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Safety and Efficacy Study of TNX-201 Capsules for Treatment of Single Tension-Type Headache

Primary Purpose

Tension-Type Headache

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
TNX-201
Placebo
Sponsored by
Tonix Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tension-Type Headache

Eligibility Criteria

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

Inclusion Criteria:

  1. Capable of reading and understanding English and able to provide written informed consent to participate.
  2. Male or female adults ≥ 18 and < 65 years of age at the time of Visit 1.
  3. Body mass index (BMI) ≥ 18.5 and ≤ 45.0.
  4. Greater than 1 year history of episodic tension-type headache with onset prior to 50 years of age.
  5. History of tension-type headaches that typically last ≥ 4 hours if untreated.
  6. History of 2-14 tension-type headaches per month for the last 3 months prior to Visit 1.
  7. Diagnosis must comply with the International Headache Society (IHS) diagnostic criteria.
  8. No significant ECG findings at Screening
  9. If female, is either not of childbearing potential or is practicing a predefined medically acceptable method of birth control (hormonal methods, intrauterine device, double-barrier method, sexually-exclusive vasectomized male partner, same-sex relationship) throughout the study.
  10. Willing and able to comply with all protocol-specified requirements.

Exclusion Criteria:

  1. Known or suspected hypersensitivity to isometheptene mucate or any excipients used in the formulation.
  2. Use of any excluded concomitant medications.
  3. Current use of opiate analgesics.
  4. Use of any prophylactic drug therapy for headache control within 4 weeks of screening (e.g., anticonvulsants, mood stabilizers, beta-blocker, antidepressants, muscle relaxants, botulinum toxin). Subjects taking any of these medications for an indication other than headache (e.g., a beta-blocker for hypertension) will require medical monitor's approval prior to initiation of the Run-In Period.
  5. History of medication use for acute headache on ≥ 10 days per month on average during the 3 months prior to Visit 1.
  6. Positive results for addictive substances (e.g., cocaine, phencyclidine (PCP), amphetamines, opiates) at Screening.
  7. History of migraine that exceeds a mean of four attacks per month during the preceding calendar year.
  8. Lifetime history of schizophrenia, schizoaffective disorder, bipolar I/II disorder, delusional disorder, or psychotic disorder not otherwise specified.
  9. Chronic pain disorders requiring medical treatment with opioids, chronic daily use of NSAIDs at the time of screening
  10. History of coronary artery disease, coronary vasospasm, aortic aneurysm, peripheral vascular disease or other ischemic diseases (e.g., ischemic bowel syndrome or Raynaud's syndrome).
  11. Inadequately controlled hypertension or persistently elevated systolic blood pressure or diastolic blood pressure upon repeat assessment at screening or on the day of randomization.
  12. Current history of two or more CAD risk factors at Screening (tobacco use, receiving anti-hypertensive medication for hypertension, high LDL cholesterol or low HDL cholesterol levels, family history of premature CAD, diabetes mellitus)
  13. History cerebral vascular accident, transient ischemic attack, seizure disorders.
  14. Other clinically significant cardiac disease.
  15. History of concurrent illness that requires hospitalization within 30 days prior to Visit 1.
  16. Current evidence of human immunodeficiency virus infection or clinically significant hepatitis B or C infection.
  17. Clinically significant laboratory abnormalities based on screening laboratory tests and/or medical history.
  18. Participation in another investigational trial during the 30 days prior to Visit 1 or during this trial. Subjects who have participated in non-interventional trials may be permitted to participate on a case-by-case basis after review with the Medical Monitor.
  19. Women who are pregnant, breast-feeding, or planning to become pregnant during this trial.
  20. Any other household member currently participating in a Tonix-sponsored study or family member or relative of investigative staff.
  21. Any condition and/or medical history that would make the subject unsuitable for study participation and completion.

Sites / Locations

  • James D. Wolfe, MD
  • Avail Clinical Research LLC.
  • Nathan Segall, MD, CPI
  • Michigan Head-Pain Neurological Institute
  • Gary D. Berman, MD
  • John Rubino, MD
  • PMG Research of Winston-Salem, LLC.
  • Rapid Medical Research, Inc.
  • Stephan C. Sharp, MD
  • Duane G. Wombolt, MD

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

TNX-201

Placebo

Arm Description

4 X 35 mg capsules to be taken when qualifying tension-type headache occurs

4 X placebo capsules to be taken when qualifying tension-type headache occurs

Outcomes

Primary Outcome Measures

Number of Subjects Pain Free
Number of subjects pain free at 2 hours post-dose (Pain assessed by 4-point NRS, VAS, and binary yes/no question). 4-point NRS grades: 0=none, 1=mild, 2=moderate, 3=severe; "pain-free" defined as score = 0. VAS: 0-100 scale, anchored by verbal anchors of No Pain (0) vs. Worst Imaginable Headache Pain (100). "Pain-free" was defined as a score <= 5

