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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03347188
Other study ID # TV48125-CNS-20024
Secondary ID
Status Completed
Phase Phase 2
First received
Last updated
Start date December 18, 2017
Est. completion date June 3, 2020

Study information

Verified date December 2022
Source Teva Branded Pharmaceutical Products R&D, Inc.
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the safety and efficacy of fremanezumab in adult participants aged 18 to 70 years, inclusive, for the prevention of PTH. The study will include a double-blind (DB) treatment period (12 weeks) and an open-label (OL) treatment period (12 weeks).


Recruitment information / eligibility

Status Completed
Enrollment 87
Est. completion date June 3, 2020
Est. primary completion date March 13, 2020
Accepts healthy volunteers No
Gender All
Age group 18 Years to 70 Years
Eligibility Inclusion Criteria: - The participant has a body weight greater than or equal to (=) 45 kilograms (kg). - Traumatic injury to the head has occurred, defined as a structural or functional injury resulting from the action of external forces. - The participant has a diagnosis of PTH. - The participant is not using preventive medications for headache. - Women of childbearing potential whose male partners are potentially fertile (that is, no vasectomy) must use highly effective birth control methods for the duration of the study and for 30 weeks after the last study drug administration. Men must be sterile or, if they are potentially fertile or reproductively competent (that is, not surgically or congenitally sterile) and their female partners are of childbearing potential, must use, together with their female partners, acceptable birth control methods for the duration of the study and for 30 weeks after the last study drug administration. NOTE- Additional criteria apply, please contact the investigator for more information. Exclusion Criteria: - The participant has a previous history of brain imaging showing evidence of intracerebral hemorrhage, subdural or epidural hematomas, or subarachnoid hemorrhage as a consequence of the traumatic head injury. Brain images with structurally insignificant changes, as discussed and approved by the sponsor, will be reviewed by the sponsor on a case-by-case basis. - The participant has PTH attributed to craniotomy. - The participant has whiplash and subsequent headache but no history of head injury or concussion. - The participant is using analgesic medications containing opioids (including codeine) or a barbiturate on average more than 15 days per month. - The participant has had exposure to a monoclonal antibody (mAb) targeting the calcitonin gene-related peptide (CGRP) pathway (erenumab, eptinezumab, galcanezumab, and fremanezumab) during the 6 months prior to the day of the screening visit. - The participant is currently being treated with onabotulinumtoxinA (for example, Botox, Dysport, Xeomin) application in the head or neck or received any such injection during the 3 months prior to the screening visit. - The participant has been implanted with any electronic devices for headache prevention during the 3 months prior to the screening visit or is currently using any implanted or externally applied stimulator or device. - The participant has been treated with a nerve block for head and/or neck during the 3 months prior to the screening visit. - The participant is a pregnant or lactating woman or plans to become pregnant during the study. NOTE- Additional criteria apply, please contact the investigator for more information.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Fremanezumab
Fremanezumab will be administered per dose and schedule specified in the arm.
Placebo
Placebo matching to fremanezumab will be administered per schedule specified in the arm.

Locations

Country Name City State
United States Teva Investigational Site 14119 Albany New York
United States Teva Investigational Site 14229 Amherst New York
United States Teva Investigational Site 14118 Bronx New York
United States Teva Investigational Site 14055 Dallas Texas
United States Teva Investigational Site 14114 Durham North Carolina
United States Teva Investigational Site 14045 Fairfield Connecticut
United States Teva Investigational Site 14067 Indianapolis Indiana
United States Teva Investigational Site 14051 Kansas City Missouri
United States Teva Investigational Site 14048 Little Rock Arkansas
United States Teva Investigational Site 30236 Little Rock Arkansas
United States Teva Investigational Site 14052 Long Beach California
United States Teva Investigational Site 14053 Los Angeles California
United States Teva Investigational Site 14058 Louisville Kentucky
United States Teva Investigational Site 14063 Miami Florida
United States Teva Investigational Site 14044 Morgantown West Virginia
United States Teva Investigational Site 14230 Nashville Tennessee
United States Teva Investigational Site 14047 New York New York
United States Teva Investigational Site 14041 North Miami Florida
United States Teva Investigational Site 14064 Philadelphia Pennsylvania
United States Teva Investigational Site 14065 Phoenix Arizona
United States Teva Investigational Site 14040 Pittsburgh Pennsylvania
United States Teva Investigational Site 14049 Portland Oregon
United States Teva Investigational Site 14057 Riverwoods Illinois
United States Teva Investigational Site 14046 Saint Louis Missouri
United States Teva Investigational Site 14059 Salisbury North Carolina
United States Teva Investigational Site 14060 San Diego California
United States Teva Investigational Site 14054 San Francisco California
United States Teva Investigational Site 14069 Scottsdale Arizona
United States Teva Investigational Site 14113 Spokane Washington
United States Teva Investigational Site 14043 Springfield Missouri
United States Teva Investigational Site 14056 Tampa Florida
United States Teva Investigational Site 14050 Waco Texas
United States Teva Investigational Site 14061 Waltham Massachusetts

