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    Summary
    EudraCT Number:2020-003517-35
    Sponsor's Protocol Code Number:BHV3000-311
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-09-01
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2020-003517-35
    A.3Full title of the trial
    Phase 3, multicenter, randomized, double-blind, group sequential, placebo-controlled study to assess efficacy and safety of rimegepant for the treatment of migraine (with or without aura) in children and adolescents ≥ 6 to <18 years of age.
    Estudio en fase III multicéntrico, aleatorizado, doble ciego, en grupos secuenciales y controlado con placebo para evaluar la eficacia y la seguridad de rimegepant para el tratamiento de la migraña (con o sin aura) en niños y adolescentes de ≥6 años a <18 años
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Randomized study in children and adolescents with migraine: Acute Treatment
    Estudio aleatorizado en niños y adolescentes con migraña.
    A.4.1Sponsor's protocol code numberBHV3000-311
    A.5.4Other Identifiers
    Name:IND numberNumber:109,886
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorBiohaven Pharmaceuticals, Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportBiohaven Pharmaceuticals, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBiohaven Pharmaceuticals, Inc.
    B.5.2Functional name of contact pointTamara Noonan
    B.5.3 Address:
    B.5.3.1Street Address215 Church Street
    B.5.3.2Town/ cityNew Haven, CT
    B.5.3.3Post code06510
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1203 915 8492
    B.5.6E-mailtamara.noonan@biohavenpharma.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameRimegepant
    D.3.2Product code BHV-3000
    D.3.4Pharmaceutical form Orodispersible tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRimegepant
    D.3.9.1CAS number 1289023-67-1
    D.3.9.2Current sponsor codeBHV-3000
    D.3.9.3Other descriptive nameformerly BMS-927711
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameRimegepant
    D.3.2Product code BHV-3000
    D.3.4Pharmaceutical form Orodispersible tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNRimegepant
    D.3.9.1CAS number 1289023-67-1
    D.3.9.2Current sponsor codeBHV-3000
    D.3.9.3Other descriptive nameformerly BMS-927711
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number75
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboOrodispersible tablet
    D.8.4Route of administration of the placeboOral use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboOrodispersible tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Acute Migraine (with or without aura)
    Migraña aguda (con o sin aura)
    E.1.1.1Medical condition in easily understood language
    Migraine
    Migraña
    E.1.1.2Therapeutic area Diseases [C] - Nervous System Diseases [C10]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level HLT
    E.1.2Classification code 10027603
    E.1.2Term Migraine headaches
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10052787
    E.1.2Term Migraine without aura
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10027607
    E.1.2Term Migraine with aura
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10027599
    E.1.2Term Migraine
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10066635
    E.1.2Term Acute migraine
    E.1.2System Organ Class 10029205 - Nervous system disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the efficacy of rimegepant compared with placebo in the acute
    treatment of migraine in adolescent population (≥ 12 to < 18 years of age) as measured by pain freedom at two hours post-dose.
    Evaluar la eficacia de rimegepant, en comparación con placebo, en el tratamiento agudo de la migraña en población adolescente (≥ 12 a < 18 años de edad), medida por la ausencia de dolor dos horas después de la administración de la dosis.
    E.2.2Secondary objectives of the trial
    Key Secondary Objective:
    To evaluate the efficacy of rimegepant relative to placebo in the acute
    treatment of migraine in the combined population of children and
    adolescents (≥ 6 to < 18 years of age) as measured by pain freedom at
    two hours post-dose.

    For the list of the other Secondary Objectives please refer to the study protocol.
    Objetivo secundario principal:
    • Evaluar la eficacia de rimegepant, en comparación con placebo, en el tratamiento agudo de la migraña en la población combinada de niños y adolescentes (≥ 6 a < 18 años de edad), medida por la ausencia de dolor dos horas después de la administración de la dosis.

