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    Summary
    EudraCT Number:2022-001176-34
    Sponsor's Protocol Code Number:BHV3000-407
    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:2023-01-16
    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 number2022-001176-34
    A.3Full title of the trial
    BHV3000-407: A Phase 4, Randomized, Doubleblind, Placebo-controlled Study to Evaluate the Efficacy and Tolerability of Rimegepant for the Prevention of Migraine in Adults with a History of Inadequate Response to Oral Preventive Medications.
    BHV3000-407: Estudio en fase IV, aleatorizado, doble ciego, controlado con placebo, para evaluar la eficacia y tolerabilidad de rimegepant para la prevención de la migraña en adultos con antecedentes de respuesta inadecuada a medicamentos preventivos orales.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Study to Evaluate the Efficacy and Tolerability of Rimegepant for the Prevention of Migraine in Adults with a History of Inadequate Response to other Oral Preventive Medications.
    Un Estudio para evaluar la eficacia y tolerabilidad de rimegepant para la prevención de la migraña en adultos con antecedentes de respuesta inadecuada a medicamentos preventivos orales.
    A.4.1Sponsor's protocol code numberBHV3000-407
    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 supportPfizer
    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 pointLisa Rana
    B.5.3 Address:
    B.5.3.1Street Address215 Church Street
    B.5.3.2Town/ cityNew Haven
    B.5.3.3Post code06510
    B.5.3.4CountryUnited States
    B.5.4Telephone number0018603912300
    B.5.6E-maillisa.rana@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 Yes
    D.2.1.1.1Trade name Vydura
    D.2.1.1.2Name of the Marketing Authorisation holderBiohaven Pharmaceutical Ireland DAC
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    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 sulfate
    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 1374024-48-2
    D.3.9.2Current sponsor codeBHV-3000
    D.3.9.3Other descriptive nameRimegepant sulfate
    D.3.9.4EV Substance CodeSUB215832
    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
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    migraine headaches with or without aura
    Migraña con o sin aura
    E.1.1.1Medical condition in easily understood language
    accute and episodic migraine with or without aura
    migraña aguda y episódica con o sin aura
    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 PT
    E.1.2Classification code 10027599
    E.1.2Term 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 compare the efficacy of rimegepant to placebo as an EOD dosing regimen for prophylaxis in adults with a history of inadequate response to agents across 2-4 categories of recognized, orally-administered migraine preventive medications as measured by the mean reduction from the Observation Phase in the number of migraine days per month (28 days) over the entire DBT Phase.
    Comparar la eficacia de rimegepant con placebo como pauta posológica C/2D para la profilaxis en adultos con antecedentes de respuesta inadecuada a fármacos en 2-4 categorías de medicamentos preventivos para la migraña administrados por vía oral reconocidos, medidos por la reducción media de la fase de observación en el número de días con migraña al mes (1 mes = 28 días) durante toda la fase de TDC.
    E.2.2Secondary objectives of the trial
    Key Secondary Objectives:
    1. To compare the proportion of subjects with ≥ 50% reduction from the Observation Phase in the number of migraine days of moderate or severe headache pain intensity per month over the entire DBT Phase (Weeks 1 to 12) between rimegepant and placebo.
    2. To compare the mean reduction from the Observation Phase in the number of migraine days per month in the first 4 weeks of the DBT Phase between rimegepant and placebo.
    3. To compare the mean reduction from the Observation Phase in the number of migraine days per month in the last 4 weeks of the DBT Phase between rimegepant and placebo.
    4. To compare the mean change from baseline in the Migraine-Specific Quality-of-Life Questionnaire v 2.1 (MSQ) restrictive role function domain score at Week 12 of the DBT Phase between rimegepant and placebo.
    5. To compare the mean change from baseline in Migraine Interictal Burden Scale (MIBS) score at Week 12 of the DBT Phase between rimegepant and placebo.
    1.Comparar la proporción de pacientes con ≥50 % de reducción desde la fase de observación en el número de días con migraña de intensidad del dolor de cabeza moderada o grave por mes durante toda la fase de TDC (semanas 1 a 12) entre rimegepant y placebo. 2.Comparar la reducción media desde la fase de observación en el número de días con migraña al mes en las primeras 4 semanas de la fase de TDC entre rimegepant y placebo. 3.Comparar la reducción media desde la fase de observación en el número de días con migraña al mes en las últimas 4 semanas de la fase de TDC entre rimegepant y placebo. 4. Comparar el cambio medio desde el inicio en el cuestionario de calidad de vida específico para la migraña v 2.1 (MSQ v 2.1) en la puntuación de la función de rol restrictiva en la semana 12 de la fase de TDC entre rimegepant y placebo. 5.Comparar el cambio medio desde el inicio en la puntuación de la escala MIBS en la semana 12 de la fase de TDC entre rimegepant y placebo.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1) Signed Written Informed Consent:
    a) Written informed consent must be obtained from the subject in accordance with requirements of the study center’s institutional review board
    (IRB) or ethics committee, prior to the initiation of any protocol-required procedures
    b) Subjects must agree to provide all requested demographic information as required by local regulations (i.e., year of birth, sex at birth, ethnicity
    race)
    c) Subjects must be able to read and communicate with site staff.
    2) Target Population:
    Minimum 1 year documented history of migraines (with or without aura) consistent with a diagnosis according to the International Classification of Headache Disorders, 3rd Edition.3 Per self-report, with confirmation from Investigator / supporting medical record, subjects must have:
    a) Migraine attacks present for more than 1 year from the Screening Visit
    b) Age of onset prior to 50 years of age
    c) Migraine attacks lasting about 4–72 hours, if untreated
    d) 4 to 14 migraine days, on average, across the 3 months prior to the Screening Visit
    e) 4 to 14 migraine days during the 28-day Observation Phase
    f) Subjects must be able to distinguish migraine attacks from tension/cluster headaches
    g) Prior inadequate response, within 10 years of the Screening Visit, to agents across 2-4 categories of recognized, orally-administered migraine-preventive medications where at least one example of prior inadequate response is due to lack of efficacy or prior intolerance (not contraindication)
    3) Age and Reproductive Status:
    a) Male and female subjects 18-65 years-old
    b) Women of childbearing potential (WOCBP) with non-sterile male partners, and non-sterile males with female partners of childbearing potential using two acceptable methods of contraception (with at least 1 highly effective)
    c) At the Baseline Visit, prior to dispensing investigational study drug, WOCBP must have a negative pregnancy test (minimum sensitivity 25 IU/L or equivalent units of HCG) before dosing with study drug.
    1) Consentimiento informado por escrito firmado

