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    Clinical Trial Results:
    Biomarker and Genetic Predictors of Erenumab Treatment Response, a Phase 4 Investigational Open-label Study (INTERROGATE)

    Summary
    EudraCT number
    2019-002331-28
    Trial protocol
    DK  
    Global end of trial date
    18 Jan 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    28 Dec 2023
    First version publication date
    28 Dec 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    20190006
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04265755
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Amgen Inc.
    Sponsor organisation address
    One Amgen Center Drive, Thousand Oaks, CA, United States,
    Public contact
    Study Director, Amgen Inc., +1 8665726436, medinfo@amgen.com
    Scientific contact
    Study Director, Amgen Inc., +1 8665726436, medinfo@amgen.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    18 Jan 2023
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Jan 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of the study was to explore the relationship between clinical response to erenumab and genetic biomarkers.
    Protection of trial subjects
    This study was conducted in accordance with International Council for Harmonisation Good Clinical Practice and other regulations/guidelines.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    26 Oct 2020
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Denmark: 696
    Country: Number of subjects enrolled
    Iceland: 710
    Worldwide total number of subjects
    1406
    EEA total number of subjects
    1406
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    1366
    From 65 to 84 years
    40
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 1406 participants were enrolled in Denmark and Iceland between October 2020 and January 2023. As pre-specified, the primary objective of the study was to assess the relationship between migraine polygenic risk score (mPRS) and the reduction in mean monthly migraine days (MMD) after using erenumab, regardless of erenumab dose received.

    Pre-assignment
    Screening details
    The study consisted of the following: - A Screening Period of up to 3 weeks. - A Baseline Period of 4 - 5 weeks to collect data on migraine headaches and acute headache medication use. - A 24-week, Open-label Treatment Period.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Erenumab 70 mg/140 mg
    Arm description
    Participants were enrolled into the Open-label Treatment Period and received erenumab 70 mg or 140 mg administered subcutaneously (SC) once every 4 weeks (Q4W) at the discretion of the investigator. Per protocol, dose switching between erenumab 70 mg and 140 mg was permitted at Week 12. However, participants could switch dose before or after Week 12 if needed based on investigator discretion. Dose comparison was not pre-specified.
    Arm type
    Experimental

    Investigational medicinal product name
    Erenumab
    Investigational medicinal product code
    AMG 334
    Other name
    AIMOVIG
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Administered via autoinjector pen.

    Number of subjects in period 1
    Erenumab 70 mg/140 mg
    Started
    1406
    Dose switch from Baseline dose
    504 [1]
    Completed
    1353
    Not completed
    53
         Adverse event, serious fatal
    1
         Consent withdrawn by subject
    39
         Lost to follow-up
    11
         Decision by sponsor
    2
    Notes
    [1] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Milestone includes only participants who switched from Baseline dose.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Erenumab 70 mg/140 mg
    Reporting group description
    Participants were enrolled into the Open-label Treatment Period and received erenumab 70 mg or 140 mg administered subcutaneously (SC) once every 4 weeks (Q4W) at the discretion of the investigator. Per protocol, dose switching between erenumab 70 mg and 140 mg was permitted at Week 12. However, participants could switch dose before or after Week 12 if needed based on investigator discretion. Dose comparison was not pre-specified.

    Reporting group values
    Erenumab 70 mg/140 mg Total
    Number of subjects
    1406 1406
    Age categorical
    Units: Subjects
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    42.5 ± 11.9 -
    Sex: Female, Male
    Units:
        Female
    1228 1228
        Male
    178 178
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    22 22
        Not Hispanic or Latino
    1384 1384
        Unknown or Not Reported
    0 0
    Race/Ethnicity, Customized
    Units: Subjects
        American Indian or Alaska Native
    2 2
        Asian
    17 17
        Black or African American
    2 2
        Multiple
    9 9
        Native Hawaiian or Other Pacific Islander
    0 0
        White
    1353 1353
        Other
    23 23
    MMDs During the Baseline Period
    A migraine day was defined as a calendar day (00:00 to 23:59) in which the participant reported any migraine headache or took any triptan-based acute migraine-specific medication. Monthly migraine days were calculated as the number of migraine days in the 4 - 5 week Baseline Period.
    Units: days / month
        arithmetic mean (standard deviation)
    12.82 ± 5.92 -

