downtown LA Research Center
  • Allergy & Asthma Associates of Southern California
  • Allergy and Asthma Associates of Santa Clara Valley Research Center
  • California Medical Clinic for Headache
  • Empire Clinical Research
  • Colorado Allergy & AsthmaCenters, PC
  • Ki Health Partners
  • Avail Clinical Research, LLC
  • Medical Research Group of Central Florida
  • Meridien Research
  • Clinical Research Atlanta
  • Boston Clinical Trials
  • Novex Medical Research
  • Northeast Medical Research Associates, Inc.
  • MedVadis Research Corporation
  • Michigan Head Pain &Neurological Institute
  • Westside Family Medical Center, P.C
  • Clinical Research Institute, Inc.
  • The Clinical Research Center, LLC
  • Clinvest/A Division of Banyan Group Inc.
  • Nebraska Medical Research Institute
  • Dartmouth-Hitchcock Medical Center
  • Princeton Center for Clinical Research
  • Headache Wellness Center, PC
  • Peters Medical Research LLC
  • North Carolina Clinical Research
  • PMG Research of Raleigh
  • CTI Clinical Research Center
  • Coastal Carolina Research Center
  • Nashville Neurosciences Group
  • Central Texas Health Research
  • Sylvana Research Associates
  • Charlottesville Medical Research Center LLC

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

ZP-Zolmitriptan 1 mg

ZP-Zolmitriptan 1.9 mg

ZP-Zolmitriptan 3.8 mg

Placebo

Arm Description

ZP-Zolmitriptan 1 mg patch single administration

ZP-Zolmitriptan 1.9 mg patch single administration

ZP-Zolmitriptan 3.8 mg (1.9 mg x 2 patches) single administration

Placebo (either single or double patch) single administration

Outcomes

Primary Outcome Measures

Proportion of Subjects With Pain Freedom
Pain Freedom at 2 hours post study drug administration is one of the co-primary endpoints. Subjects were queried via their eDiary about their level of migraine pain (none, mild, moderate, or severe) at various intervals post-dose. Subjects who answered none at 2 hours post study drug were considered pain free at 2 hours.
Proportion of Subjects With Freedom From Most Bothersome Pre-specified Other Symptom (Nausea, Photophobia, or Phonophobia Pre-specified by Subject)
The proportion of subjects with freedom from the subject's pre-specified most bothersome symptom at 2 hours is one of two parts of the co-primary efficacy endpoint. This endpoint will be evaluated separately but both endpoints have to be met statistically for the study to be considered a success.

Secondary Outcome Measures

Full Information

First Posted
April 14, 2016
Last Updated
February 13, 2018
Sponsor
Zosano Pharma Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT02745392
Brief Title
Safety and Efficacy of ZP-Zolmitriptan Intracutaneous Microneedle Systems for the Acute Treatment of Migraine
Acronym
Zotrip
Official Title
Randomized, Double-blind, Multi-center, Parallel-group, Dose-ranging Comparison of the Safety and Efficacy of the ZP-Zolmitriptan Intracutaneous Microneedle Systems to Placebo for the Acute Treatment of Migraine
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Completed
Study Start Date
June 2016 (undefined)
Primary Completion Date
January 2017 (Actual)
Study Completion Date
January 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zosano Pharma Corporation

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a randomized, double-blind, multi-center, parallel-group study designed to compare the safety and efficacy of a range of doses of ZP-Zolmitriptan intracutaneous microneedle systems to placebo.
Detailed Description
This is a randomized, double-blind, multi-center, parallel group study designed to compare the safety and efficacy of a range of doses of ZP-Zolmitriptan intracutaneous microneedle systems to placebo. Subjects who have consented and meet the entry criteria will be randomized to one of four blinded treatment groups. There will be a screening period of up to 1 week, followed by a run-in period to record migraine activity. The run-in period is to determine eligibility for randomization, and is planned to be 4 weeks in duration but may be extended up to an additional 4 weeks to accommodate scheduling. Qualified subjects will randomize to the double-blind treatment period at Day 0 and will have up to 8 weeks to confirm and treat a qualifying migraine. Using the eDiary to confirm they are experiencing a qualified migraine, subjects will self-administer the patch or patches and continue to respond to questions in the eDiary for 48 hours post treatment administration.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Migraine
Keywords
migraine, migraine headache, acute migraine, acute migraine headache

