Comparison of Ketorolac Nasal Spray to Sumatriptan Nasal Spray and Placebo for Acute Treatment of Migraine

NCT ID: NCT01807234

Last Updated: 2017-03-13

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE4
• Total Enrollment: 72 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2013-02-28
• Study Completion Date: 2014-12-31

Brief Summary

The investigators propose to test the efficacy of ketorolac nasal spray versus sumatriptan nasal spray versus placebo for acute abortive therapy of migraine head pain as well as for migraine associated symptoms including nausea and allodynia.

Detailed Description

Participants are randomized to Ketorolac NS 31.5 mg, Sumatriptan NS 20 mg or placebo to treat three moderate to severe migraine attacks and switched treatments with each attack so that they received each treatment only once.

For each treated attack (moderate to severe migraine attack), participants utilized two study treatments (A and B). Study treatment A administered as one spray in each nostril, and study treatment B administered as one spray in one nostril.

Randomized to Ketorolac, A=Ketorolac, B=Placebo Randomized to Sumatriptan, A=Placebo, B=Sumatriptan Randomized to Placebo, A=Placebo, B=Placebo

Conditions

Migraines

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Ketorolac/Placebo

Ketorolac 31.5 mg single dose nasal spray and Placebo

Group Type: EXPERIMENTAL

Ketorolac

Intervention Type: DRUG

Single dose of Ketorolac (Sprix) nasal spray 31.5 mg, one spray in each nostril for an acute migraine attack.

Placebo

Intervention Type: DRUG

Placebo one spray in each nostril and placebo one nasal spray.

Sumatriptan/Placebo

Sumatriptan 20 mg single dose nasal spray and placebo

Group Type: EXPERIMENTAL

Sumatriptan

Intervention Type: DRUG

Sumatriptan (Imitrex) 20 mg one single dose of nasal spray for an acute migraine attack.

Placebo

Intervention Type: DRUG

Placebo one spray in each nostril and placebo one nasal spray.

Ketorolac Placebo/Sumatriptan placebo

single dose Ketorolac placebo, single dose Sumatriptan placebo

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DRUG

Placebo one spray in each nostril and placebo one nasal spray.

Interventions

Ketorolac

Single dose of Ketorolac (Sprix) nasal spray 31.5 mg, one spray in each nostril for an acute migraine attack.

Intervention Type: DRUG

Sumatriptan

Sumatriptan (Imitrex) 20 mg one single dose of nasal spray for an acute migraine attack.

Intervention Type: DRUG

Placebo

Placebo one spray in each nostril and placebo one nasal spray.

Intervention Type: DRUG

Other Intervention Names

Sprix; Imitrex

Eligibility Criteria

Exclusion Criteria

At the Screening Visit, a subject must meet the following criteria to participate in this study:

1.18-65 years of age 2.Fulfills International Classification of Headache Disorders (ICHD)-II Criteria of migraine as noted below in Table 1 3.History of migraines for at least one year 4.Migraine onset prior to the age of 50 years of age 5.Headache frequency (of any headaches, migraine or non-migraine) < 9 days per month 6.At visit 2, participants must report two or more headache days during the 28-day run-in period on the headache diary. 7.At least 48 hours of freedom from headache between treated migraine attacks. 8.If currently using headache preventive medications, must be on a stable dose for at least 3 months prior to enrollment and throughout the study period and be on no more than one prophylactic agent. 9.Able to complete all study procedures, including the questionnaire (assessing demographics, headache characteristics, headache comorbidities and medical history at the initial visit and headache characteristics) and the required headache calendars, and all study visits; 10.Able to understand, read and sign an informed consent (English).

1. Any condition (history or presence of) which contraindicates the use of triptans or NSAIDs including:

• Known hypersensitivity or intolerance to triptans or NSAIDs
• Contraindications to triptan use (uncontrolled hypertension, ischemic heart disease, prinz-metal angina, cardiac arrhythmias, multiple risk factors for atherosclerotic vascular disease, primary vasculopathies, and basilar and hemiplegic migraine)
• Cerebrovascular disease except for mild non-specific white matter disease
• Peripheral vascular disease or any other ischemic disease including myocardial infarction
• Uncontrolled hypertension (systolic BP 160 mmHg or diastolic BP 95 mmHg or (both)
• Migraine aura fulfilling ICHD-II criteria for hemiplegic or basilar-type migraine
• Any history of chronic renal or hepatic impairment
• Use of an ergotamine-containing medication or monamine oxidase inhibitor
• Known or suspected pregnancy, negative pregnancy test
• Lactation
• Bleeding dsycrasias including gastritis, peptic ulcer disease,gastrointestinal bleeding

2. Physician diagnosis of any pain syndrome other than migraine

3. Classification as treatment resistant by investigator

4. Known drug or substance abuse

5. Any opioid use in past 2 months

6. Use of any medication, which could interfere with study assessments

7. History of noncompliance with taking medication;

8. Use of any experimental drug or device within 30 days prior to the Screening Visit (Visit 1);

9. Any abnormal finding or condition deemed clinically significant by the investigator on history, screening, or physical exam that contraindicates the use of triptans or NSAIDs or that might interfere with the patient's safety, study participation, or which might confound the interpretation of the study results.

10. Any history of chronic renal or hepatic disease already excluded above under number 1; plus see exclusion 9.

11. History of chronic pulmonary disorder including nasal polyps (see 1) and asthma.

12. History of upper respiratory infection or other respiratory tract condition that could interfere with the absorption of the nasal spray or with assessment of AEs including rhinitis medicamentosa (chronic daily use of topical decongestants).

13. History of nasal surgery.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

American Regent, Inc.

INDUSTRY

Sponsor Role: collaborator

Johns Hopkins University

OTHER

Sponsor Role: lead

Responsible Party

Drs Barbara Peterlin

Director, The Johns Hopkins Bayview Headache Research

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

The Johns Hopkins Bayview Headache Center

Baltimore, Maryland, United States

Countries

United States

References

Rao AS, Gelaye B, Kurth T, Dash PD, Nitchie H, Peterlin BL. A Randomized Trial of Ketorolac vs. Sumatripan vs. Placebo Nasal Spray (KSPN) for Acute Migraine. Headache. 2016 Feb;56(2):331-40. doi: 10.1111/head.12767. Epub 2016 Feb 3.

Reference Type: DERIVED

PMID: 26840902 (View on PubMed)

Other Identifiers

NA00075486

Identifier Type: -

Identifier Source: org_study_id