Non-invasive Neurostimulation of the Vagus Nerve for the Treatment of Cluster Headache

NCT ID: NCT01792817

Last Updated: 2019-12-17

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-02-28

Study Completion Date

2014-10-31

Brief Summary

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Multi-center, prospective, double-blind, randomized, sham-controlled pivotal study of non-invasive vagus nerve stimulation with the GammaCore® device for the acute treatment of cluster headache. The study compares the safety and effectiveness of an active treatment (GammaCore) against a sham treatment.

Detailed Description

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Phase 1: Prospective, randomized (1:1 active treatment:sham control allocation), double blinded, sham controlled treatment (active or sham) phase

Phase 2: Prospective, non-randomized, active treatment phase.

Phase 1 - Two Arms:

1. Active Treatment with the GammaCore Device
2. Sham Treatment with a placebo device

Phase 2 - One Arm:

Active Treatment with the GammaCore Device

Conditions

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Cluster Headache

Keywords

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Cluster Headache GammaCore vagal nerve stimulation nVNS VNS non invasive vagus nerve stimulation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Sham GammaCore device

The Sham GammaCore device looks and operates like the Active GammaCore device, but does not deliver a therapeutic stimulation treatment.

Group Type SHAM_COMPARATOR

Sham GammaCore device

Intervention Type DEVICE

Treatment with sham stimulator

GammaCore Device

Non-Invasive Vagus Nerve Stimulator

Group Type EXPERIMENTAL

GammaCore

Intervention Type DEVICE

Treatment with active gammacore vagus nerve stimulator

Interventions

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GammaCore

Treatment with active gammacore vagus nerve stimulator

Intervention Type DEVICE

Sham GammaCore device

Treatment with sham stimulator

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Is between the ages of 18 and 75 years.
2. Has been diagnosed with cluster headache, in accordance with the ICHD-2

Classification criteria (2ndEd):

o At least 5 attacks fulfilling the following criteria:
* Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 minutes if untreated
* Headache is accompanied by at least 1 of the following:
* Ipsilateral conjunctival injection and/or lacrimation
* Ipsilateral nasal congestion and/or rhinorrhea
* Ipsilateral eyelid edema
* Ipsilateral forehead and facial sweating
* Ipsilateral miosis and/or ptosis
* A sense of restlessness or agitation
3. currently experiencing cluster headaches, and from clinical history is expected to continue experiencing cluster headaches for a period of at least 4 weeks.
4. able to distinguish CH from other headaches (i.e. migraine, tension-type headaches).
5. capable of completing headache pain self-assessments.
6. \[Intentionally left blank\].
7. Agrees to use the GammaCore device as intended and follow all of the requirements of the study, including follow-up visit requirements.
8. Agrees to record usage of the GammaCore device, all required study data, and report any adverse device effects to the study center within 24 hours of any such adverse device effects.
9. able to provide written Informed Consent