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
ZP-Zolmitriptan 1 mg
Arm Type
Experimental
Arm Description
ZP-Zolmitriptan 1 mg patch single administration
Arm Title
ZP-Zolmitriptan 1.9 mg
Arm Type
Experimental
Arm Description
ZP-Zolmitriptan 1.9 mg patch single administration
Arm Title
ZP-Zolmitriptan 3.8 mg
Arm Type
Experimental
Arm Description
ZP-Zolmitriptan 3.8 mg (1.9 mg x 2 patches) single administration
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo (either single or double patch) single administration
Intervention Type
Drug
Intervention Name(s)
ZP-Zolmitriptan
Intervention Description
ZP-Zolmitriptan single administration delivered via intracutaneous microneedle patch delivery system
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo patch(es) to match ZP-Zolmitriptan single administration delivered via intracutaneous microneedle patch delivery system (one or two patches)
Primary Outcome Measure Information:
Title
Proportion of Subjects With Pain Freedom
Description
Pain Freedom at 2 hours post study drug administration is one of the co-primary endpoints. Subjects were queried via their eDiary about their level of migraine pain (none, mild, moderate, or severe) at various intervals post-dose. Subjects who answered none at 2 hours post study drug were considered pain free at 2 hours.
Time Frame
2 hours
Title
Proportion of Subjects With Freedom From Most Bothersome Pre-specified Other Symptom (Nausea, Photophobia, or Phonophobia Pre-specified by Subject)
Description
The proportion of subjects with freedom from the subject's pre-specified most bothersome symptom at 2 hours is one of two parts of the co-primary efficacy endpoint. This endpoint will be evaluated separately but both endpoints have to be met statistically for the study to be considered a success.
Time Frame
2 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: Greater than 1 year history of episodic, acute migraine (with or without aura) with onset prior to 50 years of age. Diagnosis must comply with International Headache Society (IHS) diagnostic criteria. Diagnostic criteria must include a history of at least five attacks not attributed to any other disorder that include all of the following criteria: Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated) Headache has at least two of the following characteristics: (i) unilateral location (ii) pulsating quality (iii) moderate or severe pain intensity (iv) aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs) c) During headache at least one of the following: (i) nausea and/or vomiting (ii) both photophobia and phonophobia Migraine history during the 6-month period prior to the run-in period must include: 2-8 migraines per month and no more than 10 headache days per month Women of child-bearing potential must not be pregnant, must agree to avoid pregnancy during the trial, and must use an acceptable methods of birth control for the duration of the trial. No significant ECG findings, defined by: ischemic changes Q-waves in at least two contiguous leads, clinically significant intra-ventricular conduction abnormalities (left bundle branch block or Wolf-Parkinson-White syndrome), or clinically significant arrhythmias (e.g., current atrial fibrillation) Able to understand the operation of the electronic diary and is able to apply the demo study drug patch. Exclusion Criteria: Contraindication to triptans Use of any prohibited concomitant medications within 10 days of the Run-in Period History of hemiplegic or basilar migraine Participation in another investigational trial during the 30 days prior to the Run-in Period or during this study Previous participation in a clinical trial of ZP-Zolmitriptan Diagnosis of cancer (other than non-invasive skin cancer) within the 5 years prior to the Run-in Period History of unstable psychiatric illness requiring medication or hospitalization in the 12 months prior to the Run-in Period Subjects who have known allergy or sensitivity to zolmitriptan or its derivatives or formulations Subjects who have known allergy or sensitivity to adhesives Planned participation in activities which cause inflammation, irritation, sunburn, lesions, or tattoos at the intended application site from two weeks prior to screening through the last day of study participation Use of opiate analgesics or barbiturates more frequently than one day/week Women who are pregnant, breast-feeding or plan a pregnancy during this study Clinically significant liver disease Clinically significant kidney disease History of coronary artery disease (CAD), coronary vasospasm (including Prinzmetal's angina), aortic aneurysm, peripheral vascular disease or other ischemic diseases (e.g., ischemic bowel syndrome or Raynaud's syndrome) Three or more of the following CAD risk factors: Current tobacco use Hypertension or receiving anti-hypertensive medication for treatment of hypertension Hyperlipidemia or on prescribed anti-cholesterol treatment Family history of premature coronary artery disease (< 55 years of age in male first degree relatives or < 65 years of age in female first degree relatives) Diabetes mellitus History of cerebral vascular accident, transient ischemic attacks, or seizures Hospitalization within the 30 days prior to the Run-in Period Any other household member currently participating in a ZP-Zolmitriptan study or relatives of site staff Any reason to believe that compliance with the study requirements and completion of evaluations required for this study will not be possible History or current abuse or dependence on alcohol or drugs that would interfere with adherence to study requirements Any clinically relevant abnormal findings in the physical exam, vital signs or laboratory tests that, in the opinion of the Investigator, may put the subject at risk To be eligible for Treatment, subjects must continue to meet all eligibility criteria and the following criteria observed during the Run-in Period: An average of at least two qualifying migraines per 28-day period No more than 10 headache days in the last 28 days prior to randomization Demonstrated ability to properly use the eDiary and apply the demo study drug patch Confirmation of continuing good general health, or stable non-serious disease that in the opinion of the Investigator will not place the subject at risk.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donald Kellerman, Pharm.D.
