Efficacy, Tolerability, and Safety Study of DFN-15

BioDelivery Sciences International622 enrolled

Overview

Efficacy, Tolerability, and Safety of DFN-15 in episodic migraine with or without aura, being conducted at multiple centers in the United States.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

622

Conditions

Migraine Headache

Interventions

DFN-15 ActiveDRUG

DFN-15 PlaceboOTHER

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. A history of episodic migraine, who experience 2 to 8 migraine attacks per month for at least the past 12 months, with no more than 14 headache days per month, and with 48 hours of headache-free time between migraine attacks. 2. Patients who have migraine with or without aura with onset before age 50 years 3. Report usual migraine pain of 2 (moderate) or 3 (severe) on headache pain severity scale without treatment. 4. Subjects who are willing and able to: 1. Evaluate and record pain, migraine symptoms, and study drug effectiveness information in real-time using a subject eDiary for the duration of the study; 2. Record each instance of the use of study drug and rescue medication in real-time using a subject eDiary for the duration of the study; 3. Comply with all other study procedures and scheduling requirements. Exclusion Criteria: 1. Minors, even if they are in the specified study age range 2. Medication overuse: 1. Opioids greater than or equal to 10 days during the 90 days prior to screening 2. Combination medications (e.g., Fiorinal®) greater than or equal to 10 days during the 90 days prior to screening (applies only if includes opioid and/or barbiturate) 3. Nonsteroidal Anti-inflammatory Drugs or other simple medications greater than 14 days a month during the 90 days prior to screening 4. Triptans or ergots greater than or equal to 10 days a month during the 90 days prior to screening 3. Treated with onabotulinumtoxin A (Botox®) for migraine within 4 months prior to screening. (If treated for cosmetic reasons, subjects may be included). 4. Current treatment with antipsychotics or use of antipsychotics within 30 days prior to randomization. 5. Patients who have received treatment with an investigational drug or device within 30 days of randomization, or participated in a central nervous system clinical trial within 2 months prior to randomization 6. Patients with positive screening test for human immunodeficiency virus \[HIV\], positive hepatitis B surface antigen (HBsAg), or positive hepatitis C virus \[HCV\] antibody 7. Subjects who are employees or immediate relatives of the employees of the Sponsor, any of its affiliates or partners, or of the clinical research study site.

Locations (45)

Outcomes

Primary Outcomes

Percentage of Subjects Who Are Pain-free at 2 Hours Postdose (DB1)

Percentage of subjects who were pain-free 2 hours postdose compared between DFN-15 and placebo in the DB1 period (defined as a reduction from predose moderate \[Grade 2\] or severe \[Grade 3\] pain to none \[Grade 0\]) during DB1.

Time frame: 2 hours post dose

Percentage of Subjects Who Are Free From Their MBS at 2 Hours Postdose (DB1)

Percentage of subjects who are free from their most bothersome symptom (MBS) among nausea, photophobia, and phonophobia at 2 hours postdose during DB1.

Time frame: 2 hours post dose

Secondary Outcomes

Freedom From Nausea, Photophobia, and Phonophobia Postdose (DB1 and DB2)

The percentage of subjects who were free from nausea, photophobia, and phonophobia at 15, 30, and 45 minutes and 1, 1.5, 2, 4, and 24 hours postdose during each DB treatment period were summarized by symptom, treatment group, and time point.

Time frame: 15 minutes through 24 hours

Time to Headache Pain Relief Postdose (DB1 and DB2)

Time frame: 2 hours postdose

Time to Headache Pain Freedom Postdose (DB1 and DB2)

Time frame: 2 hours postdose

Headache Pain Relief Postdose (DB1 and DB2)

Headache pain relief during postdose in DB1 was defined as a reduction from moderate or severe pain at predose reduced to mild or none postdose, and for DB2 as moderate or severe pain at predose reduced to mild or none postdose, or mild pain at predose reduced to none postdose. Outcome measure shows percentage of subjects experiencing headache pain relief by time point.

Time frame: 15 minutes to 24 hours postdose

Data from ClinicalTrials.gov

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Site 744

Birmingham, Alabama, United States

Site 727

Phoenix, Arizona, United States

Site 723

Little Rock, Arkansas, United States

Site 718

Rogers, Arkansas, United States

Site 709

Los Angeles, California, United States

Site 708

Orange, California, United States

Site 729

San Diego, California, United States

Site 725

Santa Monica, California, United States

Site 738

Simi Valley, California, United States

Site 733

Upland, California, United States

...and 35 more locations

Headache Pain Freedom Postdose (DB1 and DB2)

The percentage of subjects who were pain-free at 15, 30, and 45 minutes and 1, 1.5, 2 (DB2), and 4, and 24 hours postdose during each DB treatment period were summarized by treatment group.

