An Acute Migraine Factorial Study

NCT06245902 | Completed Phase 2 FDA Drug

• 1 other identifier: ANODYNE-1 Version 1.3
• Study Type: interventional
• Target: 92
• Locations: 1 country
• Sites: 1

Brief Summary

The study consists of a screening visit, out-patient treatment of a moderate or severe migraine attack with a single dose of the study medication within 8 weeks, and End-of-Study Visit 2-7 days after dosing.

Conditions

Migraine With or Without Aura

Keywords

Migraine Disorders

Outcome Measures

Primary Outcomes (3)

• % of patients reporting no headache pain.

  Self-reported headache pain on a four-point Likert scale.

  2 hours post-dose

• % of patients having absence of most bothersome migraine-associated symptom (MBS).

  MBS was prospectively identified at baseline. Self-reported MBS as present or absent.

  2 hours post-dose

• % of patients who have "sustained pain freedom"

  Defined as having no headache pain at 2 hours after dose, with no use of rescue medication and no relapse of headache pain within 24 hours after administration of the investigational drug.

  24-hour post-dose.

Secondary Outcomes (3)

• % of patients having absence of nausea, photophobia, phonophobia, and neck/shoulder pain

  24-hour post-dose.

• % of patients who used rescue medications

  2-24 hours

• % of patients who had headache pain relapse.

  2-48 hours

Other Outcomes (1)

• % of patients who experienced adverse events

  48 hours

Study Arms (5)

Naltrexone and Acetaminophen

EXPERIMENTAL

Patients take one capsule containing naltrexone and one capsule containing acetaminophen together for a qualifying migraine

Drug: Naltrexone and Acetaminophen

Naltrexon/Acetaminophen-High Capsules

EXPERIMENTAL

Patient take one capsule containing naltrexone (high dose) and one capsule containing acetaminophen together for a qualifying migraine

Drug: Naltrexone and Acetaminophen-High Dose

Naltrexone Alone Capsules

ACTIVE COMPARATOR

Patient take one capsule containing naltrexone and one capsule containing placebo together for a qualifying migraine

Drug: Naltrexone Alone (regular dose)

Acetaminophen Alone Capsules

ACTIVE COMPARATOR

Patient take one capsule containing naltrexone and one capsule containing placebo together for a qualifying migraine

Drug: Acetaminophen Alone

Placebo Capsules

PLACEBO COMPARATOR

Patient take two capsule containing placebo together for a qualifying migraine

Drug: Matching Placebo

Interventions

Naltrexone and Acetaminophen DRUG

Naltrexone plus acetaminophen

Naltrexone and Acetaminophen

Naltrexone and Acetaminophen-High Dose DRUG

Naltrexon (high dose) plus acetaminophen

Naltrexon/Acetaminophen-High Capsules

Naltrexone Alone (regular dose) DRUG

Naltrexone Alone plus Placebo

Naltrexone Alone Capsules

Acetaminophen Alone DRUG

Acetaminophen Alone plus Placebo

Acetaminophen Alone Capsules

Matching Placebo DRUG

Two Placebo capsules

Placebo Capsules

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male or female 18 years of age or older.
• History of migraine with or without aura according to the International Classification of Headache Disorders (ICHD)-3rd edition (beta version) for at least one-year with first migraine prior to age 50.
• Migraine-associated nausea with ≥half of migraine attacks.
• migraines per month in each of the previous 3 months.
• The patient is able to complete study questionnaires, comply with the study requirements and restrictions, and willing to provide written informed consent and authorize HIPAA.
• The female patient who is premenopausal or postmenopausal less than 1 year, or have not had surgical sterilization (i.e., tubal ligation, partial or complete hysterectomy) must have a negative urine pregnancy test, be non-lactating, and commit to using adequate and reliable contraception throughout the study (e.g., barrier with additional spermicidal, intra-uterine device, hormonal contraception). The male patient must be surgically sterile or commit to the use of 2 different methods of birth control during the study and for 28 days after taking the study drug.

You may not qualify if:

• The patient in the opinion of the investigator, may have medication-overuse headache pain (as defined by ICHD - 3 beta criteria for medication-overuse headache), (analgesic, opioid, ergotamine or triptan overuse) during the 3 months preceding screening.
• The patient in the opinion of the investigator has chronic migraine (as defined by ICHD - 3 beta criteria for chronic migraine).
• History of cluster headache or neurologically complicated migraine (hemiplegic, basilar, retinal, ophthalmoplegic migraine).
• Any concurrent medical or psychiatric condition, this includes, but is not limited to chronic unstable debilitating diseases, significant renal or hepatic impairment.
• A history within the previous 3 years of abuse of any drug, prescription, illicit, or alcohol.
• The Female patient is pregnant or breast-feeding. The Male patient is not practicing 2 different methods of birth control with their partner during the study, and for 28 days after the investigational drug last dose or will not remain abstinent during the study, and for 28 days after the last dose.
• Use of opiates or barbiturates more than 3 days per month.
• Known-hypersensitivity reaction to any of the components of the investigational drug.
• Consumption of analgesic medication for other conditions on a regular basis, (nonsteroidal anti-inflammatory drugs, or acetaminophen, or muscle relaxants).
• Use of emergency care treatment more than 3 times in the previous 6 months.
• Participation in another study with an investigational drug within 30 days prior to randomization and/or a plan to participate during the study.

Sponsors & Collaborators

• Allodynic Therapeutics, Inc: lead

Study Sites (1)

Annette C. Toledano MD

North Miami, Florida, 33181, United States

Location

Related Publications (11)

• Wang X, Zhang Y, Peng Y, Hutchinson MR, Rice KC, Yin H, Watkins LR. Pharmacological characterization of the opioid inactive isomers (+)-naltrexone and (+)-naloxone as antagonists of toll-like receptor 4. Br J Pharmacol. 2016 Mar;173(5):856-69. doi: 10.1111/bph.13394. Epub 2016 Feb 4.

  PMID: 26603732 RESULT

• Kato J, Svensson CI. Role of extracellular damage-associated molecular pattern molecules (DAMPs) as mediators of persistent pain. Prog Mol Biol Transl Sci. 2015;131:251-79. doi: 10.1016/bs.pmbts.2014.11.014. Epub 2015 Jan 30.

  PMID: 25744676 RESULT

• Lewis SS, Loram LC, Hutchinson MR, Li CM, Zhang Y, Maier SF, Huang Y, Rice KC, Watkins LR. (+)-naloxone, an opioid-inactive toll-like receptor 4 signaling inhibitor, reverses multiple models of chronic neuropathic pain in rats. J Pain. 2012 May;13(5):498-506. doi: 10.1016/j.jpain.2012.02.005. Epub 2012 Apr 20.

  PMID: 22520687 RESULT

• Watkins LR, Hutchinson MR, Ledeboer A, Wieseler-Frank J, Milligan ED, Maier SF. Norman Cousins Lecture. Glia as the "bad guys": implications for improving clinical pain control and the clinical utility of opioids. Brain Behav Immun. 2007 Feb;21(2):131-46. doi: 10.1016/j.bbi.2006.10.011. Epub 2006 Dec 18.

  PMID: 17175134 RESULT

• Hutchinson MR, Zhang Y, Brown K, Coats BD, Shridhar M, Sholar PW, Patel SJ, Crysdale NY, Harrison JA, Maier SF, Rice KC, Watkins LR. Non-stereoselective reversal of neuropathic pain by naloxone and naltrexone: involvement of toll-like receptor 4 (TLR4). Eur J Neurosci. 2008 Jul;28(1):20-9. doi: 10.1111/j.1460-9568.2008.06321.x.

  PMID: 18662331 RESULT

• Wieseler J, Ellis A, McFadden A, Stone K, Brown K, Cady S, Bastos LF, Sprunger D, Rezvani N, Johnson K, Rice KC, Maier SF, Watkins LR. Supradural inflammatory soup in awake and freely moving rats induces facial allodynia that is blocked by putative immune modulators. Brain Res. 2017 Jun 1;1664:87-94. doi: 10.1016/j.brainres.2017.03.011. Epub 2017 Mar 16.

  PMID: 28322750 RESULT

• Su M, Ran Y, He Z, Zhang M, Hu G, Tang W, Zhao D, Yu S. Inhibition of toll-like receptor 4 alleviates hyperalgesia induced by acute dural inflammation in experimental migraine. Mol Pain. 2018 Jan-Dec;14:1744806918754612. doi: 10.1177/1744806918754612. Epub 2018 Jan 8.

  PMID: 29310498 RESULT

• Dewall CN, Macdonald G, Webster GD, Masten CL, Baumeister RF, Powell C, Combs D, Schurtz DR, Stillman TF, Tice DM, Eisenberger NI. Acetaminophen reduces social pain: behavioral and neural evidence. Psychol Sci. 2010 Jul;21(7):931-7. doi: 10.1177/0956797610374741. Epub 2010 Jun 14.

  PMID: 20548058 RESULT

• Younger J, Mackey S. Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study. Pain Med. 2009 May-Jun;10(4):663-72. doi: 10.1111/j.1526-4637.2009.00613.x. Epub 2009 Apr 22.

  PMID: 19453963 RESULT

• Lipton RB, Baggish JS, Stewart WF, Codispoti JR, Fu M. Efficacy and safety of acetaminophen in the treatment of migraine: results of a randomized, double-blind, placebo-controlled, population-based study. Arch Intern Med. 2000 Dec 11-25;160(22):3486-92. doi: 10.1001/archinte.160.22.3486.

  PMID: 11112243 RESULT

• Kaki AM, El-Yaski AZ, Youseif E. Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale. Reg Anesth Pain Med. 2005 Sep-Oct;30(5):422-8. doi: 10.1016/j.rapm.2005.05.013.

  PMID: 16135345 RESULT

Related Links

• 2009-2013 Pain Research Advances \| Interagency Pain ...Thus, identifying potential new medications is critical. Recent evidence indicates a pivotal role for the receptor known as toll-like receptor 4 (TLR4 ...

MeSH Terms

Conditions

Migraine Disorders

Interventions

Naltrexone; Acetaminophen

Condition Hierarchy (Ancestors)

Headache Disorders, Primary; Headache Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Naloxone; Morphinans; Opiate Alkaloids; Alkaloids; Heterocyclic Compounds; Heterocyclic Compounds, Bridged-Ring; Heterocyclic Compounds, 4 or More Rings; Heterocyclic Compounds, Fused-Ring; Phenanthrenes; Polycyclic Aromatic Hydrocarbons; Polycyclic Compounds; Acetanilides; Anilides; Amides; Organic Chemicals; Aniline Compounds; Amines

Study Officials

• Annette C Toledano, M.D.

  Allodynic Therapeutics, Inc

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Factorial Design
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 30, 2024
• First Posted: February 7, 2024
• Study Start: February 18, 2017
• Primary Completion: February 8, 2018
• Study Completion: February 8, 2018
• Last Updated: February 7, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)