A Study to Evaluate the Effectiveness and Safety of Dysport® for the Prevention of Chronic Migraine in Adults

Chronic Migraine Clinical Trial

— C-BEOND  

Official title:

A Phase III, Randomised, Double-blind, Placebo-controlled, Multicenter, Parallel-group Study With Extension Phase to Evaluate the Efficacy and Safety of Dysport® for the Prevention of Chronic Migraine in Adult Participants

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06047444
• Other study ID #: CLIN-52120-463
• Status: Recruiting
• Phase: Phase 3
• Start date: October 12, 2023
• Est. completion date: December 21, 2026

Study information

• Verified date: April 2024
• Source: Ipsen
• Contact: Ipsen Clinical Study Enquiries
• Phone: See e mail
• Email: clinical.trials[@]ipsen.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to understand the safety and effectiveness of the study drug, Dysport® when compared with placebo in preventing chronic migraine. A migraine is a headache with severe throbbing pain or a pulsating sensation, usually on one side of the head, and is often accompanied by feeling or being sick and a sensitivity to bright lights and sound. Chronic migraine is defined as having at least 15 days of headache a month with at least 8 of those days being migraine headache days. Migraines are caused by a series of events which cause the brain to get stimulated/activated, which results in the release of chemicals that cause pain. Dysport® is a formulation of Botulinum toxin type A (BoNT-A), a medication that stops the release of these chemical messengers. The study will consist of 3 periods: 1. A 'screening period' of 6 to 12 weeks to assess whether the participant can take part to the study and requires 1 visit. 2. A first Treatment Phase of 24 weeks. On Day 1 and at Week 12 of the first Treatment Phase, participants will receive injections into various muscles across the head, neck, face and shoulders. The injections will contain either a dose "A" or dose "B" of Dysport® or a placebo (an inactive substance or treatment that looks the same as, and is given in the same way as, an active drug or intervention/treatment being studied). Participants will make 4 visits to the clinic in person and have 4 remote (online) visits. 3. A second Treatment Phase of 24 weeks (extension phase). At Week 24 and at Week 36, all participants will get Dysport® (dose "A" or dose "B"). There will be 3 in person visits and 4 remote visits. Participants will need to complete an e-diary and questionnaires throughout the study. Participants will undergo blood samplings, urine collections, physical examinations, and clinical evaluations. They may continue some other medications, but the details need to be recorded. The total study duration for a participant will be up to 60 weeks (approx. 14 months).

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 720
• Est. completion date: December 21, 2026
• Est. primary completion date: June 22, 2026
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria :

• Participant must be =18 years of age inclusive, at the time of signing the informed consent and privacy/data protection documentation
• Participant has a diagnosis for more than 12 months, prior to screening visit, of chronic migraine according to the International Classification of Headache Disorders definition and diagnostic criteria
• Migraine onset occurred when participant was <50 years of age
• Has baseline number of monthly headache days (MHD) =15 and baseline number of monthly migraine days (MMD) of =8, using eDiary data collected during the 4 weeks nearest to randomisation on Day 1 (but prior to randomisation)
• Has baseline number of valid diary days =22 days collected during the 4 weeks nearest to randomisation on Day 1

Exclusion Criteria :

• History or current diagnosis of migraine with brainstem aura, retinal migraine, complications of migraine, tension-type headache, trigeminal autonomic cephalalgias, hypnic headache, hemicrania continua, or new daily persistent headache
• Headache attributed to another disorder (e.g. secondary headaches), except medication overuse headache, which is permitted
• Use of any of the following medications in the specified timeframe prior to start of

completion of the screening daily headache eDiary:

• a. Within 24 weeks
• i. Botulinum toxin for migraine (or for any other medical/aesthetic reason within 16 weeks)
• b. Within 12 weeks
• i. CGRP antagonists (monoclonal antibody or gepant) for preventive treatment of migraine (acute treatment of headache/migraine with a gepant is permitted)ii. Cannabidiol or other types of cannabinoids
• c. Within 4 weeks
• i. Anaesthetic or steroid injection in any region targeted for injection with study intervention
• ii. Use of medical device to treat migraine (e.g. non-invasive neuromodulation therapies such as nerve stimulation (gammaCore), transcranial magnetic stimulation (cephaly), external trigeminal nerve stimulation, transcutaneous electrical nerve stimulation, and peripheral neuroelectrical stimulation)
• iii. Other interventions for migraine assessed to interfere with study evaluations (e.g. acupuncture in head and neck region, cranial traction, nociceptive trigeminal inhibition, occipital nerve block treatments, and dental splints for headache) iv. Use of opioids or barbiturates for more than 2 days/month. Note: participants are permitted to take one concomitant migraine preventative treatment (not listed above); however, the dose of this medication should be stable for =3 months before start of the screening eDiary

Related Conditions & MeSH terms

• Chronic Migraine
• Migraine Disorders

Intervention

Biological:
• Botulinum toxin type A
Dose "A" Unit/Injection (U/I), Intramuscular (IM) on every 12 weeks during a period of 36 weeks with a total of 4 injections.
• Botulinum toxin type A
Dose "B" U/I, IM on every 12 weeks during a period of 36 weeks with a total of 4 injections.

