Long-Term Safety of Treximet (Sumatriptan/Naproxen Sodium) for Migraine in Adolescents

Migraine Disorders Clinical Trial

Official title:

Study TXA107977, a Long-Term Safety Study of a Combination Product Containing Sumatriptan Succinate and Naproxen Sodium for the Treatment of Migraine in Adolescents

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00488514
• Other study ID #: TXA107977
• Status: Completed
• Phase: Phase 3
• First received: June 18, 2007
• Last updated: May 31, 2012
• Start date: July 2007
• Est. completion date: August 2009

Study information

• Verified date: March 2011
• Source: GlaxoSmithKline
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

This study was designed to determine long-term safety of TREXIMET (sumatriptan/naproxen sodium) in adolescents for the acute treatment of migraine.

Description:

This study was designed to determine long-term safety of TREXIMET (sumatriptan/naproxen sodium) in adolescents (aged 12 to 17 years) for the acute treatment of migraine.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 656
• Est. completion date: August 2009
• Est. primary completion date: August 2009
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 12 Years to 17 Years

Eligibility

Inclusion Criteria:

• Subject is between 12 and 17 years old at the Screening visit.

• If subject is female, she must have a negative urine pregnancy test at screening, does not plan to become pregnant during the course of the study and agrees to use an acceptable method of birth control (i.e., a method with a failure rate <1% or abstinence) if she is/becomes sexually active.

• Subject has migraine with or without aura (2004 ICHD-II criteria).

• Subject has history suggestive of typical migraine attacks with duration of about 2 or more hours (untreated, or unsuccessfully treated).

• Subject has at least 2, but not more than 8, migraine attacks per month in each of the 2 months prior to the Screening visit.

• Subject has at least a 6-month history of moderate to severe migraine attacks, sufficient to establish a definitive diagnosis of migraine.

• Subject is able to distinguish migraine from other headaches (e.g., tension-type headaches).

• Subject and subject's parent or legal guardian are willing and able to provide informed consent prior to entry into this treatment phase of the study.

• Subject and subject's parent or legal guardian are able to read and write English or Spanish.

• Subject is able to understand and complete the electronic device to report treatment information.

Exclusion Criteria:

• Subject is < 75 pounds (33.3kg).

• Subject has =15 headache days per month in total, retinal (ICHD-II 1.4), basilar (ICHD-II 1.26) or hemiplegic migraine (ICHD-II 1.25), or secondary headaches.

• Subject, in the investigator's opinion, is likely to have unrecognized cardiovascular or cerebrovascular disease (See Appendix 1, section 11.1).

• Subject has uncontrolled hypertension (See Appendix 2, section 11.2) or is taking any angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker.

• Subject has a history of congenital heart disease, cardiac arrhythmias requiring medication, or a history of a clinically significant electrocardiogram abnormality that, in the investigator's opinion, contraindicates participation in this study.

• Subject has evidence or history of any ischemic vascular diseases including: ischemic heart disease, ischemic abdominal syndromes, peripheral vascular disease or Raynaud's Syndrome, or signs/symptoms consistent with any of the above.

• Subject has evidence or history of central nervous system pathology including stroke and/or transient ischemic attacks (TIAs), epilepsy or structural brain lesions which lower the convulsive threshold; or has been treated with an antiepileptic drug for seizure control within 5 years prior to screening.

• Subject has a history of impaired hepatic or renal function that, in the investigator's opinion, contraindicates participation in this study.

• Subject has hypersensitivity, allergy, intolerance, or contraindication to the use of any triptan, NSAID or aspirin (including all sumatriptan and naproxen preparations) or has nasal polyps and asthma.

• Subject is currently taking, or has taken in the previous three months, a migraine prophylactic medication containing methysergide or dihydroergotamine; or is taking a medication that is not stabilized (i.e., change of dose within the past 2 months) for either chronic or intermittent migraine prophylaxis or for a co-morbid condition that is not stabilized.

• Subject has a recent history of regular use of opioids or barbiturates for treatment of his/her migraine headache and/or other non-migraine pain. Regular use is defined as an average of 4 days per month over the last 6 months.