Sponsors (1)

Lead Sponsor Collaborator
Teva Branded Pharmaceutical Products R&D, Inc.

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary DB Period: Mean Change From Baseline in Monthly Average Number of Headache Days of at Least Moderate Severity During the 12-Week Treatment Period After the First Dose of Fremanezumab A headache day was defined as a day when a participant reported a headache of at least moderate severity. Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28. The change was calculated as post-baseline value - baseline value. Least square (LS) mean was calculated using analysis of covariance (ANCOVA) model with the duration of post traumatic headache history (less than 12 month since the brain injury or greater or equal to 12 month since the brain injury) and treatment as fixed effects and the baseline monthly average number of headache days of at least moderate severity as a covariate. Baseline (Day -28 to Day -1), up to Week 12
Secondary DB Period: Number of Participants Reaching at Least 50% Reduction From Baseline in Monthly Average Number of Headache Days of Any Severity During 12-Week Treatment With Fremanezumab Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28. Baseline (Day -28 to Day-1) up to Week 12
Secondary DB Period: Number of Participants Reaching at Least 50% Reduction From Baseline in the Monthly Average Number of Headache Days of at Least Moderate Severity During 12-Week Treatment With Fremanezumab A headache day was defined as a day when a participant reported a headache of at least moderate severity. Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28. Baseline (Day -28 to Day-1) up to Week 12
Secondary DB Period: Number of Participants Reaching at Least 50% Reduction From Baseline in the Monthly Average Number of Headache Days of at Least Moderate Severity During First 4-Week (Month 1), 5- to 8-Week (Month 2), and 9- to 12-Week (Month 3) A headache day was defined as a day when a participant reported a headache of at least moderate severity. Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28. Baseline (Day -28 to Day-1) up to Months 1, 2, and 3
Secondary DB Period: Change From Baseline in the Number of Headache Days of At Least Moderate Severity During the First 4-Week (Month 1), 5- to 8-Week (Month 2), and 9- to 12-Week (Month 3) A headache day was defined as a day when a participant reported a headache of at least moderate severity. Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28. The change was calculated as post-baseline value - baseline value. LS mean was calculated using ANCOVA model with the duration of post traumatic headache history (less than 12 month since the brain injury or greater or equal to 12 month since the brain injury) and treatment as fixed effects and the baseline monthly average number of headache days of at least moderate severity as a covariate. This approach was used in generating the LS mean values only and was not considered to be an additional statistical analysis, no additional statistical analyses are reported for this outcome measure. Baseline (Day -28 to Day -1), up to Months 1, 2, and 3
Secondary DB Period: Change From Baseline in Disability Score, as Measured by the 6-Item Headache Impact Test (HIT-6) Total Score at Week 12 After the First Dose of Fremanezumab HIT-6 is a tool used to measure the impact headaches have on a participant's normal daily life and ability to function. The HIT-6 consists of 6 items, including pain, social functioning, role functioning, vitality, cognitive functioning, and psychological distress. Each item was answered on a 5-point Likert scale (6=never, 8=rarely, 10=sometimes, 11=very often, or 13=always), which were summed to produce a total score that ranged from 36 to 78, with larger scores reflecting greater impact of headache on the daily life of the participant. Baseline (Day -28 to Day -1), Week 12
Secondary DB Period: Number of Participants (Responder and Non-Responder) With the Patient Global Impression of Change (PGIC) Scale at Weeks 4, 8, and 12 After the First Dose of Fremanezumab The PGIC scale is a validated generic tool for the assessment of overall change in the severity of illness following treatment. Participants rated how they felt during assigned time points compared with how they felt before receiving study drug on a 7-point scale, where 1 = No change (or it got worse); 2 = Almost the same, hardly any change at all; 3 = A little better, but no noticeable change; 4 = Somewhat better, but the change has not made any real difference; 5 = Moderately better, and a slight but noticeable change; 6 = Better, and a definite improvement that has made a real and worthwhile difference; and 7 = A great deal better, and a considerable improvement that has made all the difference. Responders were those with a scale of 5 to 7 and non-responders were those with a scale of 1 to 4. Weeks 4, 8, and 12
