E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Migraine in patients with unsuccessful prior preventive treatments |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Nervous System Diseases [C10] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10027599 |
E.1.2 | Term | Migraine |
E.1.2 | System Organ Class | 10029205 - Nervous system disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
• To evaluate the efficacy of eptinezumab for the prevention of migraine in patients with unsuccessful prior preventive treatments |
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E.2.2 | Secondary objectives of the trial |
• To evaluate the health-related quality of life and work productivity impact of eptinezumab
• To evaluate the effect of long-term treatment with eptinezumab |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• The patient has a diagnosis of migraine, with a history of chronic or episodic migraines of at least 12 months prior to the Screening Visit.
• The patient has a migraine onset of ≤50 years of age.
• The patient has ≥4 migraine days per month for each month within the past 3 months prior to the Screening Visit.
• The patient has demonstrated compliance with the Headache eDiary by entry of data for at least 24 of the 28 days following the Screening Visit.
• The patient fulfils the following criteria for chronic migraine (CM) or episodic migraine (EM) in prospectively collected information in the eDiary during the screening period:
– For patients with CM: Migraine occurring on ≥8 days and headache occurring on >14 days
– For patients with EM: Migraine occurring on ≥4 days and headache occurring on ≤14 days
• The patient has documented evidence of treatment failure (must be supported by medical record or by physician’s confirmation specific to each treatment) in the past 10 years of 2-4 different migraine preventive medications.
• The patient has a history of either previous or active use of triptans for migraine.
• The patient is aged ≥18 and ≤75 years at the Screening Visit.
Other inclusion criteria may apply. |
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E.4 | Principal exclusion criteria |
• The patient has experienced failure on a previous treatment targeting the calcitonin gene-related peptide (CGRP) pathway.
• The patient has a treatment failure on valproate/divalproex or botulinum toxin A/B and the treatment is not the latest preventive medication prior to study inclusion. The medication is regarded as the latest if the medication start date is after the start date of the other preventive medications and the medication stop date is after the stop date of the other preventive medications.
• The patient has confounding and clinically significant pain syndromes, (e.g. fibromyalgia, chronic low back pain, complex regional pain syndrome).
• The patient has a diagnosis of acute or active temporomandibular disorder.
• The patient has a history or diagnosis of chronic tension-type headache, hypnic headache, cluster headache, hemicrania continua, new daily persistent headache, or unusual migraine subtypes such as hemiplegic migraine (sporadic and familial), ophthalmoplegic migraine, and migraine with neurological accompaniments that are not typical of migraine aura (diplopia, altered consciousness, or long duration).
• The patient has a psychiatric condition that is uncontrolled and/or untreated for a minimum of 6 months prior to the Screening Visit. Patients with a lifetime history of psychosis and/or mania in the last 5 years prior to the Screening Visit are excluded.
• The patient has a history of clinically significant cardiovascular disease or vascular ischaemia or thromboembolic events (e.g. cerebrovascular accident, deep vein thrombosis, or pulmonary embolism).
Other exclusion criteria may apply. |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Change from baseline in the number of monthly migraine days |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. [Time Frame: From Baseline to Weeks 1-12] |
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E.5.2 | Secondary end point(s) |
2. Response: patients with 50% reduction from baseline in monthly migraine days
3. Change from baseline in the number of monthly migraine days
4. Response: patients with 75% reduction from baseline in monthly migraine days
5. Response: patients with 100% reduction from baseline in monthly migraine days
6. Response: patients with 50% reduction from baseline in monthly headache days
7. Response: patients with 75% reduction from baseline in monthly headache days
8. Response: patients with 100% reduction from baseline in monthly headache days
9. Change from baseline in the number of monthly headache days
10. Migraine/headaches with severe pain intensity
11. Change from baseline in the number of monthly migraine days with use of acute medication
12. Patient Global Impression of Change (PGIC) score. The PGIC is a patient-reported measure of improvement in pain sensation and quality of life scored on a scale from 1 (very much improved) to 7 (very much worse)
13. Change from baseline in the number of monthly migraine days in patients with Medication Overuse Headache (MOH)
14. Number of Patients with a migraine on the day after first dosing
15. Change in Most Bothersome Symptom (MBS) score. Patients will identify a migraine-related symptom that is most bothersome for them. Patients will be asked to rate the improvement in this symptom from screening on a 7-point scale. The pre-specified bothersome items are: nausea, vomiting, sensitivity to light, sensitivity with sound
16. Change from baseline in the Headache Impact Test (HIT-6) score
17. Change from baseline in the Migraine-Specific Quality of Life (MSQ v. 2.1) sub-scores
Sub-scores: Role Function-Restrictive, Role Function-Preventive, Emotional Function)
18. Change from baseline in the Health-Related Quality of Life (EQ-5D-5L) Visual Analogue Scale (VAS) score
19. Change from baseline in Health Care Resources Utilisation (HCRU) score
20. Change from baseline in work productivity as measured using the Work Productivity and Activity Impairment Questionnaire (WPAI) sub-scores
Sub-scores: (Absenteeism, Presenteeism, Work productivity loss, Activity impairment) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
2. [Time Frame: From Baseline to Weeks 1-12, Weeks 13-24, Weeks 25-36, Weeks 37-48, Weeks 49-60, Weeks 61-72]
3. [Time Frame: From Baseline to Weeks 13-24, Weeks 25-36, Weeks 37-48, Weeks 49-60, Weeks 61-72]
4. [Time Frame: From Baseline to Weeks 1-12, Weeks 13-24, Weeks 25-36, Weeks 37-48, Weeks 49-60, Weeks 61-72]
5, 6, 7, 8, 9, 10, 13, 15. [Time Frame: From Baseline to Weeks 1-12]
11. [Time Frame: From Baseline to Weeks 1-12, Weeks 13-24]
12. [Time Frame: At Week 12 and at Week 24]
14. [Time Frame: On the day after first dosing]
16. [Time Frame: From Baseline to Week 12 and from baseline to Week 24, at Weeks 36, 48, 60, and 72]
17, 18, 19, 20. [Time Frame: From Baseline to Week 12, from Baseline to Week 24] |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 19 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 80 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
United States |
Finland |
France |
Poland |
Sweden |
Bulgaria |
Spain |
Czechia |
Germany |
Italy |
Belgium |
Denmark |
Georgia |
Hungary |
Russian Federation |
Slovakia |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The overall end of the study is defined as the last protocol-specified contact with the last patient ongoing in the study. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 10 |