    Para la lista del resto de objetivos secundarios, por favor dirijase al protocolo del estudio
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Pharmacokinetic Sub-study:

    Children (≥ 6 to < 12 years of age) who opt to participate in this site-specific sub-study will receive a dose of rimegepant ODT (consistent with their assigned dose at randomization) after all EOT procedures have been performed. PK sampling will occur at 0.5 hour and 2 hours post dose and a trough sample at 4 to 6 hours post dose (actual time recorded). Details concerning the conduct of this sub-study will be described in a separate study manual.
    Subestudio farmacocinético:
    Los niños (≥ 6 a <12 años) que opten por participar en este subestudio específico del sitio recibirán una dosis de rimegepant ODT (consistente con la dosis asignada en la aleatorización) después de que se hayan realizado todos los procedimientos de EOT. El muestreo de PK se producirá a las 0,5 horas y 2 horas después de la dosis y una muestra mínima a las 4 a 6 horas después de la dosis (tiempo real registrado). Los detalles sobre la realización de este subestudio se describirán en un manual de estudio separado.


























































































    Los niños (≥ 6 a <12 años) que opten por participar en este subestudio específico del sitio recibirán una dosis de rimegepant ODT (consistente con la dosis asignada en la aleatorización) después de que se hayan realizado todos los procedimientos de EOT.

















































    El muestreo de PK se producirá a las 0,5 horas y 2 horas después de la dosis y una muestra mínima entre 4 y 6 horas después de la dosis (tiempo real registrado).

















































    Los detalles sobre la realización de este subestudio se describirán en un manual de estudio separado.











































    Subestudio farmacocinético:



























































































    Los niños (≥ 6 a <12 años) que opten por participar en este subestudio específico del sitio recibirán una dosis de rimegepant ODT (consistente con la dosis asignada en la aleatorización) después de que se hayan realizado todos los procedimientos de EOT.

















































    El muestreo de PK se producirá a las 0,5 horas y 2 horas después de la dosis y una muestra mínima entre 4 y 6 horas después de la dosis (tiempo real registrado).

















































    Los detalles sobre la realización de este subestudio se describirán en un manual de estudio separado.










































    Subestudio farmacocinético:

    Los niños (≥ 6 a <12 años) que opten por participar en este subestudio específico del sitio recibirán una dosis de rimegepant ODT (consistente con la dosis asignada en la aleatorización) después de que se hayan realizado todos los procedimientos de EOT. El muestreo de PK se producirá a las 0,5 horas y 2 horas después de la dosis y una muestra mínima entre 4 y 6 horas después de la dosis (tiempo real registrado). Los detalles sobre la realización de este subestudio se describirán en un manual de estudio separado.
    E.3Principal inclusion criteria
    1. Signed Written Informed Consent:
    a. The participant must be capable of communicating with the site personnel;
    b. The participant is able to understand the Informed Assent Form (IAF) and the
    participant’s parent(s)/legal representative(s) (according to local regulations) are/is able to read and understand the Informed Consent Form (ICF);
    c. The participant has signed the IAF and the participant’s parent(s)/legal representative(s) (according to local regulations) have/has signed the ICF prior to the conduct of any study-specific procedures;
    d. The participant and the participant’s parent(s)/legal representative(s) (as required according to local regulations) are/is willing and able to attend study appointments within the specified time windows;
    e. The participant must be able to read and comprehend written instructions and be willing to complete all questionnaires under supervision of legal representative(s) as required by the protocol.

    2. Target Population:
    a. History of migraine (with or without aura) for > 6 months before Screening according to the IHS Classification ICHD-319 specifications for pediatric migraine. History may be verified using both medical records and recall by the participant and/or participant’s parent(s)/legal representative(s);
    b. History of 1 to 8 moderate or severe attacks per month during the 2 months prior to enrollment. A history of attacks lasting approximately > 3 hours without treatment. History may be verified using both medical records and recall by the participant and/or participant’s parent(s)/legal representative(s).
    c. Participants on prophylactic migraine medication are permitted to remain on therapy if the dose has been stable for at least 12 weeks prior to the Baseline Visit, and the dose is not expected to change during the course of the study;
    d. Participants are required to verbally distinguish between migraine and other types of headaches;
    e. Participants must have a weight > 40 kg (child cohort weight requirement > 15 kg) at the Screening Visit;
    f. Participants must have adequate venous access for blood sampling;