    End points

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    End points reporting groups
    Reporting group title
    Erenumab 70 mg/140 mg
    Reporting group description
    Participants were enrolled into the Open-label Treatment Period and received erenumab 70 mg or 140 mg administered subcutaneously (SC) once every 4 weeks (Q4W) at the discretion of the investigator. Per protocol, dose switching between erenumab 70 mg and 140 mg was permitted at Week 12. However, participants could switch dose before or after Week 12 if needed based on investigator discretion. Dose comparison was not pre-specified.

    Primary: Percentage of Participants Achieving at Least a 50% Reduction From Baseline in Mean Monthly Migraine Days Over Months 4, 5, and 6 in relation to mPRS

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    End point title
    Percentage of Participants Achieving at Least a 50% Reduction From Baseline in Mean Monthly Migraine Days Over Months 4, 5, and 6 in relation to mPRS [1]
    End point description
    A migraine day was defined as a calendar day (00:00 to 23:59) in which the participant reports any migraine headache or takes any triptan-based acute migraine-specific medication. At least a 50% reduction from Baseline in monthly migraine days was determined if: (average number of migraine days per month during the last 3 months [months 4, 5, and 6] of the 24-week Open-label Treatment Period minus number of migraine days during the 4-week Baseline Period) / number of migraine days during the 4-week Baseline Period * 100, was less than or equal to -50%. The odds ratio of achieving ≥ 50% reduction from Baseline in mean MMD over months 4, 5, and 6 in relation to mPRS was 1.01 (95% confidence interval = 0.90, 1.13; p = 0.86).
    End point type
    Primary
    End point timeframe
    4-week Baseline Period and the last 3 months (Months 4, 5, and 6) of the 24-week Open-label Treatment Period
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Additional statistics added to endpoint description due to system limitations inhibiting presentation for single arm studies.
    End point values
    Erenumab 70 mg/140 mg
    Number of subjects analysed
    1368 [2]
    Units: percentage of participants
        number (confidence interval 95%)
    54.9 (52.22 to 57.56)
    Notes
    [2] - EAS: participants in FAS who received at least 1 dose of investigational product.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to 24 weeks
    Adverse event reporting additional description
    All-cause mortality is reported for all participants enrolled/randomized in the study. Serious adverse events and other adverse events are reported for all participants who received at least one dose of study drug.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.1
    Reporting groups
    Reporting group title
    Erenumab 70 mg
    Reporting group description
    Participants who were initially enrolled into the Open-label Treatment Period and received erenumab 70 mg administered SC Q4W at the discretion of the investigator.

    Reporting group title
    Erenumab 140 mg
    Reporting group description
    Participants who were initially enrolled into the Open-label Treatment Period and received erenumab 140 mg administered SC Q4W at the discretion of the investigator.

    Reporting group title
    Erenumab 140 mg Switch to 70 mg
    Reporting group description
    Participants who initially received erenumab 140 mg administered SC Q4W and were dose switched to erenumab 70 mg per investigation's discretion.

    Reporting group title
    Erenumab 70 mg Switch to 140 mg
    Reporting group description
    Participants who initially received erenumab 70 mg administered SC Q4W and were dose switched to erenumab 140 mg per investigation's discretion.