Secondary Outcome Measures

Number of Subjects Pain Free at 15, 30, 60, 90 Minutes and 4 Hours Post-dose (Pain Will be Assessed by 4-point NRS, VAS, and Binary Yes/no Question)
4-point NRS grades: 0=none, 1=mild, 2=moderate, 3=severe. VAS: 0-100 scale, No Pain vs. Worst Imaginable Headache Pain
Number of Subjects Using Rescue Medication During the 24-hour Post-dose Period
Number of Subjects With at Least a Two-category Improvement From Baseline at 2 Hours Post-dose in VAS Severity Category (Carvalho Responders)
The Carvalho Responder analysis refers to subjects with at least 2 categories of improvement in their VAS severity category (0-100 scale). VAS severity categories were defined as "severe" if between 52-100 inclusive, "moderate" between 31-51 inclusive, "mild" between 6-30 inclusive, and pain-free if less than 6. Therefore, a Carvalho responder was either a subject who had a VAS response classified as 'severe' at baseline and 'mild' or pain-free at the post-dose assessment time point, or a subject who had a VAS response classified as 'moderate' at baseline and pain-free at the post-dose assessment time point.

Full Information

First Posted
April 15, 2015
Last Updated
March 13, 2017
Sponsor
Tonix Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02423408
Brief Title
Safety and Efficacy Study of TNX-201 Capsules for Treatment of Single Tension-Type Headache
Official Title
A Proof-of-Concept Phase 2, Double-Blind, Randomized, Multicenter, Placebo-Controlled Study to Evaluate the Efficacy and Safety of TNX-201 for the Treatment of A Single Tension-Type Headache
Study Type
Interventional

2. Study Status

Record Verification Date
December 2016
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
February 2016 (Actual)
Study Completion Date
February 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tonix Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a randomized, multicenter, double-blind, placebo-controlled, parallel-group study to evaluate the safety and efficacy of a single dose of TNX-201 (140 mg) for the treatment of a single qualifying Tension-Type-Headache (TTH).
Detailed Description
The study will be conducted in 4 periods (the Screening Period, the Run-In Period, the Double-Blind Treatment Period and the Follow-up Period) and 4 visits (the Screening Visit, Enrollment Visit, Randomization Visit and End-of-Study Visit). Screening Period- Eligible subjects who provide written informed consent to participate will have study assessments performed at the Screening. Run-In Period- The Run-In Period will last for at least 28 days. During the Run-In period, subjects will be assessed for frequency of headache, study compliance and to ensure they meet all required study criteria for randomization. Double-Blind Treatment Period- The Double-Blind Treatment Period (Treatment Period) will last up to 4 weeks or until a qualifying headache episode has occurred and been treated using the study drug, whichever occurs first. Follow-up Period- All subjects will return to the investigational site for this visit, regardless of whether they have treated a qualifying TTH with study medication. Subjects who have not treated a qualifying TTH with study drug during the Treatment Period will be asked to return study materials and undergo safety evaluations at the End-of-Study Visit and will be discharged from the study. Subjects who have treated a qualifying TTH with study drug during the Treatment Period will ingest a 140 mg dose of open-label TNX-201 at this visit and undergo urine and blood sample collection for 3 hours post-dose to characterize each subject's genetic metabolism and PK profile.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tension-Type Headache