    3. Age and Reproductive Status
    a. Male and female participants ≥ 6 to < 18 years of age (participants must not reach their 18th birthday during the study);
    b. The participant, if a female who is sexually active and of childbearing potential (defined as females who have experienced menarche), or a male who is sexually active, must be willing to use one of the following acceptable methods of contraception to avoid pregnancy throughout the study and for 60 days after study drug administration in such a manner that the risk of pregnancy is minimized. See Section 5.6 for the definition of childbearing potential;
    c. The participant, if a female who has experienced menarche, must have a confirmed negative serum and urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of human chorionic gonadotropin [HCG]) at the Screening Visit and at Day 1 (respectively);
    d. Females must not be breastfeeding;
    e. No clinically significant abnormality identified on the medical or laboratory evaluation. A participant with a clinical abnormality or laboratory parameters outside the lab normal reference range may be included only if the investigator considers that the finding is not clinically significant and will not introduce additional risk factors and will not interfere with the study procedures.
    1. Consentimiento informado por escrito firmado
    a El participante debe poder comunicarse con el personal del sitio;
    b. El participante puede comprender el Formulario de asentimiento informado (IAF) y el
    los padres / representantes legales del participante (de acuerdo con las regulaciones locales) pueden leer y comprender el Formulario de consentimiento informado (ICF);
    c. El participante ha firmado el IAF y el padre (s) / representante (s) legal (de acuerdo con las regulaciones locales) han firmado el ICF antes de la realización de cualquier procedimiento específico del estudio;
    d. El participante y los padres / representantes legales del participante (según se requiera de acuerdo con las regulaciones locales) están dispuestos y pueden asistir a las citas de estudio dentro de las ventanas de tiempo especificadas;
    e. El participante debe poder leer y comprender las instrucciones escritas y estar dispuesto a completar todos los cuestionarios bajo la supervisión de un representante legal, según lo requiere el protocolo
    2. Población objetivo:
    una. Antecedentes de migraña (con o sin aura) durante > 6 meses antes de la selección de acuerdo con las especificaciones de clasificación ICHD-319 de IHS para migraña pediátrica. El historial puede ser verificado utilizando tanto los registros médicos como el recuerdo por parte del participante y/o los padres/representantes legales del participante;
    b. Historial de 1 a 8 ataques moderados o severos por mes durante los 2 meses previos a la inscripción. Antecedentes de ataques que duran aproximadamente > 3 horas sin tratamiento. El historial puede ser verificado utilizando tanto los registros médicos como el recuerdo por parte del participante y/o los padres/representantes legales del participante.
    C. Los participantes que toman medicamentos profilácticos para la migraña pueden continuar con la terapia si la dosis se ha mantenido estable durante al menos 12 semanas antes de la visita inicial y no se espera que la dosis cambie durante el transcurso del estudio;
    d. Se requiere que los participantes distingan verbalmente entre la migraña y otros tipos de dolores de cabeza;
    mi. Los participantes deben tener un peso > 40 kg (requisito de peso de la cohorte infantil > 15 kg) en la visita de selección;
    F. Los participantes deben tener un acceso venoso adecuado para la toma de muestras de sangre;


