A Study of a Melatonin Receptor Agonist to Prevent Migraine

Migraine Clinical Trial

Official title:

A Randomized, Double-blind Placebo-controlled, Parallel Group Study to Study the Efficacy and Tolerability of Ramelteon (Rozerem) in the Prophylaxis of Migraine

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00739024
• Other study ID #: CRC 0690
• Status: Terminated
• Phase: Phase 2
• First received: August 19, 2008
• Last updated: August 22, 2012
• Start date: April 2008
• Est. completion date: September 2010

Study information

• Verified date: August 2012
• Source: Swedish Medical Center
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to see if ramelteon will reduce the number of migraine headaches over a 12 week period. The safety and tolerability of ramelteon will also be evaluated. Ramelteon has been approved by the U.S. Food and Drug Administration (FDA) for insomnia (trouble sleeping); however; ramelteon has not been approved for the prevention of migraines.

Description:

Sleep has played an important role in migraine. Younger migraine sufferers usually report relief of migraine after sleep. In older migraine sufferers migraine is sometimes triggered with sleep changes. Occurrence of migraine in the early morning is very common. Therefore in these individuals regulation of sleep may improve the frequency of migraine. Recent PET studies done during migraine demonstrated activation of hypothalamus during migraine. In light of this new data and the known action of ramelteon on the melatonin receptors it may theoretically provide an insight on a possible mechanism of action in migraine.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 18
• Est. completion date: September 2010
• Est. primary completion date: April 2009
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• Male or female, ages 18 to 65 years, inclusive.

• An established history of migraine, with or without aura and probable migraine, conforming to the revised IHS criteria (2004) for at least 1 year before screening, sufficient to establish the diagnosis.

• To be randomized, during the prospective 4-week baseline period (approximately 28 days before Visit 2), subjects must have more than 4 migraine/probable migraine attacks per month (using the 24-hour rule).

• Must have been less than 50 years of age at the time of initial migraine onset.

• Must have no clinically significant and relevant abnormalities on physical or neurologic examinations

• Must have completed a washout of all prophylactic medications for migraine before the start of the 4-week prospective baseline period (ie, 28 days before Visit 2, when randomization occurs).

• Female subjects must be at least 1 of the following:

• postmenopausal, or

• surgically incapable of being children, or

• practicing a highly effective method of birth control

Exclusion Criteria:

• Most frequent type of headache does not meet the revised IHS diagnostic criteria for migraine with aura or without aura or probable migraine.

• Pregnant or lactating women, or sexually active women of childbearing potential who are not using an appropriate method of contraception.

• Failed adequate trials of prophylactic agents with demonstrated or possible efficacy in the prophylaxis of migraine. These agents include beta-blockers, tricyclic antidepressants, valproate, topiramate, and methysergide.

• Unable to complete the diary in a timely and accurate manner after each migraine headache attacks, either independently or with assistance.

• Overuse of analgesics or specific agents for abortive treatment of migraine attacks, which makes the investigator suspect medication overuse headache.

• Receiving non-pharmacological prophylactic treatments such as acupuncture, chiropractic, or massage, if these were started less than 1 month before the screening visit (Day -28). These therapies may be continued if started before that time.

• Currently abusing alcohol or other drugs.

• Have a central nervous system neoplasm or infection, demyelinating disease, degenerative or progressive central nervous system disease, or active epilepsy.

• History of serious systemic disease, including hepatic insufficiency, renal insufficiency, a malignant neoplasm, any disorder in which prognosis for survival is less than 3 months, or any disorder which in the judgment of the investigator will place the subject at excessive risk by participation in a controlled trial.

• Have a significant psychiatric disorder, such as acute psychosis, schizophrenia, severe bipolar disorder, or severe unipolar mood disorder, of sufficient severity to preclude safe and effective participation of the subject in the study.

• Require continued use of any of protocol-defined prohibited medications during the study

• Have any recent or remote history of suicide attempt or ideation

• Known or strongly suspected to be non-compliant in administering daily medications.

• Received an experimental drug or used an experimental device within 30 days before the Screening Visit.

• Employees of the investigator or study center, with direct involvement in the proposed study or other studies under the direction of that investigator or study center, as well as family members of the employees or the investigator

• Any reason for which the investigator, upon her evaluation, feels that it is in the subject's best interest not to continue on in the study.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention

Related Conditions & MeSH terms

• Migraine
• Migraine Disorders
• Migraine with Aura
• Migraine Without Aura

Intervention

Drug:
• Ramelteon
8 mg tablet, oral, once daily
• Placebo
Placebo tablet, oral, once daily

Locations

Country	Name	City	State
United States	Swedish Pain and Headache Center	Seattle	Washington

Sponsors (2)

Lead Sponsor	Collaborator
Swedish Medical Center	Takeda

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	T-Test	It was planned to use a simple T-Test or ANoVa for data analysis. No Analysis was made due to insufficient recruitment. Planned primary efficacy variable was the percent reduction in the average monthly miqraine/probable migraine frequency from the baseline period to the entire double-blind treatment phase of the study.	4 weeks	No