    Serious adverse events
    Erenumab 70 mg Erenumab 140 mg Erenumab 140 mg Switch to 70 mg Erenumab 70 mg Switch to 140 mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 214 (3.74%)
    14 / 688 (2.03%)
    1 / 7 (14.29%)
    8 / 497 (1.61%)
         number of deaths (all causes)
    1
    0
    0
    0
         number of deaths resulting from adverse events
    Vascular disorders
    Raynaud's phenomenon
         subjects affected / exposed
    0 / 214 (0.00%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    1 / 497 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Abortion spontaneous
         subjects affected / exposed
    1 / 214 (0.47%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    0 / 214 (0.00%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    1 / 497 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    1 / 214 (0.47%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Suicidal ideation
         subjects affected / exposed
    0 / 214 (0.00%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    1 / 497 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Suicide attempt
         subjects affected / exposed
    1 / 214 (0.47%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    1 / 497 (0.20%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Ankle fracture
         subjects affected / exposed
    1 / 214 (0.47%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Upper limb fracture
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 214 (0.47%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumothorax traumatic
         subjects affected / exposed
    0 / 214 (0.00%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    1 / 497 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Wound
         subjects affected / exposed
    0 / 214 (0.00%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    1 / 497 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Coronary artery disease
         subjects affected / exposed
    0 / 214 (0.00%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    1 / 497 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Paraesthesia
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychogenic seizure
         subjects affected / exposed
    0 / 214 (0.00%)
    0 / 688 (0.00%)
    1 / 7 (14.29%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sensory disturbance
         subjects affected / exposed
    0 / 214 (0.00%)
    2 / 688 (0.29%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Pancreatitis haemorrhagic
         subjects affected / exposed
    1 / 214 (0.47%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Inflammatory bowel disease
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal colic
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    0 / 497 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    COVID-19
         subjects affected / exposed
    1 / 214 (0.47%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    1 / 497 (0.20%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    1 / 214 (0.47%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    2 / 497 (0.40%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Erenumab 70 mg Erenumab 140 mg Erenumab 140 mg Switch to 70 mg Erenumab 70 mg Switch to 140 mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    172 / 214 (80.37%)
    417 / 688 (60.61%)
    7 / 7 (100.00%)
    391 / 497 (78.67%)
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    12 / 214 (5.61%)
    12 / 688 (1.74%)
    0 / 7 (0.00%)
    18 / 497 (3.62%)
         occurrences all number
    13
    14
    0
    18
    Migraine
         subjects affected / exposed
    6 / 214 (2.80%)
    14 / 688 (2.03%)
    1 / 7 (14.29%)
    8 / 497 (1.61%)
         occurrences all number
    6
    15
    1
    9
    Psychogenic seizure
         subjects affected / exposed
    0 / 214 (0.00%)
    0 / 688 (0.00%)
    1 / 7 (14.29%)
    0 / 497 (0.00%)
         occurrences all number
    0
    0
    2
    0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    15 / 214 (7.01%)
    47 / 688 (6.83%)
    0 / 7 (0.00%)
    37 / 497 (7.44%)
         occurrences all number
    15
    53
    0
    42
    Influenza like illness
         subjects affected / exposed
    12 / 214 (5.61%)
    14 / 688 (2.03%)
    0 / 7 (0.00%)
    16 / 497 (3.22%)
         occurrences all number
    14
    17
    0
    16
    Injection site bruising
         subjects affected / exposed
    9 / 214 (4.21%)
    0 / 688 (0.00%)
    0 / 7 (0.00%)
    34 / 497 (6.84%)
         occurrences all number
    10
    0
    0
    38
    Injection site erythema
         subjects affected / exposed
    20 / 214 (9.35%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    36 / 497 (7.24%)
         occurrences all number
    20
    1
    0
    38