Secondary DB Period: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) An adverse event (AE) was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. TEAEs were defined as AEs occurring at or after the first dose of the study drug. Serious AEs were defined as death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section. Baseline (Day -28 to -1) up to Week 12
Secondary OL Period: Number of Participants With TEAEs An AE was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. TEAEs were defined as AEs occurring at or after the first dose of the study drug. Serious AEs were defined as death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section. Week 12 up to Week 24
Secondary DB Period: Number of Participants Who Did Not Complete the Study Number of participants who did not complete the study due to any reason and due to AEs are reported. Baseline (Day -28 to Day -1) up to Week 12
Secondary OL Period: Number of Participants Who Did Not Complete the Study Number of participants who did not complete the study due to any reason and due to AEs are reported. Week 12 up to Week 24
Secondary DB Period: Number of Participants Who Received Concomitant Medications Concomitant medications included: agents acting on renin-angiotensin system, analgesics, anesthetics, anti-parkinson drugs, antianemic preparations, antibacterials for systemic use, antidiarrheals, intestinal antiinflammatory/antiinfective agents, antiemetics and antinauseants, antiepileptics, antifungals for dermatologiocal use, antihistamines for systemic use, antihypertensives, antiinflammatory and antirheumatics, antineoplastic agents, antiobesity preparations, antipruritics, antithrombotics, antivirals for systemic use, beta blocking agents, calcium channel blockers, cardiac therapy, corticosteroids, cough and cold preparations, diuretics, lipid modifying agents, nasal preparations, thyroid therapy, urologicals, vaccines, psycholeptics, psycoanaleptics, ophthalmologicals, general nutrients, mineral supplements, muscle relaxants, vitamins, drugs used in diabetes, sex hormones and modulators of the genital system, immunosuppresants, drugs for acid related disorders etc. Baseline (Day -28 to Day -1) up to Week 12
Secondary OL Period: Number of Participants Who Received Concomitant Medications Concomitant medications included: agents acting on renin-angiotensin system, analgesics, anti-parkinson drugs, antianemic preparations, antibacterials for systemic use, antiemetics and antinauseants, antihistamines for systemic use, antihypertensives, antiinflammatory and antirheumatics, antineoplastic agents, antithrombotics, beta blocking agents, calcium channel blockers, corticosteroids for systemic use, cough and cold preparations, diuretics, lipid modifying agents, nasal preparations, other gynecologicals, other nervous system drugs, thyroid therapy, unspecified herbal and traditional medicine, urologicals, vaccines, psycholeptics, psycoanaleptics, general nutrients, mineral supplements, muscle relaxants, vitamins, sex hormones and modulators of the genital system, drugs for acid related disorders, drugs for constipation, drugs for obstructive airways disease etc. Week 12 up to Week 24
Secondary Number of Participants With Positive Findings on Electronic Columbia Suicide Severity Rating Scale (eC-SSRS) eC-SSRS is a questionnaire to assess suicidal ideation (severity and intensity) and behavior. Suicidal ideation: A series of 1 -5 questions (with 'yes' or 'no' response) with 5 types of ideation of increasing severity: 1. wish to be dead, 2. non-specific active suicidal thoughts, 3. active suicidal ideation with any methods (not plan) without intent to act, 4. active suicidal ideation with some intent to act, without specific plan, 5. active suicidal ideation with specific plan and intent. A positive finding was defined as a 'yes' response to question 4 or 5. Baseline (Day -28 to Day -1) up to Week 24
Secondary Number of Participants With Treatment-Emergent Antidrug Antibodies (ADA) Number of participants with treatment-emergent antidrug antibodies reported. Baseline (Day -28 to Day -1) up to Week 24
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