Other:
• Placebo
"0" U/I, IM on Day 1 and Week 12 with a total of 2 injections.

Biological:
• Botulinum toxin type A
Dose "A" U/I, IM at Week 24 and Week 36 with a total of 2 injections.
• Botulinum toxin type A
Dose "B" U/I, IM at Week 24 and Week 36 with a total of 2 injections.

Locations

Country	Name	City	State
Canada	124007	Halifax
Canada	124005	Montréal
Canada	124004	Red Deer
Canada	124003	Sarnia
Czechia	203007	Brno
Czechia	203008	Brno
Czechia	203005	Jihlava
Czechia	203010	Ostrava - Poruba
Czechia	203006	Praha
Czechia	203004	Praha 4
Czechia	203011	Praha 5
Czechia	203003	Praha 8
Georgia	268002	Batumi
Georgia	268001	Tbilisi
Georgia	268003	Tbilisi
Georgia	268004	Tbilisi
Georgia	268005	Tbilisi
Georgia	268006	Tbilisi
Germany	276002	Berlin
Germany	276007	Berlin
Germany	276003	Greifswald
Germany	276004	Haag In Oberbayern
Germany	276006	Kassel
Germany	276001	München
Italy	380006	Bologna
Italy	380005	Napoli
Italy	380001	Pavia
Italy	380003	Pozzilli
Italy	380002	Roma
Italy	380004	Roma
Poland	616004	Bydgoszcz
Poland	616001	Gdynia
Poland	616006	Katowice
Poland	616003	Kraków
Poland	616005	Kraków
Poland	616007	Kraków
Poland	616002	Lublin
Poland	616008	Oswiecim
Spain	724009	Córdoba
Spain	724002	Madrid
Spain	724006	Madrid
Spain	724001	Málaga
Spain	724010	Sevilla
Spain	724003	Valencia
Spain	724008	Valencia
Spain	724004	Zaragoza
United Kingdom	826002	Brighton
United Kingdom	826001	Brixton
United States	840019	Amherst	New York
United States	840029	Aurora	Colorado
United States	840023	Aventura	Florida
United States	840024	Birmingham	Alabama
United States	840051	Boston	Massachusetts
United States	840001	Brooklyn	New York
United States	840031	Burnsville	Minnesota
United States	840017	Chesterfield	Missouri
United States	840046	Chicago	Illinois
United States	840020	Columbia	Washington
United States	840008	Cordova	Tennessee
United States	840021	Fort Wayne	Indiana
United States	840025	Frisco	Texas
United States	840030	Fullerton	California
United States	840039	Fullerton	California
United States	840005	Hendersonville	North Carolina
United States	840004	Hialeah	Florida
United States	840013	Hollywood	Florida
United States	840012	Houston	Texas
United States	840043	Las Vegas	Nevada
United States	840037	Los Angeles	California
United States	840042	Miami	Florida
United States	840026	New Albany	Ohio
United States	840010	Orange	California
United States	840011	Palo Alto	California
United States	840049	Papillion	Nebraska
United States	840022	Philadelphia	Pennsylvania
United States	840018	Phoenix	Arizona
United States	840007	Plano	Texas
United States	840044	Portland	Oregon
United States	840014	Poughkeepsie	New York
United States	840035	Riverwoods	Illinois
United States	840009	Rochester	New York
United States	840036	Salt Lake City	Utah
United States	840038	Savannah	Georgia
United States	840034	Scottsdale	Arizona
United States	840032	Tampa	Florida
United States	840040	Tampa	Florida
United States	840027	Tempe	Arizona
United States	840015	West Valley City	Utah
United States	840052	Winter Park	Florida

Sponsors (1)