• Subject has taken, or plans to take, a monoamine oxidase inhibitor (MAOI), including herbal preparations containing St. John's Wort (Hypericum perforatum), anytime within the 2 weeks prior to screening through 2 weeks post final study treatment.

• Subject history of any bleeding disorder or is currently taking any anti-coagulant or any antiplatelet agent.

• Subject has evidence or history of any gastrointestinal surgery or GI ulceration or perforation in the past six months, gastrointestinal bleeding in the past year; or evidence or history of inflammatory bowel disease.

• Subject tests positive for illicit substances on toxicology screen, or has evidence of alcohol or substance abuse within the last year, or any concurrent medical or psychiatric condition which, in the investigator's judgment, will likely interfere with the study conduct, subject cooperation, or evaluation and interpretation of the study results, or which otherwise contraindicates participation in this clinical trial.

• Subject has participated in an investigational drug trial within the previous 4 weeks or plans to participate in another study at any time during this study.

Study Design

Allocation: Non-Randomized, Endpoint Classification: Safety Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Migraine Disorders

Intervention

Drug:
• Combination Tablet of Treximet (sumatriptan/naproxen sodium)
Combination Tablet of Treximet(sumatriptan/naproxen sodium)

Locations

Country	Name	City	State
United States	GSK Investigational Site	Albany	New York
United States	GSK Investigational Site	Albuquerque	New Mexico
United States	GSK Investigational Site	Amherst	New York
United States	GSK Investigational Site	Anderson	Indiana
United States	GSK Investigational Site	Ann Arbor	Michigan
United States	GSK Investigational Site	Atlanta	Georgia
United States	GSK Investigational Site	Aurora	Colorado
United States	GSK Investigational Site	Bardstown	Kentucky
United States	GSK Investigational Site	Bremerton	Washington
United States	GSK Investigational Site	Charlottesville	Virginia
United States	GSK Investigational Site	Chico	California
United States	GSK Investigational Site	Cincinnati	Ohio
United States	GSK Investigational Site	Cleveland	Ohio
United States	GSK Investigational Site	Colorado Springs	Colorado
United States	GSK Investigational Site	Columbus	Ohio
United States	GSK Investigational Site	Dallas	Texas
United States	GSK Investigational Site	East Hartford	Connecticut
United States	GSK Investigational Site	Endwell	New York
United States	GSK Investigational Site	Eugene	Oregon
United States	GSK Investigational Site	Fair Oaks	California
United States	GSK Investigational Site	Fairfield	Connecticut
United States	GSK Investigational Site	Fresno	California
United States	GSK Investigational Site	Fullerton	California
United States	GSK Investigational Site	Georgetown	Texas
United States	GSK Investigational Site	Gilbert	Arizona
United States	GSK Investigational Site	Greer	South Carolina
United States	GSK Investigational Site	Henderson	Nevada
United States	GSK Investigational Site	Huntington Beach	California
United States	GSK Investigational Site	Irvine	California
United States	GSK Investigational Site	Jonesboro	Arkansas
United States	GSK Investigational Site	Kalamazoo	Michigan
United States	GSK Investigational Site	La Jolla	California
United States	GSK Investigational Site	Little Rock	Arkansas
United States	GSK Investigational Site	Loxahatchee	Florida
United States	GSK Investigational Site	Medford	Oregon
United States	GSK Investigational Site	Mount Vernon	New York
United States	GSK Investigational Site	Murray	Kentucky
United States	GSK Investigational Site	Nashville	Tennessee
United States	GSK Investigational Site	Nassau Bay	Texas
United States	GSK Investigational Site	New York	New York
United States	GSK Investigational Site	Newport Beach	California
United States	GSK Investigational Site	Norfolk	Virginia
United States	GSK Investigational Site	Northridge	California
United States	GSK Investigational Site	Oklahoma City	Oklahoma
United States	GSK Investigational Site	Omaha	Nebraska
United States	GSK Investigational Site	Paw Paw	Michigan
United States	GSK Investigational Site	Pensacola	Florida
United States	GSK Investigational Site	Phoenix	Arizona
United States	GSK Investigational Site	Plainview	New York
United States	GSK Investigational Site	Plano	Texas
United States	GSK Investigational Site	Plymouth	Minnesota
United States	GSK Investigational Site	Portland	Oregon
United States	GSK Investigational Site	Protage	Michigan
United States	GSK Investigational Site	Raleigh	North Carolina
United States	GSK Investigational Site	Redondo Beach	California
United States	GSK Investigational Site	Richland	Michigan
United States	GSK Investigational Site	Ridgewood	New Jersey
United States	GSK Investigational Site	Rochester	New York
United States	GSK Investigational Site	Rochester	New York
United States	GSK Investigational Site	Roseville	California
United States	GSK Investigational Site	Sacramento	California
United States	GSK Investigational Site	Salt Lake City	Utah
United States	GSK Investigational Site	Salt Lake City	Utah
United States	GSK Investigational Site	San Antonio	Texas
United States	GSK Investigational Site	San Francisco	California
United States	GSK Investigational Site	Santa Monica	California
United States	GSK Investigational Site	Savannah	Georgia
United States	GSK Investigational Site	St. Louis	Missouri
United States	GSK Investigational Site	St. Petersburg	Florida
United States	GSK Investigational Site	Vorhees	New Jersey
United States	GSK Investigational Site	Walnut Creek	California
United States	GSK Investigational Site	Wenatchee	Washington
United States	GSK Investigational Site	West Palm Beach	Florida
United States	GSK Investigational Site	Westerville	Ohio
United States	GSK Investigational Site	Williamsville	New York