    Injection site pruritus
         subjects affected / exposed
    1 / 214 (0.47%)
    2 / 688 (0.29%)
    1 / 7 (14.29%)
    7 / 497 (1.41%)
         occurrences all number
    1
    3
    1
    8
    Pyrexia
         subjects affected / exposed
    4 / 214 (1.87%)
    5 / 688 (0.73%)
    1 / 7 (14.29%)
    6 / 497 (1.21%)
         occurrences all number
    4
    5
    1
    6
    Immune system disorders
    Immunisation reaction
         subjects affected / exposed
    17 / 214 (7.94%)
    1 / 688 (0.15%)
    0 / 7 (0.00%)
    35 / 497 (7.04%)
         occurrences all number
    25
    2
    0
    54
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    92 / 214 (42.99%)
    280 / 688 (40.70%)
    5 / 7 (71.43%)
    193 / 497 (38.83%)
         occurrences all number
    95
    286
    5
    206
    Gastrooesophageal reflux disease
         subjects affected / exposed
    7 / 214 (3.27%)
    7 / 688 (1.02%)
    1 / 7 (14.29%)
    2 / 497 (0.40%)
         occurrences all number
    7
    7
    1
    2
    Irritable bowel syndrome
         subjects affected / exposed
    0 / 214 (0.00%)
    1 / 688 (0.15%)
    1 / 7 (14.29%)
    1 / 497 (0.20%)
         occurrences all number
    0
    1
    1
    1
    Skin and subcutaneous tissue disorders
    Night sweats
         subjects affected / exposed
    1 / 214 (0.47%)
    0 / 688 (0.00%)
    1 / 7 (14.29%)
    0 / 497 (0.00%)
         occurrences all number
    1
    0
    1
    0
    Alopecia
         subjects affected / exposed
    37 / 214 (17.29%)
    72 / 688 (10.47%)
    1 / 7 (14.29%)
    71 / 497 (14.29%)
         occurrences all number
    37
    72
    1
    71
    Pruritus
         subjects affected / exposed
    5 / 214 (2.34%)
    33 / 688 (4.80%)
    3 / 7 (42.86%)
    9 / 497 (1.81%)
         occurrences all number
    6
    34
    4
    10
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    15 / 214 (7.01%)
    3 / 688 (0.44%)
    0 / 7 (0.00%)
    14 / 497 (2.82%)
         occurrences all number
    15
    3
    0
    14
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    12 / 214 (5.61%)
    3 / 688 (0.44%)
    0 / 7 (0.00%)
    12 / 497 (2.41%)
         occurrences all number
    12
    3
    0
    12
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    21 / 214 (9.81%)
    17 / 688 (2.47%)
    0 / 7 (0.00%)
    76 / 497 (15.29%)
         occurrences all number
    24
    20
    0
    83
    Nasopharyngitis
         subjects affected / exposed
    10 / 214 (4.67%)
    15 / 688 (2.18%)
    0 / 7 (0.00%)
    35 / 497 (7.04%)
         occurrences all number
    10
    15
    0
    36
    Conjunctivitis
         subjects affected / exposed
    0 / 214 (0.00%)
    2 / 688 (0.29%)
    1 / 7 (14.29%)
    1 / 497 (0.20%)
         occurrences all number
    0
    2
    1
    1
    COVID-19
         subjects affected / exposed
    49 / 214 (22.90%)
    57 / 688 (8.28%)
    1 / 7 (14.29%)
    103 / 497 (20.72%)
         occurrences all number
    52
    57
    1
    105

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 Feb 2021
    - The Screening and Baseline Periods were separated. - Statistical analyses were updated. - Notes were added to the schedule of assessments (SOA) to clarify activities. - Optional substudy assessments were put under separate SOA. - References to some exploratory objectives were removed. - Benefit risk-assessment language was updated to reflect current assessments. - End of study language edited to reflect current template format. - Added exclusion criteria 215: “Initiation, discontinuation, or change of dosing of migraine prophylactic medications within 2 months prior to the start of the baseline period, during the baseline period or planned during the study”. - Screen failure and rescreening language updated: a subject may be rescreened once if in the opinion of the investigator, the reason for the initial screen failure has been resolved or is no longer applicable. - Excluded treatments, medical devices, and/or procedures during the study period sections were updated. - Hepatotoxicity sections were removed per template language regarding it as optional.
    23 Feb 2022
    - Reduced the sample size from 2000 participants to 1400 participants throughout the protocol as the study centers were not able to achieve the enrollment target and it was determined that a lower sample would still provide sufficient analytical power. - Updated sample size determination to align with the sample size. - Updated section on serious adverse events after the protocol-required reporting period, product complaints, adverse device effect definition, serious adverse event reporting by electronic data collection tool as per the latest template text.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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