Time frame: 15 minutes to 24 hours postdose

Absence of Screening MBS at Time Points Postdose (DB1 and DB2)

The percentage of subjects with their Screening MBS (most bothersome symptoms) among nausea, photophobia, and phonophobia (from eDiary data collection) absent at 15, 30, and 45 minutes and 1, 1.5, 2 (DB2 period), 4, and 24 hours postdose during each DB treatment period were summarized by treatment group and time point.

Time frame: 15 minutes to 24 hours postdose

Change in Functional Disability Score Postdose (DB1 and DB2)

The values of the functional disability scale were: 0=no disability, able to function normally; 1=performance of daily activities mildly impaired, can still do everything but with difficulty; 2=performance of daily activities moderately impaired, unable to do some things; 3=performance of daily activities severely impaired, cannot do all or most things, bed rest may be necessary. A decrease in values indicates improvement from baseline.

Time frame: 2 to 24 hours postdose

Headache Pain Freedom Among Subjects With Cutaneous Allodynia (DB1 and DB2)

The percentage of subjects who were pain-free at 2 and 4 hours postdose during each DB treatment period among those subjects reporting cutaneous allodynia before dosing were summarized by treatment group and time point.

Time frame: 2 to 4 hours postdose

Headache Pain Freedom Among BMI Category (DB1 and DB2)

The percentage of subjects who were pain-free at 2 and 4 hours postdose whose BMI was \<30 kg/m2 vs. subjects whose BMI was ≥30 kg/m2 during each DB treatment period were summarized by treatment group and time point.

Time frame: 2 to 4 hours postdose

Headache Pain Recurrence Postdose (DB1 and DB2)

Headache pain recurrence was defined as pain-free at 2 hours postdose with pain reported as mild, moderate, or severe at 24 hours postdose. This outcome measure shows percentage of subjects who reported pain-free status and 2 hours postdose but subsequently reported recurrent pain at 24 hours postdose.

Time frame: 2 to 24 hours postdose

Sustained Headache Pain Relief Postdose (DB1 and DB2)

Sustained headache pain relief was defined as pain relief at 2 hours postdose with no use of rescue medication and no worsening of headache pain within 2 to 24 hours postdose. This outcome measure shows the percentage of subjects who reported pain relief at 2 hours postdose with no use of rescue medication or worsening of headache pain through 24 hours postdose.

Time frame: 2 to 24 hours postdose

Sustained Headache Pain Freedom Postdose (DB1 and DB2)

Sustained headache pain freedom was defined as pain-free at 2 hours postdose, with no use of rescue medication and no recurrence of headache pain within 2 to 24 hours postdose. This outcome measure shows percentage of subjects who were pain-free at 2 hours postdose without the use of rescue medication or recurrence of headache pain through 24 hours postdose.

Time frame: 2 to 24 hours postdose

Use of Rescue Medication Postdose (DB1 and DB2)

The percentage of subjects who used rescue mediation after 2 hours (2 to 24 hours) postdose compared between DFN-15 and placebo in each DB period.

Time frame: 2 to 24 hours postdose

Subject-Rated Treatment Satisfaction Postdose (DB1 and DB2)

Subject-rated treatment overall satisfaction was based on a 7-point scale at 2 and 4 hours postdose during each DB treatment period. The difference between the subject-rated study drug treatment satisfaction score at 2 and 4 hours postdose and the baseline PPMQ-R (Patient Perception of Migraine Questionnaire) response for the same question were summarized by treatment group (global satisfaction item at baseline asked about the subject's usual migraine treatment). The possible values of the subject treatment satisfaction scale were: 1=very satisfied, 2=satisfied, 3=somewhat satisfied, 4=neither satisfied nor dissatisfied, 5=somewhat dissatisfied, 6=dissatisfied, 7=very dissatisfied. A decrease in values indicates improvement from baseline.

Time frame: 2 to 4 hours postdose

Subject-Rated Treatment Satisfaction at 24 Hours Postdose - PPMQ-R (DB1 and DB2)

Patient Perception of Migraine Questionnaire-Revised had 30 questions assessing subject's satisfaction with migraine medication, including 3 global items \& 4 subscales (i.e., efficacy, function, ease of use, tolerability). A 5-point scale (1-Not At All to 5-Extremely) was used for tolerability subscale questions; a 7-point scale (1-Very Satisfied to 7-Very Dissatisfied) was used for all other subscales and global items. Total score was average of efficacy/function/ease of use subscale scores. Each subscale \& total scores were transformed to range from 0-100, with higher scores indicating better satisfaction or tolerability. Total raw score/global items were not transformed. The total raw score could range from 17 (min) to 119 (max), with lower scores indicating better satisfaction. Change from baseline scores at 24-hour-postdose for each subscale score, global item score, total score, \& total raw score were summarized by treatment group below.

Time frame: 24 hours postdose