    3. Edad y estado reproductivo
    una. Participantes masculinos y femeninos de ≥ 6 a < 18 años de edad (los participantes no deben cumplir los 18 años durante el estudio);
    b. El participante, si es una mujer sexualmente activa y en edad fértil (definida como mujeres que han experimentado la menarquia) o un hombre sexualmente activo, debe estar dispuesto a usar uno de los siguientes métodos anticonceptivos aceptables para evitar el embarazo durante todo el estudio y durante 60 días después de la administración del fármaco del estudio de manera que se minimice el riesgo de embarazo. Consulte la Sección 5.6 para conocer la definición de capacidad de procrear;
    C. La participante, si es una mujer que ha experimentado la menarquia, debe tener una prueba de embarazo en suero y orina negativa confirmada (sensibilidad mínima de 25 UI/L o unidades equivalentes de gonadotropina coriónica humana [HCG]) en la visita de selección y en el día 1 (respectivamente) ;
    d. Las hembras no deben estar amamantando;
    mi. No se identificó ninguna anomalía clínicamente significativa en la evaluación médica o de laboratorio. Un participante con una anormalidad clínica o parámetros de laboratorio fuera del rango de referencia normal del laboratorio puede ser incluido solo si el investigador considera que el hallazgo no es clínicamente significativo y no introducirá factores de riesgo adicionales y no interferirá con los procedimientos del estudio.
    E.4Principal exclusion criteria
    1. Target Disease Exclusion:
    a. Participant has a history of cluster headache or hemiplegic migraine headache.
    b. The participant has a continuous migraine (defined as an unrelenting headache) during within 1 month prior to Screening Visit;
    c. The participant has a history or diagnosis of complicated migraine (ICHD-3 version, 2018), 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, or migraine with neurological accompaniments that are not typical of migraine aura (diplopia, altered consciousness, or long duration);
    d. The participant has a confounding and clinically significant pain syndrome that may interfere with the participant’s ability to participate in this study.
    2. Medical History and Concurrent Diseases
    a. The participant has any current psychiatric condition that is uncontrolled and/or untreated for a minimum of 6 months prior to the Screening Visit. Participants with a lifetime history of psychosis and/or mania are excluded;
    b. History of suicidal behavior or the participant is at risk of self-harm or harm to others;
    c. History of major psychiatric disorder. Participants with anxiety disorder and/or mild major depressive disorder are permitted in the study if they are considered by the investigator to be stable and are taking no more than 1 medication for each disorder.
    Participants must have been on a stable dose within the 3 months before the Baseline Visit;
    d. The participant has a current diagnosis or history of substance abuse (excluding nicotine and caffeine) or alcohol abuse (DSM-5® criteria) < 2 years prior to the Screening Visit, as verified with legal representative(s) and in the opinion of the Investigator;
    e. The participant has reported current use of, or has tested positive at the Screening visit for, drugs of abuse (amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, opiates, MDMA, methamphetamines, oxycodone, phencyclidine).
    f. The participant has a history of cancer.
    g. The participant has any other disorder for which the treatment takes priority over treatment of migraine or is likely to interfere with study treatment or safety assessments.
    h. The participant has a history of moderate or severe head trauma or other neurological disorder (including seizure disorder) or systemic medical disease that is, in the investigator’s opinion, likely to affect central nervous system functioning.
    i. The participant has had recent or planned surgery, requiring general anesthesia, <8 weeks prior to the Screening Visit.
    j. The participant has or has had one or more of the following conditions that is/are considered clinically relevant in the context of the study:
    - i. Uncontrolled hypertension
    - ii. Cardiovascular disease
    - iii. Cardiomyopathy
    - iv. Serious heart rhythm abnormalities
    - v. Cerebrovascular disease (for example CNS Vascular ischemia)
    - vi. Thromboembolic event
    - vii. Diabetes
    - viii. Raynaud’s disease
    - ix. Life-threatening allergy (for example anaphylaxis)
    k. The participant has had gastrointestinal surgery that interferes with physiological absorption and motility (i.e., gastric bypass, duodenectomy, or gastric banding).
    l. The participant has one or more clinically significant out-of-range vital signs at the Screening or Baseline Visit.
    m. The participant has a current diagnosis of viral hepatitis or a history of liver disease.
    n. The participant has tested positive for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), or human immunodeficiency virus (HIV) during the Screening Visit.
    3. Allergies and Adverse Drug Reactions
    a. The participant has a history of severe drug allergy or hypersensitivity or known hypersensitivity or intolerance to the excipients in rimegepant.
    b. The participant has a history of anaphylaxis, documented hypersensitivity reaction, or clinically significant reaction to any drug.
    4. ECG and Laboratory Test Findings
    a. Clinically significant abnormality identified on the medical or laboratory evaluation. A participant with a clinical abnormality or laboratory parameters outside the reference range may be included only if the investigator considers the finding not clinically significant, that it will not introduce additional risk factors, nor interfere with the study procedures.
    b. The participant has evidence of organ dysfunction or any clinically significant deviation from normal on physical examination, vital signs, 12-lead electrocardiogram (ECG), or clinical laboratory determinations beyond what is consistent with the target population.