Exclusion Criteria

1. had surgery to treat cluster headache.
2. currently taking prophylactic medication (including chronic opioids and non-prescribed street drugs) for indications other than CH that in the opinion of the clinician may interfere with the study.
3. \[Intentionally left blank\].
4. undergone botulinum toxin injections in the head and/or neck in the last 3 months or nerve blocks (occipital or other) in the head or neck in the last month.
5. history of aneurysm, intracranial hemorrhage, brain tumors or significant head trauma.
6. lesion (including lymphadenopathy), dysaesthesia, previous surgery or abnormal anatomy at the treatment site.
7. structural intracranial, or cervical vascular lesions that may potentially cause headache attacks.
8. other significant pain problem (including cancer pain, fibromyalgia, and trigeminal neuralgia/TAC-cluster) that might confound the study assessments.
9. known or suspected severe atherosclerotic cardiovascular disease, severe carotid artery disease (e.g. bruits or history of TIA or CVA), congestive heart failure (CHF), known severe coronary artery disease or recent myocardial infarction.
10. history of prolonged QT interval or a history of clinically significant arrhythmia.
11. abnormal baseline ECG (e.g. second and third degree heart block, atrial fibrillation, atrial flutter, recent history of ventricular tachycardia or ventricular fibrillation, or clinically significant premature ventricular contraction).
12. previous bilateral or right cervical vagotomy.
13. uncontrolled high blood pressure.
14. currently implanted with an electrical and/or neurostimulator device, including but not limited to cardiac pacemaker or defibrillator, vagal neurostimulator, deep brain stimulator, spinal stimulator, bone growth stimulator, or cochlear implant.
15. history of carotid endarterectomy or vascular neck surgery on the right side.
16. implanted with metal cervical spine hardware or has a metallic implant near the GammaCore stimulation site.
17. recent or repeated history of syncope.
18. recent or repeated history of seizure.
19. known history or suspicion of substance abuse or addiction, or overuse of acute headache medication for headaches other than CH.
20. psychiatric or cognitive disorder and/or behavioral problems which in the opinion of the clinician may interfere with the study.
21. pregnant, nursing, thinking of becoming pregnant in the next 4 months, or of childbearing years and is unwilling to use an accepted form of birth control.
22. participating in any other therapeutic clinical investigation or has participated in a clinical trial in the preceding 30 days.
23. Belongs to a vulnerable population or has any condition such that his or her ability to provide informed consent, comply with follow-up requirements, or provide self-assessments is compromised
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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ElectroCore INC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lia Spitzer

Role: STUDY_DIRECTOR

ElectroCore INC

Locations

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California Medical Clinic for Headache

Santa Monica, California, United States

Site Status

Stanford University Medical Center

Stanford, California, United States

Site Status

Colorado Neurological Institute

Englewood, Colorado, United States

Site Status

Associated Neurologists of Southern Connecticut

Fairfield, Connecticut, United States

Site Status

Tampa General Hospital Headache Center

Tampa, Florida, United States

Site Status

Diamond Headache Clinic

Chicago, Illinois, United States

Site Status

University of Iowa Hospital and Clinics

Iowa City, Iowa, United States

Site Status

Norton Neurology

Louisville, Kentucky, United States

Site Status

Mid-Atlantic Headache Institute

Pikesville, Maryland, United States

Site Status

New England Regional Headache Center

Worcester, Massachusetts, United States

Site Status

Michigan Head Pain & Neurological Institute

Ann Arbor, Michigan, United States

Site Status

Headache Care Center

Springfield, Missouri, United States

Site Status

Dent Neurologic Institute

Amherst, New York, United States

Site Status

Montefiore Headache Center

New York, New York, United States

Site Status

Center for Headache Care and Research at Island Neurological Associates, PC

Plainview, New York, United States

Site Status

Carolina Headache Institute

Chapel Hill, North Carolina, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Jefferson Headache Center

Philadelphia, Pennsylvania, United States

Site Status

UT Southwestern Medical Center

Dallas, Texas, United States

Site Status

West Virginia University Dept of Neurology

Morgantown, West Virginia, United States

Site Status

Countries

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United States

References

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de Coo IF, Marin JC, Silberstein SD, Friedman DI, Gaul C, McClure CK, Tyagi A, Liebler E, Tepper SJ, Ferrari MD, Goadsby PJ. Differential efficacy of non-invasive vagus nerve stimulation for the acute treatment of episodic and chronic cluster headache: A meta-analysis. Cephalalgia. 2019 Jul;39(8):967-977. doi: 10.1177/0333102419856607. Epub 2019 Jun 10.

Reference Type DERIVED
PMID: 31246132 (View on PubMed)

Silberstein SD, Mechtler LL, Kudrow DB, Calhoun AH, McClure C, Saper JR, Liebler EJ, Rubenstein Engel E, Tepper SJ; ACT1 Study Group. Non-Invasive Vagus Nerve Stimulation for the ACute Treatment of Cluster Headache: Findings From the Randomized, Double-Blind, Sham-Controlled ACT1 Study. Headache. 2016 Sep;56(8):1317-32. doi: 10.1111/head.12896.

Reference Type DERIVED
PMID: 27593728 (View on PubMed)

Other Identifiers

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CH-US-01

Identifier Type: -

Identifier Source: org_study_id