Lead Sponsor	Collaborator
Ipsen

Countries where clinical trial is conducted

United States,  Canada,  Czechia,  Georgia,  Germany,  Italy,  Poland,  Spain,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change from baseline in monthly migraine days (MMD)	The monthly migraine days (MMD) is assessed by eDiary, completed every day by the participant, to evaluate the efficacy of Dysport® compared to placebo.	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Change from baseline in MMD of =50%	The monthly migraine days (MMD) is assessed by a daily eDiary.	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Change from baseline in MMD of =75%	The monthly migraine days (MMD) is assessed by a daily eDiary.	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Cumulative number of MMD	The cumulative number of monthly migraine days (MMD) is assessed by a daily eDiary.	From Day 1 to Week 24
Secondary	Change from baseline in MMD of moderate or severe intensity	The intensity of MMD is assessed by a daily eDiary.	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Change from baseline in monthly headache days (MHD) of moderate or severe intensity	The intensity of monthly headache days (MHD) is assessed by a daily eDiary.	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Change from baseline in MHD of moderate or severe intensity of =50%	The intensity of monthly headache days (MHD) is assessed by a daily eDiary.	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Change from baseline in MHD of moderate or severe intensity of =75%	The intensity of monthly headache days (MHD) is assessed by a daily eDiary.	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Cumulative number of MHD of moderate or severe intensity	The cumulative number of monthly headache days (MHD) is assessed by a daily eDiary.	From Day 1 to Week 24
Secondary	Change from baseline in the number of days per month of acute migraine medication intake	The acute migraine medication intake will be recorded in the daily eDiary Acute migraine medication is defined as triptan, ergotamine, gepant, or ditan	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Headache medication overuser (yes, no)	The headache medication overuse will be assessed by a concomitant medication log completed at each visit and acute medication taken to treat acute attack will be recorded in the daily eDiary. The headache medication overuse is defined as a participant with =10 days/month if ergotamine, triptan, gepant, ditan, opioid or combination analgesic, or =15 days/month if non-opioid analgesic (such as paracetamol, aspirin, NSAID)	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Use of acute migraine medication (yes or no)	The use of acute migraine medication will be recorded in the daily eDiary.	Every 4 weeks from Week 4 (Weeks 1-4) to Week 24 (Weeks 21-24)
Secondary	Patient's Global Impression of Change (PGIC) score	The PGIC will be assessed by a questionnaire (7-point scale, score of 1 indicates very much improved and score of 7 indicates very much worse)	At Weeek 12 and Week 24
Secondary	Change from baseline of =1 and =2 grades in PGIC score	The PGIC will be assessed by a questionnaire (7-point scale, score of 1 indicates very much improved and score of 7 indicates very much worse)	At Weeek 12 and Week 24
Secondary	Change from baseline in role function restrictive domain of Migraine Specific Quality of Life (MSQ) Questionnaire	The MSQ will be assessed by a questionnaire (Scores range from 0-100, higher scores indicate a better quality of life)	At Weeek 12 and Week 24
Secondary	Change from baseline in total MSQ score	The MSQ will be assessed by a questionnaire (Scores range from 0-100, higher scores indicate a better quality of life)	At Weeek 12 and Week 24
Secondary	Change in MSQ score to the minimally important difference/change (MID/MIC)	The MSQ will be assessed by a questionnaire (Scores range from 0-100, higher scores indicate a better quality of life)	At Weeek 12 and Week 24
Secondary	Change from baseline in total 6-item Headache Impact Test (HIT-6) score	The HIT-6 will be assessed by a questionnaire (scores range from 36-78 and higher scores indicate a greater impact of headache on subject's life)	At Week 12 and Week 24
Secondary	Change from baseline in HIT-6 score to MID/MIC	The HIT-6 will be assessed by a questionnaire (scores range from 36-78 and higher scores indicate a greater impact of headache on subject's life)	At Weeek 12 and Week 24
Secondary	Change from baseline in Short Form 12 (SF-12) Questionnaire score	The SF-12 will be assessed by a questionnaire (scores range from 0-100, with higher scores indicating better functioning)	At Weeek 12 and Week 24
Secondary	Chronic migraine status	Chronic migraine status will be assessed by the daily eDiary and defined as number of participants with =15 MHD and =8 MMD	At Week 24 (Week 21-24)
Secondary	Time to onset of effect	Time to onset of effect is defined as the first time point post randomisation where MMD is reduced from baseline =50%	From first time point post randomisation to Week 24
Secondary	Incidence of Treatment emergent adverse event (TEAEs)	An Adverse event (AE) is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention.	Up to Week 24
Secondary	Percentage of Participants with clinically significant changes in vital signs	Percentage of participants with clinically significant changes in vital signs will be reported. The clinical significance will be graded by the investigator.	From baseline up to Week 24
Secondary	Percentage of participants with clinically significant laboratory parameters (blood chemistry, haematology)	Percentage of participants with clinically significant change in laboratory parameters (blood chemistry, hematology and coagulation) will be reported. The clinical significance will graded by the investigator.	From baseline up to Week 24
Secondary	Treatment-emergence of suicidal ideation/suicidal behaviour	It will be assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS) questionnaire that consists of 4 subscales: Ideation severity subscale: questions answered yes/no, severity of ideation scored 1-5 with 5 being most severe; Intensity of ideation subscale : scores range from 2-25 with higher scores indicating more severe intensity of ideation.; Suicide behaviour subscale:4 types of suicidal behaviours are scored yes/no; Behaviour Lethality subscale: actual lethality/medical damage scores 0-5, with 5 being most severe ( death) and potential lethality scores 0-2 with 2 being more potentially lethal.	From baseline up to Week 24
Secondary	Percentage of participants with Binding antibodies to Dysport®	It will be assessed by collecting blood samples at baseline and Week 24. The determination of putative antibodies against BoNT-A will be evaluated using a validated method of electrochemiluminescence assays (ECLA) for the presence of binding antibodies to BoNT-A.	At Week 24
Secondary	Percentage of participants with neutralising antibodies to Dysport®	It will be performed only with confirmed positive samples in ECLA (confirmation of presence of binding antibodies) . The characterization of antibodies against BoNT-A will be evaluated using a validated method of cell-based assays (CBA) for the presence of neutralising antibodies to BoNT-A	At Week 24