Sponsors (1)

Lead Sponsor	Collaborator
GlaxoSmithKline

Country where clinical trial is conducted

United States, 

References & Publications (1)

McDonald SA, Hershey AD, Pearlman EM, Winner PK, Rothner DA, Linder SL, Richard NE, Derosier FJ. Long-term safety and tolerability of a single, fixed-dose tablet of sumatriptan and naproxen sodium (SumaRT/Nap) in adolescent migraineurs. Headache. 2010; 48

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of Participants With the Indicated Drug-related Adverse Events	The number of participants with a drug-related adverse event (AE). Frequency threshold for reporting a drug-related AE: >=2% participants recorded as having at least one occurrence of a reported drug-related AE.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Participants With Any Adverse Event Categorized by Severity	The number of participants with at least one mild (an event that is easily tolerated by the participant, causing minimal discomfort and not interfering with everyday activities), moderate (an event that is sufficiently discomforting to interfere with normal everyday activities), or severe adverse event (an event that prevents normal everyday activities) was recorded.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Participants With Any Adverse Event Categorized Over Time	The number of participants with an adverse event occurring in either the first six months of the study (months 0-6; <=194 days) or the second six months of the study (months 6-12; =>194 days until end of study) was recorded.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Participants With Any Adverse Event Categorized by Participant Age	The number of participants with any adverse event by age group (12-14 and 15-17 years) is recorded.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Participants With Any Adverse Event Categorized by Participant Race	The number of participants with any adverse event was categorized by race. The category "Other" captures : American Indian or Alaskan Native; Asian, Native Hawaiian, or Other Pacific Islander; African American/African Heritage and Asian; African American/African Heritage and White; and American Indian or Alaskan Native and White.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Participants With Any Adverse Event Categorized by Participant Gender	The number of participants with adverse events by gender is recorded.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Participants With Any Adverse Event That Occurred Within 3 or 5 Days of the First Dose of the Combination Tablet	The number of participants with adverse events that occurred within 3 or 5 days of their first dose of the Combination Tablet was recorded.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Tablets Taken, After Which at Least One Adverse Event Occurred Within 3 or 5 Days of Dosing With That Combination Tablet	The number of events that occurred within 3 or 5 days of dosing with the combination tablet on a per tablet basis. A total of 8413, 5876, and 9989 tablets were taken by the 6 Month Completer, 12 Month Completer, and the Safety Populations, respectively.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Participants With Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Creatinine, Potassium, and Blood Urea Nitrogen (BUN) Values of Interest That Shifted From Normal at Baseline to Abnormal at the End of Study Visit	A shift from "normal to low," for example, indicates that a value was normal at baseline but low at the end of study visit. The value ranges were determined by the central laboratory. Reference ranges: ALT, 12 years old (y): 0-45 Units/liter (U/L), >13 y: 0-48 U/L; AST, 12 y: 0-42 U/L, >13 y 0-42 U/L; creatinine, 12 y: 27-88 micromoles/liter (UMOL/L), >13 y: 44-124 UMOL/L; potassium, 12 y: 3.5-5.5 millimoles/liter (MMOL/L), >13 y: 3.5-5.3 MMOL/L; BUN, 12-17 y: 24-101 milligrams (mg)/deciliter (dL).	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Participants With Hematocrit and Hemoglobin Values of Interest That Shifted From Normal at Baseline to Abnormal at the End of Study Visit	A shift from "normal to low," for example, indicates that a value was normal at baseline but low at the end of study visit. The value ranges were determined by the central laboratory. Reference ranges: hemoglobin, 12-17 years old (y): 120-160 grams (g)/L; hematocrit (expressed as the percentage of blood occupied by red blood cells), 12-17 y: 0.360-0.490.	Baseline through End of Study (up to Month 12)	No