Organizational Affiliation
Zosano Pharma Corporation
Official's Role
Study Director
Facility Information:
Facility Name
Clinical Research Advantage, Inc./Thunderbird Internal Medicine
City
Glendale
State/Province
Arizona
ZIP/Postal Code
85306
Country
United States
Facility Name
The Research Center of Southern California
City
Carlsbad
State/Province
California
ZIP/Postal Code
92011
Country
United States
Facility Name
Allergy and Asthma Specialists Medical Group and Research Center
City
Huntington Beach
State/Province
California
ZIP/Postal Code
92647
Country
United States
Facility Name
Downtown LA Research Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90017
Country
United States
Facility Name
Allergy & Asthma Associates of Southern California
City
Mission Viejo
State/Province
California
ZIP/Postal Code
92691
Country
United States
Facility Name
Allergy and Asthma Associates of Santa Clara Valley Research Center
City
San Jose
State/Province
California
ZIP/Postal Code
95117
Country
United States
Facility Name
California Medical Clinic for Headache
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Empire Clinical Research
City
Upland
State/Province
California
ZIP/Postal Code
91786
Country
United States
Facility Name
Colorado Allergy & AsthmaCenters, PC
City
Denver
State/Province
Colorado
ZIP/Postal Code
80230
Country
United States
Facility Name
Ki Health Partners
City
Stamford
State/Province
Connecticut
ZIP/Postal Code
06905
Country
United States
Facility Name
Avail Clinical Research, LLC
City
DeLand
State/Province
Florida
ZIP/Postal Code
32720
Country
United States
Facility Name
Medical Research Group of Central Florida
City
Orange City
State/Province
Florida
ZIP/Postal Code
32763
Country
United States
Facility Name
Meridien Research
City
Tampa
State/Province
Florida
ZIP/Postal Code
33634
Country
United States
Facility Name
Clinical Research Atlanta
City
Stockbridge
State/Province
Georgia
ZIP/Postal Code
30281
Country
United States
Facility Name
Boston Clinical Trials
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02131
Country
United States
Facility Name
Novex Medical Research
City
New Bedford
State/Province
Massachusetts
ZIP/Postal Code
02740
Country
United States
Facility Name
Northeast Medical Research Associates, Inc.
City
North Dartmouth
State/Province
Massachusetts
ZIP/Postal Code
02714
Country
United States
Facility Name
MedVadis Research Corporation
City
Watertown
State/Province
Massachusetts
ZIP/Postal Code
02472
Country
United States
Facility Name
Michigan Head Pain &Neurological Institute
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48104
Country
United States
Facility Name
Westside Family Medical Center, P.C
City
Kalamazoo
State/Province
Michigan
ZIP/Postal Code
49009
Country
United States
Facility Name
Clinical Research Institute, Inc.
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55402
Country
United States
Facility Name
The Clinical Research Center, LLC
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Clinvest/A Division of Banyan Group Inc.
City
Springfield
State/Province
Missouri
ZIP/Postal Code
65807
Country
United States
Facility Name
Nebraska Medical Research Institute
City
Bellevue
State/Province
Nebraska
ZIP/Postal Code
68123
Country
United States
Facility Name
Dartmouth-Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Princeton Center for Clinical Research
City
Skillman
State/Province
New Jersey
ZIP/Postal Code
08558
Country
United States
Facility Name
Headache Wellness Center, PC
City
Greensboro
State/Province
North Carolina
ZIP/Postal Code
27405
Country
United States
Facility Name
Peters Medical Research LLC
City
High Point
State/Province
North Carolina
ZIP/Postal Code
27262
Country
United States
Facility Name
North Carolina Clinical Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
PMG Research of Raleigh
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States
Facility Name
CTI Clinical Research Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45227
Country
United States
Facility Name
Coastal Carolina Research Center
City
Mount Pleasant
State/Province
South Carolina
ZIP/Postal Code
29464
Country
United States
Facility Name
Nashville Neurosciences Group
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Central Texas Health Research
City
New Braunfels
State/Province
Texas
ZIP/Postal Code
78130
Country
United States
Facility Name
Sylvana Research Associates
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Charlottesville Medical Research Center LLC
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22911-3568
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
30698272
Citation
Tepper SJ, Dodick DW, Schmidt PC, Kellerman DJ. Efficacy of ADAM Zolmitriptan for the Acute Treatment of Difficult-to-Treat Migraine Headaches. Headache. 2019 Apr;59(4):509-517. doi: 10.1111/head.13482. Epub 2019 Jan 30.
Results Reference
derived
PubMed Identifier
29022755
Citation
Spierings EL, Brandes JL, Kudrow DB, Weintraub J, Schmidt PC, Kellerman DJ, Tepper SJ. Randomized, double-blind, placebo-controlled, parallel-group, multi-center study of the safety and efficacy of ADAM zolmitriptan for the acute treatment of migraine. Cephalalgia. 2018 Feb;38(2):215-224. doi: 10.1177/0333102417737765. Epub 2017 Oct 12.
Results Reference
derived

Learn more about this trial

Safety and Efficacy of ZP-Zolmitriptan Intracutaneous Microneedle Systems for the Acute Treatment of Migraine

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