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
TNX-201
Arm Type
Experimental
Arm Description
4 X 35 mg capsules to be taken when qualifying tension-type headache occurs
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
4 X placebo capsules to be taken when qualifying tension-type headache occurs
Intervention Type
Drug
Intervention Name(s)
TNX-201
Other Intervention Name(s)
(R)-isometheptene mucate
Intervention Description
TNX-201 capsule
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
TNX-201 Placebo
Intervention Description
Placebo capsule
Primary Outcome Measure Information:
Title
Number of Subjects Pain Free
Description
Number of subjects pain free at 2 hours post-dose (Pain assessed by 4-point NRS, VAS, and binary yes/no question). 4-point NRS grades: 0=none, 1=mild, 2=moderate, 3=severe; "pain-free" defined as score = 0. VAS: 0-100 scale, anchored by verbal anchors of No Pain (0) vs. Worst Imaginable Headache Pain (100). "Pain-free" was defined as a score <= 5
Time Frame
2 hours
Secondary Outcome Measure Information:
Title
Number of Subjects Pain Free at 15, 30, 60, 90 Minutes and 4 Hours Post-dose (Pain Will be Assessed by 4-point NRS, VAS, and Binary Yes/no Question)
Description
4-point NRS grades: 0=none, 1=mild, 2=moderate, 3=severe. VAS: 0-100 scale, No Pain vs. Worst Imaginable Headache Pain
Time Frame
15, 30, 60, 90 minutes and 4 hours post-dose
Title
Number of Subjects Using Rescue Medication During the 24-hour Post-dose Period
Time Frame
24-hour post-dose period
Title
Number of Subjects With at Least a Two-category Improvement From Baseline at 2 Hours Post-dose in VAS Severity Category (Carvalho Responders)
Description
The Carvalho Responder analysis refers to subjects with at least 2 categories of improvement in their VAS severity category (0-100 scale). VAS severity categories were defined as "severe" if between 52-100 inclusive, "moderate" between 31-51 inclusive, "mild" between 6-30 inclusive, and pain-free if less than 6. Therefore, a Carvalho responder was either a subject who had a VAS response classified as 'severe' at baseline and 'mild' or pain-free at the post-dose assessment time point, or a subject who had a VAS response classified as 'moderate' at baseline and pain-free at the post-dose assessment time point.
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: Capable of reading and understanding English and able to provide written informed consent to participate. Male or female adults ≥ 18 and < 65 years of age at the time of Visit 1. Body mass index (BMI) ≥ 18.5 and ≤ 45.0. Greater than 1 year history of episodic tension-type headache with onset prior to 50 years of age. History of tension-type headaches that typically last ≥ 4 hours if untreated. History of 2-14 tension-type headaches per month for the last 3 months prior to Visit 1. Diagnosis must comply with the International Headache Society (IHS) diagnostic criteria. No significant ECG findings at Screening If female, is either not of childbearing potential or is practicing a predefined medically acceptable method of birth control (hormonal methods, intrauterine device, double-barrier method, sexually-exclusive vasectomized male partner, same-sex relationship) throughout the study. Willing and able to comply with all protocol-specified requirements. Exclusion Criteria: Known or suspected hypersensitivity to isometheptene mucate or any excipients used in the formulation. Use of any excluded concomitant medications. Current use of opiate analgesics. Use of any prophylactic drug therapy for headache control within 4 weeks of screening (e.g., anticonvulsants, mood stabilizers, beta-blocker, antidepressants, muscle relaxants, botulinum toxin). Subjects taking any of these medications for an indication other than headache (e.g., a beta-blocker for hypertension) will require medical monitor's approval prior to initiation of the Run-In Period. History of medication use for acute headache on ≥ 10 days per month on average during the 3 months prior to Visit 1. Positive results for addictive substances (e.g., cocaine, phencyclidine (PCP), amphetamines, opiates) at Screening. History of migraine that exceeds a mean of four attacks per month during the preceding calendar year. Lifetime history of schizophrenia, schizoaffective disorder, bipolar I/II disorder, delusional disorder, or psychotic disorder not otherwise specified. Chronic pain disorders requiring medical treatment with opioids, chronic daily use of NSAIDs at the time of screening History of coronary artery disease, coronary vasospasm, aortic aneurysm, peripheral vascular disease or other ischemic diseases (e.g., ischemic bowel syndrome or Raynaud's syndrome). Inadequately controlled hypertension or persistently elevated systolic blood pressure or diastolic blood pressure upon repeat assessment at screening or on the day of randomization. Current history of two or more CAD risk factors at Screening (tobacco use, receiving anti-hypertensive medication for hypertension, high LDL cholesterol or low HDL cholesterol levels, family history of premature CAD, diabetes mellitus) History cerebral vascular accident, transient ischemic attack, seizure disorders. Other clinically significant cardiac disease. History of concurrent illness that requires hospitalization within 30 days prior to Visit 1. Current evidence of human immunodeficiency virus infection or clinically significant hepatitis B or C infection. Clinically significant laboratory abnormalities based on screening laboratory tests and/or medical history. Participation in another investigational trial during the 30 days prior to Visit 1 or during this trial. Subjects who have participated in non-interventional trials may be permitted to participate on a case-by-case basis after review with the Medical Monitor. Women who are pregnant, breast-feeding, or planning to become pregnant during this trial. Any other household member currently participating in a Tonix-sponsored study or family member or relative of investigative staff. Any condition and/or medical history that would make the subject unsuitable for study participation and completion.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tracie Ruther, M.S
Organizational Affiliation
1 513 579 9911 ext 2214
Official's Role
Study Director
Facility Information:
Facility Name
James D. Wolfe, MD
City
San Jose
State/Province
California
ZIP/Postal Code
95117
Country
United States
Facility Name
Avail Clinical Research LLC.
City
DeLand
State/Province
Florida
ZIP/Postal Code
32720
Country
United States
Facility Name
Nathan Segall, MD, CPI
City
Stockbridge
State/Province
Georgia
ZIP/Postal Code
30281
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
Gary D. Berman, MD
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55402
Country
United States
Facility Name
John Rubino, MD
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States
Facility Name
PMG Research of Winston-Salem, LLC.
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Rapid Medical Research, Inc.
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44122
Country
United States
Facility Name
Stephan C. Sharp, MD
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37203
Country
United States
Facility Name
Duane G. Wombolt, MD
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23507
Country
United States

12. IPD Sharing Statement

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Safety and Efficacy Study of TNX-201 Capsules for Treatment of Single Tension-Type Headache

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