    For the complete list of exclusion criteria please refer to the study protocol
    1. Exclusión de enfermedades diana:
    a. El participante tiene antecedentes de cefalea en racimos o migraña hemipléjica.
    B. El participante tiene una migraña continua (definida como un dolor de cabeza implacable) durante el mes anterior a la visita de selección;
    C. El participante tiene antecedentes o diagnóstico de migraña complicada (ICHD-3 versión, 2018), cefalea tensional crónica, cefalea hipnótica, cefalea en racimos, hemicránea continua, nueva cefalea persistente diaria o subtipos de migraña inusuales como migraña hemipléjica (esporádica y familiar), migraña oftalmopléjica o migraña con acompañamientos neurológicos que no son típicos del aura migrañosa (diplopía, alteración de la conciencia o larga duración);
    D. El participante tiene un síndrome de dolor confuso y clínicamente significativo que puede interferir con la capacidad del participante para participar en este estudio.
    2. Historia médica y enfermedades concurrentes
    una. El participante tiene alguna condición psiquiátrica actual que no está controlada y / o no se trata durante un mínimo de 6 meses antes de la visita de selección. Se excluyen los participantes con antecedentes de psicosis y / o manía de por vida;
    B. Historial de comportamiento suicida o el participante está en riesgo de autolesión o daño a otros;
    C. Historia de trastorno psiquiátrico mayor. Los participantes con trastorno de ansiedad y / o trastorno depresivo mayor leve pueden participar en el estudio si el investigador los considera estables y no toman más de 1 medicamento para cada trastorno.
    Los participantes deben haber recibido una dosis estable en los 3 meses anteriores a la visita inicial;
    D. El participante tiene un diagnóstico actual o historial de abuso de sustancias (excluyendo nicotina y cafeína) o abuso de alcohol (criterios DSM-5®) <2 años antes de la Visita de selección, según lo verificado con los representantes legales y en la opinión del Investigador;
    e. El participante ha informado el uso actual de, o ha dado positivo en la visita de selección de drogas de abuso (anfetaminas, barbitúricos, benzodiazepinas, cannabinoides, cocaína, metadona, opiáceos, MDMA, metanfetaminas, oxicodona, fenciclidina).
    F. El participante tiene antecedentes de cáncer.
    gramo. El participante tiene cualquier otro trastorno para el cual el tratamiento tiene prioridad sobre el tratamiento de la migraña o es probable que interfiera con el tratamiento del estudio o las evaluaciones de seguridad.
    h. El participante tiene antecedentes de traumatismo craneoencefálico moderado o grave u otro trastorno neurológico (incluido el trastorno convulsivo) o enfermedad médica sistémica que, en opinión del investigador, es probable que afecte el funcionamiento del sistema nervioso central.
    i. The participant has had recent or planned surgery, requiring general anesthesia, <8 weeks prior to the Screening Visit.
    j. The participant has or has had one or more of the following conditions that is/are considered clinically relevant in the context of the study:
    - i. Uncontrolled hypertension
    - ii. Cardiovascular disease
    - iii. Cardiomyopathy
    - iv. Serious heart rhythm abnormalities
    - v. Cerebrovascular disease (for example CNS Vascular ischemia)
    - vi. Thromboembolic event
    - vii. Diabetes
    - viii. Raynaud’s disease
    - ix. Life-threatening allergy (for example anaphylaxis)
    k. The participant has had gastrointestinal surgery that interferes with physiological absorption and motility (i.e., gastric bypass, duodenectomy, or gastric banding).
    l. The participant has one or more clinically significant out-of-range vital signs at the Screening or Baseline Visit.
    m. The participant has a current diagnosis of viral hepatitis or a history of liver disease.
    n. The participant has tested positive for hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (anti-HCV), or human immunodeficiency virus (HIV) during the Screening Visit.
    3. Allergies and Adverse Drug Reactions
    a. The participant has a history of severe drug allergy or hypersensitivity or known hypersensitivity or intolerance to the excipients in rimegepant.
    b. The participant has a history of anaphylaxis, documented hypersensitivity reaction, or clinically significant reaction to any drug.
    4. ECG and Laboratory Test Findings
    a. Clinically significant abnormality identified on the medical or laboratory evaluation. A participant with a clinical abnormality or laboratory parameters outside the reference range may be included only if the investigator considers the finding not clinically significant, that it will not introduce additional risk factors, nor interfere with the study procedures.
    b. The participant has evidence of organ dysfunction or any clinically significant deviation from normal on physical examination, vital signs, 12-lead electrocardiogram (ECG), or clinical laboratory determinations beyond what is consistent with the target population.
    For the complete list of exclusion criteria please refer to the protocol
    E.5 End points
    E.5.1Primary end point(s)
    Pain freedom will be assessed using the number of participants that report no pain at 2 hours post double-blind treatment dose measured on a 4-point numeric rating scale (0=none, 1=mild, 2=moderate, 3=severe) in adolescent population (≥ 12 to < 18 years of age).
    La ausencia de dolor se evaluará utilizando el número de participantes que no informan dolor a las 2 horas después de la dosis de tratamiento doble ciego medida en una escala de calificación numérica de 4 puntos (0 = ninguno, 1 = leve, 2 = moderado, 3 = severo) en población adolescente (≥ 12 a <18 años).
    E.5.1.1Timepoint(s) of evaluation of this end point
    2 hours post double-blind treatmemt
    2 horas después del tratamiento doble ciego
