    a) Debe obtenerse el consentimiento informado por escrito del paciente de acuerdo con los requisitos del Comité de Ética de Investigación Clínica (CEIC) del centro del estudio, antes de iniciar cualquier procedimiento requerido por el protocolo.

    b) Los pacientes deben aceptar proporcionar toda la información demográfica solicitada según lo exijan las normativas locales (es decir, año de nacimiento, sexo en el momento del nacimiento, etnia y raza).

    c) Los pacientes deben ser capaces de leer y comunicarse con el personal del centro.

    2) Población objetivo

    Antecedentes documentados de migrañas durante un mínimo de 1 año (con o sin aura) coherentes con un diagnóstico según la Clasificación Internacional de Trastornos de la Cefalea, 3.a edición.
    Según autoinforme, con confirmación del investigador/registro de medicación de apoyo, los pacientes deben tener:

    a) Crisis de migraña presentes durante más de 1 año desde la visita de selección

    b) Edad de inicio antes de los 50 años de edad

    c) Los ataques de migraña, de media, duran entre 4 y 72 horas si no se tratan.

    d) De 4 a 14 días con migraña al mes (de acuerdo con los criterios ICHD-3) de media en los 3 meses anteriores a la visita de selección (el mes se define como 28 días para los fines de este protocolo).

    e) 4 a 14 días con migraña durante la fase de observación de 28 días

    f) Los pacientes deben ser capaces de distinguir los ataques de migraña de las cefaleas en racimo/tensión.

    g) Respuesta inadecuada previa, dentro de los 10 años anteriores a la visita de selección, a fármacos de entre 2-4 categorías de medicamentos preventivos de la migraña reconocidos administrados por vía oral en los que al menos un ejemplo de respuesta inadecuada previa se debe a falta de eficacia o a intolerancia previa (sin contraindicación)

    3) Edad y estado reproductivo

    a) Pacientes de ambos sexos de 18 a 65 años de edad.