Secondary	Mean Height for All Study Participants at the Indicated Time Points		Screening and Months 3, 6, 9, and 12	No
Secondary	Mean Weight for All Study Participants at the Indicated Time Points		Screening and Months 3, 6, 9, and 12	No
Secondary	Mean Body Mass Index (BMI) for All Study Participants at the Indicated Time Points	BMI = (Weight in kilograms)/(height in centimeters/100)^2	Screening and Months 3, 6, 9, and 12	No
Secondary	Mean Blood Pressure for All Study Participants at the Indicated Time Points	At each visit, a participant's blood pressure was taken three times. The average of the three readings was then calculated for each participant at each visit (mean blood pressure). The outcome measure represents the average of the mean blood pressure of all of the study participants. SBP, systolic blood pressure; DBP, diastolic blood pressure.	Screening and Months 3, 6, 9, and 12	No
Secondary	Mean Heart Rate for All Study Participants at the Indicated Time Points	A sitting heart rate was measured once for each participant at each visit.	Screening and Months 3, 6, 9, and 12	No
Secondary	Number of Participants With Abnormal Electrocardiogram Findings at Screening and at the Final Visit as Assessed by the Investigator	The number of participants with an electrocardiogram (ECG) status of normal, abnormal, clinically significant (CS), or not clinically significant (NCS), as determined by the Investigator, was reported. Specific definitions of ECG categorizations were not provided; investigators were expected to apply reasonable standards of clinical judgment. Normal, all ECG parameters within accepted normal ranges; abnormal, ECG finding(s) outside of normal ranges; CS, ECG with a CS abnormality that meets exclusion criteria; NCS, ECG with an abnormality not CS or meeting exclusion criteria per investigator.	Screening and Final Visit (up to Month 12)	No
Secondary	Number of Treated Migraine Attacks	The number of migraine attacks eligible for evaluation, not associated with rescue medication use, or prohibited medications, was summarized. Rescue medication was additional medication taken within 24 hours of Combination Tablet. Prohibited medications: ergot, opioid, barbiturate, 5-HT1 agonist, long-acting non-steroidal anti-inflammatory drug (NSAID), short-acting NSAID-containing compound, analgesic, anti-emetic, monoamine oxidase inhibitors, St. John's Wort, angiotensin-converting enzyme inhibitor, Angiotensin II receptor blockers, anti-coagulant, anti-platelet.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Treated Attacks Classified as Migraine Pain-Free (MPF) Within 24 Hours of Dosing With the Combination Tablet	The number of migraine attacks eligible for evaluation, not associated with rescue medication use, and not associated with either rescue medication use or prohibited medications were counted. Migraine Pain Free was defined as the migraine attack ending <= 24 hours after the participant was dosed with the Combination Tablet.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Treated Attacks Classified as Migraine Pain-Free (MPF) Within 4 Hours of Dosing With a Combination Tablet	The number of migraine attacks eligible for evaluation, not associated with rescue medication use, and not associated with either rescue medication use or prohibited medications were counted. Migraine Pain Free was defined as the migraine attack ending <= 4 hours after the participant was dosed with the Combination Tablet.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Treated Attacks Classified as Migraine Pain-Free Within 4 Hours That Were Also Pain Free Within 2 Hours of Dosing With the Combination Tablet	The number of migraine attacks eligible for evaluation, not associated with rescue medication use, and not associated with either rescue medication use or prohibited medications were counted. Migraine Pain Free was defined as the migraine attack ending <= 4 hours after the participant was dosed with the Combination Tablet.	Baseline through End of Study (up to Month 12)	No