    2 horas después del tratamiento doble ciego







































    2 horas después del tratamiento doble ciego
    E.5.2Secondary end point(s)
    Key secondary endpoint:

    - Pain freedom will be assessed using the number of participants that report no pain at 2 hours post double-blind treatment dose in the combined population of children and adolescents (≥ 6 to < 18 years of age). Participants with no pain are those who report 0 on the 4-point numeric scale in adolescents and who report Face 1 on the 5-Face VAS in children. 5-Face VAS in children are converted to 4 categories: Face 5 = ‘severe pain’, Faces 4 and 3 = ‘moderate pain’, Face 2 = ‘mild pain’, Face 1 = ‘no pain’.

    Other secondary endpoints:

    - Freedom from the most bothersome symptom (MBS) associated with migraine will be assessed using the number of participants that report the absence of their MBS at 2 hours post double-blind treatment dose in the adolescent population.

    - The probabilities of requiring rescue medication will be assessed using the numbers of participants that take rescue medication within 24 hours and within 48 hours after administration of double-blind treatment (rimegepant or placebo) in the adolescent population.

    - Sustained pain freedom, from 2 to 24 hours post double-blind treatment dose, will be assessed using the number of participants that do not use any rescue medications, and do not experience any headache pain through the time period of interest, in the adolescent population.

    - The proportion of participants able to function normally, at 2 hours post double-blind treatment dose, will be assessed using the number of participants that self-report as “normal” on the Functional Disability scale, in the adolescent population.

    - Pain freedom will be assessed using the number of participants that report no pain at 2 hours post double-blind treatment dose, measured by a 5-Face VAS.

    - Freedom from the most bothersome symptom (MBS) associated with migraine will be assessed using the number of participants that report the absence of their MBS at 2 hours post double-blind treatment dose in children and in the combined population of children and adolescents.

    . The probabilities of requiring rescue medication will be assessed using the numbers of participants that take rescue medication within 24 hours and within 48 hours after administration of double-blind study medication (rimegepant or placebo) in children and in the combined population of children and adolescents.

    - Sustained pain freedom, from 2 to 24 hours post double-blind treatment dose, will be assessed using the number of participants that do not use any rescue medications, and do not experience any headache pain through the time period of interest, in children and in the combined population of children and adolescents.

    - Freedom from photophobia will be assessed by tabulating the number of participants that report the absence of photophobia at 2 hours post double-blind treatment dose in the subset of participants that reported the presence of photophobia at headache baseline, in adolescents, children, and the combined population of children and adolescents.

    - Freedom from nausea will be assessed by tabulating the number of participants that report the absence of nausea at 2 hours post double-blind treatment dose in the subset of participants that reported the presence of nausea at headache baseline, in adolescents, children, and the combined population of children and adolescents.

    - Pain relief at 2 hours post double-blind treatment dose, will be assessed using the number of participants that report a pain level of moderate or severe at baseline and then report a pain level of none or mild at two hours post double-blind treatment dose in adolescents, children, and the combined population of children and adolescents.

    - Time to first report of pain relief will be based on the first time point a participant reports a pain level of none or mild post double-blind treatment dose, in adolescents, children, and the combined population of children and adolescents.
    Criterio de valoración secundario clave:

    - La ausencia de dolor se evaluará utilizando el número de participantes que no informan dolor a las 2 horas después de la dosis de tratamiento doble ciego en la población combinada de niños y adolescentes (≥ 6 a <18 años de edad). Los participantes sin dolor son aquellos que informan 0 en la escala numérica de 4 puntos en adolescentes y que informan Cara 1 en la EVA de 5 caras en niños. La EVA de 5 caras en niños se convierte en 4 categorías: Cara 5 = "dolor severo", Caras 4 y 3 = "dolor moderado", Cara 2 = "dolor leve", Cara 1 = "sin dolor".