    b) Las mujeres en edad fértil (MEF) con parejas de sexo masculino no estériles y los hombres no estériles con parejas de sexo femenino en edad fértil deben utilizar dos métodos anticonceptivos (al menos 1 método altamente eficaz y 1 método adicional) para evitar el embarazo a lo largo del estudio de tal manera que se reduzca al mínimo el riesgo de embarazo (véase la sección 5.9, Mujeres en edad fértil).

    c) En la visita inicial, antes de dispensar el fármaco del estudio en investigación, las MEF deben tener una prueba de embarazo negativa (sensibilidad mínima 25 UI/l o unidades equivalentes de HCG) antes de que se les administre el fármaco del estudio
    E.4Principal exclusion criteria
    1. Target Disease Exclusion
    a) History of cluster headaches, basilar migraine (with aura), or hemiplegic migraine
    b) Current medication overuse headaches
    c) 15 or more headache days (migraine or non-migraine) per month in any of the 3-months prior to the Screening Visit or during the 28-day Observation Phase
    d) Inadequate response to agents across > 4 categories of recognized, orally administered, migraine-preventive medications
    2. Medical History and Current Diseases:
    a) History of gastric or small intestinal surgery or disease or conditions that causes malabsorption
    b) History or diagnosis of Gilbert’s Syndrome or any other active hepatic or biliary disorder
    c) History of HIV disease, gallstones or cholecystectomy
    e) BMI ≥ 33kg/m2
    f) Hematologic or solid malignancy diagnosis within 5 years prior to the Screening Visit.
    g) Alcohol or drug abuse within the past 12 months or subjects with any significant substance use disorder within the past 12 months from the date of the Screening Visit
    h) Current diagnosis of major depressive disorder requiring treatment with an atypical antipsychotic
    i) Current diagnosis of schizophrenia, bipolar disorder, or borderline personality disorder
    j) Other major psychiatric disorder that might interfere with the ability to properly report clinical outcomes
    k) Major depressive disorder or any anxiety disorder which requires more than 1 daily medication for each disorder.
    l) Major depressive episode within last 12 months prior to the Screening Visit.
    m) Subjects who meet criteria for C-SSRS Suicidal Ideation Items 4 or 5 within the last 12 months prior to the Screening Visit, OR subjects who endorse any of the 5 C-SSRS Suicidal Behavior Items within the last 10 years prior to the Screening Visit, OR subjects who present a serious risk of suicide
    n) Active chronic pain syndromes
    o) Other pain syndromes (including trigeminal neuralgia), dementia, significant neurological disorders other than migraine
    p) Current evidence of uncontrolled, unstable or recently diagnosed cardiovascular disease
    q) Myocardial infarction, acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), cardiac surgery, stroke or transient ischemic attack within 6 months prior to the Screening Visit
    r) Uncontrolled hypertension (high blood pressure).
    s) Any unstable medical conditions (e.g., history of congenital heart disease, arrhythmia, or cancer)
    t) History of acute hepatitis within 6 months of Screening or chronic hepatitis or a positive result on anti-hepatitis A immunoglobulin M (IgM) antibody, hepatitis B surface antigen (HbsAg), or anti-hepatitis C antibody testing at Screening
    u) Positive drug screen for drugs of abuse that in the Investigator’s judgment is medically significant, in that it would impact the safety of the subject or the interpretation of the study results.
    3. Allergies and Adverse Drug Reactions: History of drug or other allergy which, in the opinion of the investigator, makes the subject unsuitable for participation in the study.
    4. Sex and Reproductive Status:
    a) WOCBP who are unwilling or unable to use an acceptable contraceptive method or abstinence to avoid pregnancy for the entire study and for 60 days after the last dose of study drug.