Secondary	Average Number of Headaches, Migraine Attacks, and Treated Migraine Attacks Per Month	The average number of headaches (non-migraine and migraine attacks), migraine attacks, and treated migraine attacks per month was calculated for each participant, based on their time in the study. The outcome measure represents the average of the mean number of the headaches, migraine headaches, and treated migraines per month of the study participants in the 6 Month, 12 Month, and ITT Populations. A treated attack is defined as a migraine treated with the Combination Tablet.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Total Migraines Headaches and Migraines Treated With the Combination Tablet	The total number of migraine headaches and the number of migraine headaches treated with the Combination Tablet during the study were summarized.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Migraine Attacks Rated With the Indicated Pain Severity	The number of migraine attacks treated at the mild, moderate, or severe intensity were counted. Pain severity was assessed by participants based on a scale of 0-3: 0=no pain, 1=mild, 2= moderate, 3=severe.	Baseline through End of Study (up to Month 12)	No
Secondary	Number of Treated Migraine Attacks With Photophobia, Phonophobia, Nausea, Neck Pain, Sinus Pain, and Vomiting	The number of treated migraine attacks with the reported migraine-associated symptoms of photophobia, phonophobia, nausea, neck pain, sinus pain, and vomiting were counted. Photophobia: sensitivity to light; phonophobia: sensitivity to sound.	Baseline through End of Study (up to Month 12)	No
Secondary	Mean Change From Baseline in the Migraine Specific Quality of Life (QOL) Questionnaire for Adolescents (MSQ-A) Score at Months 3, 6, 9, and 12	The MSQ-A consists of 14 items measuring how migraines affect QOL: Role Function (RF)-Restrictive (items 1-7) and RF-Preventative (items 8-11), examining the degree to which performance of daily activities is limited or interrupted, respectively, by migraine; RF-Emotional (items 12-14, examining frustration/helplessness due to migraine). Dimensions (dim.) are scored independently. The 14 items are reverse coded onto a 1-6 scale; dim. are then created by summing specific item scores and transforming raw total score onto a 0-100 scale. For each dim., higher scores indicate better health status.	Baseline and Months 3, 6, 9, and 12	No
Secondary	Number of Participants Categorized by Response to Each of the 3 Global Satisfaction Questions From the Patient Perception Migraine Questionnaire-Revised (PPMQ-R) at the Screening Visit	The PPMQ-R is a fully validated 32-item questionnaire assessing participant satisfaction with acute migraine medication and includes 3 questions that assess satisfaction with respect to efficacy, side effects, and overall satisfaction (i.e., How effective the medication is overall, side effects of the medication, overall satisfaction with the medication). Each item is rated on a 7-point scale ranging from "very satisfied" (1) to "very dissatisfied" (7).	Screening	No
Secondary	Number of Participants Categorized by Response to Each of the 3 Global Satisfaction Questions From the Patient Perception Migraine Questionaire-Revised (PPMQ-R) at Month 12	The PPMQ-R is a fully validated 32-item questionnaire assessing participant satisfaction with acute migraine medication and includes 3 questions that assess satisfaction with respect to efficacy, side effects, and overall satisfaction (i.e., How effective the medication is overall, side effects of the medication, overall satisfaction with the medication). Each item is rated on a 7-point scale ranging from "very satisfied" (1) to "very dissatisfied" (7).	End of Study/Month 12	No