    Otros criterios de valoración secundarios:

    - La ausencia del síntoma más molesto (MBS) asociado con la migraña se evaluará utilizando el número de participantes que informan la ausencia de su MBS 2 horas después de la dosis de tratamiento doble ciego en la población adolescente.

    - Las probabilidades de requerir medicación de rescate se evaluarán utilizando el número de participantes que toman medicación de rescate dentro de las 24 horas y dentro de las 48 horas posteriores a la administración del tratamiento doble ciego (rimegepant o placebo) en la población adolescente.

    - La ausencia de dolor sostenida, de 2 a 24 horas después de la dosis de tratamiento doble ciego, se evaluará utilizando el número de participantes que no usan ningún medicamento de rescate y no experimentan ningún dolor de cabeza durante el período de tiempo de interés, en el adolescente. población.

    - La proporción de participantes capaces de funcionar normalmente, a las 2 horas después de la dosis de tratamiento doble ciego, se evaluará utilizando el número de participantes que se autoinforman como “normales” en la escala de discapacidad funcional, en la población adolescente.

    - La ausencia de dolor se evaluará utilizando el número de participantes que no informan dolor a las 2 horas después de la dosis de tratamiento doble ciego, medido por un VAS de 5 caras.

    - La ausencia del síntoma más molesto (MBS) asociado con la migraña se evaluará utilizando el número de participantes que informan la ausencia de su MBS 2 horas después de la dosis de tratamiento doble ciego en niños y en la población combinada de niños y adolescentes.

    . Las probabilidades de requerir medicación de rescate se evaluarán utilizando el número de participantes que toman medicación de rescate dentro de las 24 horas y dentro de las 48 horas posteriores a la administración de la medicación del estudio doble ciego (rimegepant o placebo) en niños y en la población combinada de niños y adolescentes.

    - La ausencia de dolor sostenida, de 2 a 24 horas después de la dosis de tratamiento doble ciego, se evaluará utilizando la cantidad de participantes que no usan ningún medicamento de rescate y no experimentan ningún dolor de cabeza durante el período de tiempo de interés, en niños y en la población combinada de niños y adolescentes.
    E.5.2.1Timepoint(s) of evaluation of this end point
    2 hours post double-blind treatment dose for the key secondary endpoint.

    For timepoints for all the other secondar endpoints please refer to the list of endpoints
    Dos horas después de la dosis de tratamiento doble ciego para el criterio de valoración secundario clave.

    Para conocer los puntos de tiempo de todos los demás puntos finales secundarios, consulte la lista de puntos finales


























































































    Para conocer los puntos de tiempo de todos los demás puntos finales secundarios, consulte la lista de puntos finales
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Grupo secuencial
    Group sequential
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA27
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Canada
    Mexico
    United States
    Poland
    Sweden
    Spain
    Germany
    Hungary
    United Kingdom
    E.8.7Trial 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
    LVLS
    ultima visita del ultimo paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months3
    E.8.9.1In the Member State concerned days23
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months3
    E.8.9.2In all countries concerned by the trial days23
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 Yes
    F.1.1Number of subjects for this age range: 2100
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) Yes
    F.1.1.5.1Number of subjects for this age range: 354
    F.1.1.6Adolescents (12-17 years) Yes
    F.1.1.6.1Number of subjects for this age range: 1746
    F.1.2Adults (18-64 years) No
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state70
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 199
    F.4.2.2In the whole clinical trial 2100
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Participants will return to standard of care per local practice. Study drug will not be provided. Open-label study to assess the long-term safety and tolerability of rimegepant is planned to include a subset of sites participating in BHV3000-311.
    Los participantes volverán al estándar de atención según la práctica local. No se proporcionará el fármaco del estudio. Está previsto que un estudio de etiqueta abierta para evaluar la seguridad y tolerabilidad a largo plazo del rimegepant incluya un subconjunto de sitios que participan en BHV3000-311.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-06-02
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-05-27
    P. End of Trial
    P.End of Trial StatusOngoing
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