E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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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 |
In a real-world population of adults with migraine, we would like to investigate whether 50 mg diclifenac potassium (soluable) is non-inferior to 75 mg rimegepant in terms of pain freedom at 2 hours after drug intake |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Subject has provided informed consent prior to initiation of any study-specific activities/procedures. - Aged 18 to 65 years upon entry into screening - History of migraine (with or without aura) for greater than or equal to 12 months before screening according to the ICHD-32 criteria based on medical records and/or patient self-report. - Not more than 12 attack per month with moderate to severe headache pain in each of the previous 3 months |
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E.4 | Principal exclusion criteria |
· Greater than 50 years of age at migraine onset · History of cluster headache or hemiplegic migraine headache · Inability to differentiate between migraine from other headaches · Has taken medication for acute treatment of headache (including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), triptans, ergotamine, opioids, or combination analgesics) on 10 or more days per months in the previous 3 months · Has a history of migraine aura with diplopia or impairment of levels of consciousness, hemiplegic migraine, or retinal migraine. · Required hospital treatment of a migraine attack 3 or more timens in the previous 6 months
· The subject is at risk of self-harm or harm to others as evidenced by past suicidal behavior · Has a chronic non-headache pain condition requiring daily pain medication · Has a history of any prior gastrointestinal conditions (eg, diarrhea syndromes, inflammatory bowel disease) that may affect the absorption or metabolism of investigational product; participants with prior gastric bariatric interventions which have been reversed are not excluded. · Has a history of malignancy in the prior 5 years, except for adequately treated basal cell or squamous cell skin cancer, or in situ cervical cancer. · History or evidence of any other clinically significant disorder, condition or disease (except for those outlined above) that, in the opinion of the investigator would pose a risk to subject safety or interfere with the study evaluation, procedures or completion
· Start of new preventive migraine treatment within the last two months · Change in dosage of ongoing preventive migraine treatment within the last two months · Current preventive treatment with monoclonal antibodies targeting calcitonin gene related peptide (CGRP) or CGRP receptors, or current use of small-molecule CGRP receptor antagonist (e.g.erenumab, fremanezumab, galcanezumab, atogepant or rimegepant) · Changes in treatment with Selective serotonin reuptake inhibitors (SSRI) or serotonin norepinephrine reuptake inhibitors (SNRI) within the last two months
· Use of the following medication within 30 days prior to screening: Strong and moderate cytochrome P450 3A4 (CYP3A4) inhibitors, including but not limited to systemic (oral/IV) itraconazole, ketoconazole, fluconazole; erythromycin, clarithromycin, telithromycin; diltiazem, verapamil; aprepitant; cyclosporine; nefazodone; cimetidine; quinine; and HIV protease inhibitors. Strong and moderate CYP3A4 inducers, including but not limited to barbiturates (eg, phenobarbital and primidone), systemic (oral/IV) glucocorticoids, nevirapine, efavirenz, pioglitazone, carbamazepine, phenytoin, rifampin, rifabutin, and St. John’s wort. - Inhibitors of the BCRP (breast cancer resistance protein) transporter (eg, rifampicin) - Drugs with narrow therapeutic margins (eg, digoxin, warfarin) · Female subjects of childbearing potential with a positive pregnancy test assessed at screening or day 1 by a urine pregnancy test. · Female subject is pregnant or breastfeeding or planning to become pregnant or breastfeed during treatment and for an additional 16 weeks after the last dose of investigational product. · Female subjects of childbearing potential unwilling to use 1 acceptable method of effective contraception during treatment and for an additional 16 weeks after the last dose of investigational product. · Evidence of current pregnancy or breastfeeding per subject self-report or medical records · Subject has known sensitivity to any of the products or components to be administered during dosing. · Subject likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures (e.g, Clinical Outcome Assessments) to the best of the subject and investigator's knowledge |
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E.5 End points |
E.5.1 | Primary end point(s) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
2 hours after having taken the study medication |
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E.5.2 | Secondary end point(s) |
Exploratory endpoints: - Absence of the most bothersome symptom at 2 hours - Relapse - Headache intensity - Rescue medication - Global evaluation - Presence or absence of associated symptoms (nausea, photophobia, phonophobia): at the time trial treatment is administered, at the time of assessment of the primary efficacy outcome (e.g. 2 hours) and at 4, 8, 12, 24- and 48-hours post-dose - Adverse events |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Exploratory endpoints: - Absence of the most bothersome symptom: 2 hours post-dose - Relapse: 48 hours post-dose - Headache intensity: every 30 minutes until 2 hours after treatment; hourly until 4 hours after treatment; at 12, 24 and 48 hours after treatment; and at the time of relapse - Rescue medication: 2 hours post-dose - Global evaluation; 48 hours post-dose - Presence or absence of associated symptoms (nausea, photophobia, phonophobia): - Adverse events: any time |
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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 | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | No |
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) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |