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Post-Traumatic HeadachePhase 2NCT03347188

A Study to Test if Fremanezumab Reduces Headache in Participants With Posttraumatic Headache (PTH)

A Phase 2 study testing Fremanezumab in people with Post-Traumatic Headache, run by Teva Branded Pharmaceutical Products R&D, Inc. at 33 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the safety and efficacy of fremanezumab in adult participants aged 18 to 70 years, inclusive, for the prevention of PTH. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Post-Traumatic Headache
What is being tested?
Fremanezumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
87 participants
Where
33 sitesUnited States
Study dates
18 Dec 2017to 3 Jun 2020
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • The participant has a body weight greater than or equal to (≥) 45 kilograms (kg).
  • Traumatic injury to the head has occurred, defined as a structural or functional injury resulting from the action of external forces.
  • The participant has a diagnosis of PTH.
  • The participant is not using preventive medications for headache.
  • Women of childbearing potential whose male partners are potentially fertile (that is, no vasectomy) must use highly effective birth control methods for the duration of the study and for 30 weeks after the last study drug administration. Men must be sterile or, if they are potentially fertile or reproductively competent (that is, not surgically or congenitally sterile) and their female partners are of childbearing potential, must use, together with their female partners, acceptable birth control methods for the duration of the study and for 30 weeks after the last study drug administration.
  • NOTE- Additional criteria apply, please contact the investigator for more information.

Who cannot join

  • The participant has a previous history of brain imaging showing evidence of intracerebral hemorrhage, subdural or epidural hematomas, or subarachnoid hemorrhage as a consequence of the traumatic head injury. Brain images with structurally insignificant changes, as discussed and approved by the sponsor, will be reviewed by the sponsor on a case-by-case basis.
  • The participant has PTH attributed to craniotomy.
  • The participant has whiplash and subsequent headache but no history of head injury or concussion.
  • The participant is using analgesic medications containing opioids (including codeine) or a barbiturate on average more than 15 days per month.
  • The participant has had exposure to a monoclonal antibody (mAb) targeting the calcitonin gene-related peptide (CGRP) pathway (erenumab, eptinezumab, galcanezumab, and fremanezumab) during the 6 months prior to the day of the screening visit.
  • The participant is currently being treated with onabotulinumtoxinA (for example, Botox, Dysport, Xeomin) application in the head or neck or received any such injection during the 3 months prior to the screening visit.
Show all 10Show fewer
  • The participant has been implanted with any electronic devices for headache prevention during the 3 months prior to the screening visit or is currently using any implanted or externally applied stimulator or device.
  • The participant has been treated with a nerve block for head and/or neck during the 3 months prior to the screening visit.
  • The participant is a pregnant or lactating woman or plans to become pregnant during the study.
  • NOTE- Additional criteria apply, please contact the investigator for more information.

Trial locations and contacts

33 sites in 1 country.

33 sites in 1 country

United States33 sites
  • Teva Investigational Site 14119

    Albany, New York, 12208

  • Teva Investigational Site 14229

    Amherst, New York, 14226

  • Teva Investigational Site 14055

    Dallas, Texas, 75390-8565

  • Teva Investigational Site 14114

    Durham, North Carolina, 27713

  • Teva Investigational Site 14045

    Fairfield, Connecticut, 06824

  • Teva Investigational Site 14067

    Indianapolis, Indiana, 46256

  • Teva Investigational Site 14051

    Kansas City, Missouri, 64128-2226

  • Teva Investigational Site 14048

    Little Rock, Arkansas, 72205

  • Teva Investigational Site 30236

    Little Rock, Arkansas, 72205

  • Teva Investigational Site 14052

    Long Beach, California, 90806

  • Teva Investigational Site 14053

    Los Angeles, California, 90073

  • Teva Investigational Site 14058

    Louisville, Kentucky, 40207

  • Teva Investigational Site 14063

    Miami, Florida, 33136

  • Teva Investigational Site 14044

    Morgantown, West Virginia, 26506

  • Teva Investigational Site 14230

    Nashville, Tennessee, 37203

  • Teva Investigational Site 14047

    New York, New York, 10021

  • Teva Investigational Site 14041

    North Miami, Florida, 33161

  • Teva Investigational Site 14064

    Philadelphia, Pennsylvania, 19107

  • Teva Investigational Site 14065

    Phoenix, Arizona, 85018

  • Teva Investigational Site 14040

    Pittsburgh, Pennsylvania, 15236

  • Teva Investigational Site 14049

    Portland, Oregon, 97225

  • Teva Investigational Site 14057

    Riverwoods, Illinois, 60015

  • Teva Investigational Site 14059

    Salisbury, North Carolina, 28144

  • Teva Investigational Site 14060

    San Diego, California, 92161

  • Teva Investigational Site 14054

    San Francisco, California, 94109

  • Teva Investigational Site 14069

    Scottsdale, Arizona, 85259-5452

  • Teva Investigational Site 14113

    Spokane, Washington, 99202

  • Teva Investigational Site 14043

    Springfield, Missouri, 65810

  • Teva Investigational Site 14046

    St Louis, Missouri, 63141

  • Teva Investigational Site 14056

    Tampa, Florida, 33609

  • Teva Investigational Site 14118

    The Bronx, New York, 10467

  • Teva Investigational Site 14050

    Waco, Texas, 76711

  • Teva Investigational Site 14061

    Waltham, Massachusetts, 02451

Other trials in United States

About this study

Official title: A Phase 2, Multicenter, Randomized, Proof-of-Concept, Double-Blind, Placebo-Controlled, Parallel-Group Study, Including an Open-Label Period, Evaluating the Efficacy and Safety of 1 Subcutaneous Dose Regimen of Fremanezumab for the Treatment of Posttraumatic Headache (PTH)

This is a multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the safety and efficacy of fremanezumab in adult participants aged 18 to 70 years, inclusive, for the prevention of PTH. The study will include a double-blind (DB) treatment period (12 weeks) and an open-label (OL) treatment period (12 weeks).

Being tested
Fremanezumab, Placebo
Keywords
posttraumatic headache (PTH)
Medical subject headings
Post-Traumatic Headache

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • FremanezumabDrug

    Also called TEV-48125

    Fremanezumab will be administered per dose and schedule specified in the arm.

  • PlaceboDrug

    Placebo matching to fremanezumab will be administered per schedule specified in the arm.

Study groups in NCT03347188
Study groupRoleWhat they receive
FremanezumabExperimentalParticipants will receive fremanezumab 675 milligrams (mg) administered as 3 subcutaneous (SC) injections (225 mg/1.5 milliliters [mL] each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who complete the DB treatment period and continue into the OL treatment period will receive fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at Weeks 12, 16, and 20 during the OL treatment period.
Receives: Drug: Fremanezumab
PlaceboPlacebo comparatorParticipants will receive placebo matching to fremanezumab administered as 3 SC injections (1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who complete the DB treatment period and continue into the OL treatment period will receive fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at Weeks 12, 16, and 20 during the OL treatment period.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. DB Period: Mean Change From Baseline in Monthly Average Number of Headache Days of at Least Moderate Severity During the 12-Week Treatment Period After the First Dose of Fremanezumab

    A headache day was defined as a day when a participant reported a headache of at least moderate severity. Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28. The change was calculated as post-baseline value - baseline value. Least square (LS) mean was calculated using analysis of covariance (ANCOVA) model with the duration of post traumatic headache history (less than 12 month since the brain injury or greater or equal to 12 month since the brain injury) and treatment as fixed effects and the baseline monthly average number of headache days of at least moderate severity as a covariate.

    Measured: Baseline (Day -28 to Day -1), up to Week 12

Secondary outcomes (14)
  1. DB Period: Number of Participants Reaching at Least 50% Reduction From Baseline in Monthly Average Number of Headache Days of Any Severity During 12-Week Treatment With Fremanezumab

    Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28.

    Measured: Baseline (Day -28 to Day-1) up to Week 12

  2. DB Period: Number of Participants Reaching at Least 50% Reduction From Baseline in the Monthly Average Number of Headache Days of at Least Moderate Severity During 12-Week Treatment With Fremanezumab

    A headache day was defined as a day when a participant reported a headache of at least moderate severity. Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28.

    Measured: Baseline (Day -28 to Day-1) up to Week 12

  3. DB Period: Number of Participants Reaching at Least 50% Reduction From Baseline in the Monthly Average Number of Headache Days of at Least Moderate Severity During First 4-Week (Month 1), 5- to 8-Week (Month 2), and 9- to 12-Week (Month 3)

    A headache day was defined as a day when a participant reported a headache of at least moderate severity. Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28.

    Measured: Baseline (Day -28 to Day-1) up to Months 1, 2, and 3

  4. DB Period: Change From Baseline in the Number of Headache Days of At Least Moderate Severity During the First 4-Week (Month 1), 5- to 8-Week (Month 2), and 9- to 12-Week (Month 3)

    A headache day was defined as a day when a participant reported a headache of at least moderate severity. Monthly averages were derived and normalized to 28 days equivalent by the following formula: (number of days of efficacy variable over relevant period/number of days with assessments recorded in the e-diary over the relevant period) * 28. The change was calculated as post-baseline value - baseline value. LS mean was calculated using ANCOVA model with the duration of post traumatic headache history (less than 12 month since the brain injury or greater or equal to 12 month since the brain injury) and treatment as fixed effects and the baseline monthly average number of headache days of at least moderate severity as a covariate. This approach was used in generating the LS mean values only and was not considered to be an additional statistical analysis, no additional statistical analyses are reported for this outcome measure.

    Measured: Baseline (Day -28 to Day -1), up to Months 1, 2, and 3

  5. DB Period: Change From Baseline in Disability Score, as Measured by the 6-Item Headache Impact Test (HIT-6) Total Score at Week 12 After the First Dose of Fremanezumab

    HIT-6 is a tool used to measure the impact headaches have on a participant's normal daily life and ability to function. The HIT-6 consists of 6 items, including pain, social functioning, role functioning, vitality, cognitive functioning, and psychological distress. Each item was answered on a 5-point Likert scale (6=never, 8=rarely, 10=sometimes, 11=very often, or 13=always), which were summed to produce a total score that ranged from 36 to 78, with larger scores reflecting greater impact of headache on the daily life of the participant.

    Measured: Baseline (Day -28 to Day -1), Week 12

  6. DB Period: Number of Participants (Responder and Non-Responder) With the Patient Global Impression of Change (PGIC) Scale at Weeks 4, 8, and 12 After the First Dose of Fremanezumab

    The PGIC scale is a validated generic tool for the assessment of overall change in the severity of illness following treatment. Participants rated how they felt during assigned time points compared with how they felt before receiving study drug on a 7-point scale, where 1 = No change (or it got worse); 2 = Almost the same, hardly any change at all; 3 = A little better, but no noticeable change; 4 = Somewhat better, but the change has not made any real difference; 5 = Moderately better, and a slight but noticeable change; 6 = Better, and a definite improvement that has made a real and worthwhile difference; and 7 = A great deal better, and a considerable improvement that has made all the difference. Responders were those with a scale of 5 to 7 and non-responders were those with a scale of 1 to 4.

    Measured: Weeks 4, 8, and 12

  7. DB Period: Number of Participants With Treatment-Emergent Adverse Events (TEAEs)

    An adverse event (AE) was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. TEAEs were defined as AEs occurring at or after the first dose of the study drug. Serious AEs were defined as death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.

    Measured: Baseline (Day -28 to -1) up to Week 12

  8. OL Period: Number of Participants With TEAEs

    An AE was defined as any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. TEAEs were defined as AEs occurring at or after the first dose of the study drug. Serious AEs were defined as death, a life-threatening AE, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.

    Measured: Week 12 up to Week 24

  9. DB Period: Number of Participants Who Did Not Complete the Study

    Number of participants who did not complete the study due to any reason and due to AEs are reported.

    Measured: Baseline (Day -28 to Day -1) up to Week 12

  10. OL Period: Number of Participants Who Did Not Complete the Study

    Number of participants who did not complete the study due to any reason and due to AEs are reported.

    Measured: Week 12 up to Week 24

  11. DB Period: Number of Participants Who Received Concomitant Medications

    Concomitant medications included: agents acting on renin-angiotensin system, analgesics, anesthetics, anti-parkinson drugs, antianemic preparations, antibacterials for systemic use, antidiarrheals, intestinal antiinflammatory/antiinfective agents, antiemetics and antinauseants, antiepileptics, antifungals for dermatologiocal use, antihistamines for systemic use, antihypertensives, antiinflammatory and antirheumatics, antineoplastic agents, antiobesity preparations, antipruritics, antithrombotics, antivirals for systemic use, beta blocking agents, calcium channel blockers, cardiac therapy, corticosteroids, cough and cold preparations, diuretics, lipid modifying agents, nasal preparations, thyroid therapy, urologicals, vaccines, psycholeptics, psycoanaleptics, ophthalmologicals, general nutrients, mineral supplements, muscle relaxants, vitamins, drugs used in diabetes, sex hormones and modulators of the genital system, immunosuppresants, drugs for acid related disorders etc.

    Measured: Baseline (Day -28 to Day -1) up to Week 12

  12. OL Period: Number of Participants Who Received Concomitant Medications

    Concomitant medications included: agents acting on renin-angiotensin system, analgesics, anti-parkinson drugs, antianemic preparations, antibacterials for systemic use, antiemetics and antinauseants, antihistamines for systemic use, antihypertensives, antiinflammatory and antirheumatics, antineoplastic agents, antithrombotics, beta blocking agents, calcium channel blockers, corticosteroids for systemic use, cough and cold preparations, diuretics, lipid modifying agents, nasal preparations, other gynecologicals, other nervous system drugs, thyroid therapy, unspecified herbal and traditional medicine, urologicals, vaccines, psycholeptics, psycoanaleptics, general nutrients, mineral supplements, muscle relaxants, vitamins, sex hormones and modulators of the genital system, drugs for acid related disorders, drugs for constipation, drugs for obstructive airways disease etc.

    Measured: Week 12 up to Week 24

  13. Number of Participants With Positive Findings on Electronic Columbia Suicide Severity Rating Scale (eC-SSRS)

    eC-SSRS is a questionnaire to assess suicidal ideation (severity and intensity) and behavior. Suicidal ideation: A series of 1 -5 questions (with 'yes' or 'no' response) with 5 types of ideation of increasing severity: 1. wish to be dead, 2. non-specific active suicidal thoughts, 3. active suicidal ideation with any methods (not plan) without intent to act, 4. active suicidal ideation with some intent to act, without specific plan, 5. active suicidal ideation with specific plan and intent. A positive finding was defined as a 'yes' response to question 4 or 5.

    Measured: Baseline (Day -28 to Day -1) up to Week 24

  14. Number of Participants With Treatment-Emergent Antidrug Antibodies (ADA)

    Number of participants with treatment-emergent antidrug antibodies reported.

    Measured: Baseline (Day -28 to Day -1) up to Week 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Nov 2017
  2. Study start18 Dec 2017
  3. Primary completion13 Mar 2020
  4. Study completion3 Jun 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
87 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03347188
Sponsor's protocol ID
TV48125-CNS-20024
Status last verified
Dec 2022
First submitted
14 Nov 2017
Last updated
13 Dec 2022
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No
Expanded access
Available

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Fremanezumab in people with Post-Traumatic Headache, run by Teva Branded Pharmaceutical Products R&D, Inc. at 33 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 33 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Mar 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

DB Period: Mean Change From Baseline in Monthly Average Number of Headache Days of at Least Moderate Severity During the 12-Week Treatment Period After the First Dose of Fremanezumab (time frame: Baseline (Day -28 to Day -1), up to Week 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Dec 2022.

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