    b) Women who are pregnant or breastfeeding, or with a positive pregnancy test at Screening Visit
    5. ECG and Laboratory Test Findings - as specified in the protocol.
    6. Prohibited Medications and Devices
    a) Recognized migraine-preventive medication taken within 30 days prior the Screening (with exceptions)
    b) Non-Narcotic Analgesics or paracetamol taken 15 days per month during the 3 months prior to the Screening Visit
    c) Any device for migraine prevention or treatment within 3 months prior to the Screening Visit
    d) Ergotamine taken 10 days per month on a regular basis for 3 months in the year prior to the Screening Visit
    e) Narcotic, such as opioid or barbiturate taken for 4 days per month during the 3 months prior to the Screening Visit
    7. Other:
    a) Prisoners or subjects who are involuntarily incarcerated
    b) Subjects who are compulsorily detained for treatment of either a psychiatric or physical illness
    c) Non-compliance with or inability to complete eDiary during Observation Phase. Subjects with less than 24 completed eDiary reports during 28 days in the Observation Phase
    d)Exposure to non-biological investigational agents within 30 days prior to the Screening
    e)Exposure to biological investigational agents within 6 months prior to the Screening
    f)Subjects who meet criteria for C-SSRS Suicidal Ideation Items 4 or 5 within the last 12 months
    g)Previous enrollment in any multiple dose BHV3000 (rimegepant) study. Subjects may be considered for BHV3000-407 if the subject participated in any of the following single-dose studies: BHV3000-301, BHV3000-302, BHV3000-303, but did not participate in any multiple dose rimegepant study.
    h)The subject is clinically unsuitable to participate
    1. Objetivo Exclusión: a)Antec. cefalea en racimos, migraña basilar (con aura) o migraña hemipléjica. b) Cefalea por abuso de medicamentos actuales. c)15 o más días de cefalea (migraña o no migraña) al mes en cualquiera de los 3 meses anteriores a la visita de selec. o durante la fase observ. de 28 días. d)Respuesta inadecuada a fármacos en >4 categorías de medicamentos reconocidos para la migraña administrados por vía oral.2.Antec. médicos y enfermedades actuales: a)Antec. cirugía gástrica o del intestino delgado u otra enfermedad que cause alabsorción.b)Antec. o diagnóstico de síndrome de Gilbert u otro trastorno hepático o biliar activo.c)Antec. enfermedad por VIH, cálculos biliares o colecistectomía. d)IMC ≥33 kg/m2.e)Diagnóstico de neoplasia maligna hematológica o sólida en los 5 años anteriores a la visita de selec. f)Indicios de abuso de alcohol o drogas en los últimos 12 meses o trastorno significativo por consumo de drogas en los últimos 12 meses antes de la visita de selec.g)Diagnóstico actual de trastorno depresivo mayor que requiere tratamiento con un antipsicótico atípico.h)Diagnóstico actual de esquizofrenia, trastorno bipolar o trastorno límite de la personalidad.i)Antec. o indicios actuales de trastorno psiquiátrico importante que pudiera interferir en la capacidad para notificar correctamente los resultados clínicos.j)Trastorno depresivo mayor o cualquier trastorno de ansiedad que requiera más de 1 medicamento diario para cada trastorno. k)Episodio depresivo mayor en los 12 meses anteriores a la visita de selec.l)3.Pac.que cumplan los criterios de los ítems 4 o 5 de ideación de suicidio de la C-SSRS en los 12 meses anteriores a la visita de selec. O pac. que confirmen cualquiera de los 5 ítems de comportamiento suicida de la C-SSRS en los 10 años anteriores a la visita de selec. O pac. que, en opinión del investigador, presenten un riesgo grave de suicidio.m)Síndrome de dolor crónico activo.n)Otros síndromes de dolor, demencia o trastornos neurológicos significativos distintos de la migraña. o)Evidencia actual de enfermedad cardiovascular no controlada, inestable o de diagnóstico reciente.p)Infarto de miocardio, síndrome coronario agudo, intervención coronaria percutánea, cirugía cardiaca, accidente cerebrovascular o accidente isquémico transitorio en los 6 meses anteriores a la visita de selec.q)Tensión arterial alta.r)Antec. o indicios actuales de cualquier afección médica inestable (p. ej., antecedentes de cardiopatía congénita, arritmia o cáncer).s)Antec. hepatitis aguda en los 6 meses anteriores a la selec. o hepatitis crónica o resultado positivo en anticuerpos de inmunoglobulina M (IgM) contra la hepatitis A, antígeno de superficie del virus de la hepatitis B (HBsAg) o en pruebas de anticuerpos contra la hepatitis C en la selec. 3.Alergias y reacciones adversas al fármaco: Antec. fármaco u otra alergia que, en opinión del investigador, haga que el paciente no sea apto para participar.4.Sexo y estado reproductivo: a)MEF, y hombres no estériles, que no estén dispuestos o no puedan utilizar los métodos anticonceptivos o la abstinencia para evitar el embarazo durante todo el periodo del estudio y durante 60 días.b)Mujeres embarazadas o en periodo de lactancia o con un resultado positivo en la prueba de embarazo en la visita de selec.5.Hallazgos en los ECG y los análisis clínicos: ver Prot.6.Medicamentos y dispositivos prohibidos: a)Medicación preventiva de la migraña reconocida tomada en los 30 días anteriores a la visita de selec. con excepciones.b)Analgésicos no opioides o paracetamol tomados 15 días al mes durante los 3 meses previos a la visita de selec.c)cualquier dispositivo para el tratamiento o la prevención de la migraña utilizado en los 3 meses anteriores a la visita de selec. d)Ergotamina tomada 10 días al mes de forma regular durante 3 meses en el año anterior a la visita de selec.e).Narcóticos, como opioides o barbitúricos tomados 4 días al mes los 3 meses previos a la visita de selec.7.Otros:a)Presos o pac.que están retenidos involuntariamente.b)Pac.que están forzosamente internados para el tratamiento de una enfermedad psiquiátrica o física.c)Incumplimiento/incapacidad para rellenar el diario electrónico durante la fase observ. Pac.con menos de 24 informes del diario electrónico completados durante 28 días en la fase observ.d).Exposición a fármacos en investigación no biológicos en los 30 días anteriores a la visita de selec.e)Exposición a agentes biológicos en investigación en los 6 meses anteriores a la visita de selec.f)Pac.que cumplan los criterios de los ítems 4 o 5 de ideación de suicidio de la C-SSRS en los 12 meses anteriores a la visita de selec.g)Inscripción previa en cualquier estudio de dosis múltiples de BHV3000 (rimegepant). Se puede tener en cuenta a los pac. para BHV3000-407 si participó en cualquiera de los estudios de dosis única: BHV3000-301, -302, -303, pero no participó en ningún de dosis múltiples de rimegepant.h)Es inadecuado para participar.
    E.5 End points
    E.5.1Primary end point(s)
    Mean change from the Observation Phase in the number of migraine days per month over the entire double-blind treatment (DBT) Phase.
    Cambio media de la fase de observación en el número de días con migraña al mes durante toda la fase de tratamiento doble-ciego (TDC).
    E.5.1.1Timepoint(s) of evaluation of this end point
    Weeks 1 to 12.
    Semanas 1 a 12.
    E.5.2Secondary end point(s)
    Key Secondary Endpoints
    1.Proportion of subjects with ≥ 50% reduction from the Observation Phase in the number of migraine days of moderate or severe headache pain intensity per month over the entire DBT Phase (Weeks 1 to 12).
    2.Mean change from the Observation Phase in the number of migraine days per month in the first 4 weeks (Weeks 1 to 4) of the DBT Phase.
    3.Mean change from the Observation Phase in the number of migraine days per month in the last 4 weeks (Weeks 9 to 12) of the DBT Phase.
    4.Mean change from baseline in the MSQ restrictive role function domain score at Week 12 of the DBT Phase.
    5.Mean change from baseline in the MIBS score at Week 12 of the DBT Phase.

    Other Secondary Endpoints:
    1.Number and percentage of subjects with AEs by intensity, SAEs, AEs leading to study drug discontinuation, and Grade 3 to 4 laboratory test abnormalities on treatment during the DBT Phase.
    2.Proportion of subjects with ≥ 50% reduction from the Observation Phase in the number of migraine days (regardless of headache pain intensity) per month over the entire DBT Phase (Weeks 1 to 12).
    3.Mean number of acute migraine-specific medication days per month in each month and over the entire DBT Phase (Weeks 1 to 12).
    4.Mean change from baseline in MIBS scores at Weeks 4, 8, and 12 in the DBT Phase.
    5.Mean change from baseline in the MSQ domain scores (restrictive role function domain, preventive role function domain, and emotional function domain) at Weeks 4, 8, and 12 in the DBT Phase.
    6.Mean change from baseline in the MFIQ scores (Physical Function, Usual Activities, Overall impact on Usual Activities, Social Function, and Emotional Function) in each month of the DBT Phase.
    7.Mean change from baseline in the WPAI – Migraine scores (absenteeism, presenteeism, work productivity and activity impairment) at Weeks 4, 8, and 12 in the DBT Phase.
    8.Mean change from baseline in the PGA score in each month of the DBT Phase.
    1. Comparar la proporción de pacientes con ≥50 % de reducción desde la fase de observación en el número de días con migraña de intensidad del dolor de cabeza moderada o grave por mes durante toda la fase de TDC (semanas 1 a 12) entre rimegepant y placebo.
    2. Comparar la reducción media desde la fase de observación en el número de días con migraña al mes en las primeras 4 semanas de la fase de TDC entre rimegepant y placebo.
    3. Comparar la reducción media desde la fase de observación en el número de días con migraña al mes en las últimas 4 semanas de la fase de TDC entre rimegepant y placebo.
    4. Comparar el cambio medio desde el inicio en el cuestionario de calidad de vida específico para la migraña v 2.1 (Migraine-Specific Quality-of-Life Questionnaire v 2.1, MSQ) en la puntuación de la función de rol restrictiva en la semana 12 de la fase de TDC entre rimegepant y placebo.
    5. Comparar el cambio medio desde el inicio en la puntuación de la escala de carga interictal de la migraña (Migraine Interictal Burden Scale, MIBS) en la semana 12 de la fase de TDC entre rimegepant y placebo.
    Otros objetivos secundarios
    1. Evaluar las frecuencias de acontecimientos adversos por intensidad, acontecimientos adversos graves, acontecimientos adversos que provocan la interrupción del fármaco del estudio y anomalías de grado 3 a 4 en los análisis clínicos durante la fase de TDC.
    2. Evaluar la proporción de pacientes con una reducción ≥50 % desde la fase de observación en el número de días con migraña (independientemente de la intensidad del dolor de cabeza) al mes durante toda la fase de TDC (semanas 1 a 12) con rimegepant y placebo.
    3. Evaluar el número medio de días con medicación específica para la migraña aguda al mes en cada mes y durante toda la fase de TDC con rimegepant y placebo.
    4. Evaluar el cambio medio desde el inicio en la puntuación de la escala de carga interictal de la migraña (MIBS) al mes durante la fase de TDC con rimegepant y placebo.
    5. Evaluar el cambio medio desde el inicio en las puntuaciones de los dominios de MSQ (dominio de función de rol restrictivo, dominio de función de rol preventivo y dominio de función emocional) a lo largo del tiempo en la fase de TDC con rimegepant y placebo.
    6. Evaluar el cambio medio desde el inicio en las puntuaciones del Cuestionario de impacto funcional de la migraña (Migraine Functional Questionnaire, MFIQ) (función física, actividades habituales, impacto general en las actividades habituales, función social y función emocional) a lo largo del tiempo en la fase de TDC con rimegepant y placebo.
    7. Evaluar el cambio medio desde el inicio en la productividad laboral y deterioro de la actividad (Work Productivity and Activity Impairment, WPAI): puntuaciones de migraña (absentismo, presentismo, productividad laboral y deterioro de la actividad) a lo largo del tiempo en la fase de TDC con rimegepant y placebo.
    8.Evaluar el cambio medio con respecto al inicio en la ), la Evaluación global del paciente (Patient Global Assessment, PGA): Puntuación de la migraña a lo largo del tiempo en la fase de TDC con rimegepant y placebo.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Weeks 1 to 12.
    Semanas 1 a 12
    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 No
    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 Yes
    E.6.13.1Other scope of the trial description
    tolerability
    tolerabilidad
    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) No
    E.7.4Therapeutic use (Phase IV) Yes
    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 No
    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 concerned11
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA76
    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
    Australia
    Canada
    Colombia
    Mexico
    United States
    Austria
    Finland
    France
    Poland
    Sweden
    Spain
    Germany
    Italy
    Belgium
    Denmark
    United Kingdom
    E.8.7Trial has a data monitoring committee No
    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
    the last visit of the last subject undergoing the trial
    Última visita del último paciente participante en el ensayo
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months9
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    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) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 592
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 40
    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 state55
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 379
    F.4.2.2In the whole clinical trial 632
    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)
    At the end of the study the sponsor will not continue to supply study drug to subjects or investigators, given that Vydura is already approved in Europe as of April 2022 and other alternatives are currently available for the preventive treatment of episodic migraine. The Investigator should ensure that the subject receives permitted acute migraine standard of care medication to appropriately treat the patient's condition.
    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 Decision2023-03-07
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2023-01-17
    P. End of Trial
    P.End of Trial StatusOngoing
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