Intranasal Cooling for Symptomatic Relief of Migraine

NCT ID: NCT02375789

Last Updated: 2017-02-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-10-31

Study Completion Date

2016-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This study will be a randomised placebo controlled trial examining the effectiveness of using an intranasal cooling device (the RhinoChill) in providing relief of pain and symptoms of acute migraine. It will involve using two nasal catheters to cool the nasal cavity which provides localised cooling of the local nasal tissue and the blood vessels which supply blood to the brain. This cooling effect will cause the blood vessels to constrict as well as stimulating special cold receptors that are thought to be involved in the relief of migraine, thereby providing both pain and associated symptomatic relief. Ninety patients will be randomised in a 1:1 fashion, clustered to three different recruitment sites. The patients will have a 30 day period of data collection for their current migraine frequency, treatment and response to medication (with a minimum of 2 migraine attacks recorded) before starting the treatment phase with the RhinoChill Device. Treatment will be for 2 migraine attacks. Only a single treatment is allowed for the first attack, but on the second attack the patient may deliver 2 treatments with a gap of at least 2 hours between treatments.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This study is a multi centre, double blinded, randomized, prospective, parallel placebo controlled trial for demonstrating the effectiveness of the RhinoChill System for the symptomatic relief of migraine headache.

The specific study design consists of:

* Participant identification from neurology clinic records and gaining initial consent to transfer contact details to the trial team.
* Telephone contact or direct clinic contact with potential participants to describe the COOLHEAD 2 trial and to seek expressions of interest.
* Initial meetings with potential participants and discussion of trial, provision of patient information leaflets. Informed Consent taking.
* Initial 30 day prospective data collection period (minimum of 2 migraine attacks, longer period if needed)
* Randomisation to either placebo or active RhinoChill
* Device Delivery and training session for the use of the RhinoChill device, self administration, and record keeping.
* Treatment period for the treatment of 2 separate migraines with the RhinoChill.

During an initial screening visit or phonecall, the trial will be discussed with the potential participant and the inclusion/exclusion checklist will be completed.

If the patient meets all inclusion criteria and none of the exclusion criteria, they will be asked for permission to pass on contact details to a member of the trial team for further contact.

Arrangements will then be made for a meeting with the patient either at the clinic or in their own home to further discuss the trial and to consider enrolling into the study. At this time, they will be provided with a patient information sheet and will be shown the RhinoChill device. The patient will be given the opportunity to fully consider all aspects of participation in this trial and to discuss it with family members if they so wish before being being consented into the trial by a member of the study team.

At the time of consent, the researcher will also collect data for the baseline CRF and provide initial instruction on completion of the first stage data collection forms (further described below)

At the baseline visit, the patient will first be given the opportunity to ask any questions they may have about the research. A member of the research team will take informed consent and gain signatures on the consent form. Baseline data will then be collected, including history of migraine headache, frequency, severity of symptoms, medication and therapies currently ongoing or taken in the past. Base line vital signs will also be recorded at this time. Once completed, a short training session on completion of the prospective data collection forms for phase 1 of the trial will given and use of the supplied blood pressure machine and pulse oxymeter machine. Once the baseline visit has been completed the patient will begin a 30 day period of self data collection based on their migraine experience during that time frame and using data capture forms provided by the research nurse (a minimum of 2 migraine attacks are required, therefore if 2 have not occurred during the 30 days, further time will be given to allow the second migraine to occur).

If a patient has not had a single migraine in the first 30 days, then they will not be able to continue to the treatment phase as they have not met the inclusion criteria of at least 1 migraine per month. Following the conclusion to this initial period, the treatment phase will then begin.

After the end of the prospective data collection period, the patient will be randomised to either active treatment or placebo treatment. Randomisation will be provided by sealed envelopes held by E\&E CRO services (Vienna) who are also acting as independent monitors of the trial. Randomisation was performed via the online system www.sealedenvelope.com.

Training will be undertaken to ensure that the patient is fully competent and safe in the use of the RhinoChill intranasal cooling device.

The patient will be instructed on:

* Preparation of the device
* Insertion of the nasal catheter
* Selecting correct flow rate
* Positioning during treatment
* Cleaning and storage of the nasal catheters
* Trial documentation
* 24 hour contact numbers for additional supplies, troubleshooting and practical support.

The patient will also be left with a reference booklet for issues around the trial and the practical use of the RhinoChill device.

At the onset of migraine headache (or as soon as possible thereafter), the patient will start to complete the 'Treatment' CRF.

Each step of the treatment procedure is to be completed in order and as described to the patient. Patients are instructed that there is no scope for any alteration in the treatment order or requirements of the trial unless a safety issue becomes evident. If a patient does deviate from the standard procedures as outlined below, they are required to contact the 24 hour COOLHEAD 2 mobile phone to report the incident so that it can be reviewed and logged as a protocol deviation and reviewed by the site/principal investigator at the earliest opportunity. The RhinoChill device is then prepared for use and treatment can be administered.

The RhinoChill Migraine Intranasal catheters are then inserted and the 10 minute treatment is commenced on Low Flow. following these steps for each individual treatment:

It is recognised that participants in this study will already be taking medication for their migraine headache. Normal prophylaxis will be allowed as part of the trial and will be recorded in the initial screening interview. No change in prophylaxis is allowed within three months of the start of the trial or while the patient is participating in the trial.

However, acute treatments such as triptans are allowed to be taken but must be withheld until at least two hours following completion of treatment with the RhinoChill to allow assessment of the intervention. Any rescue medication taken after this point will be recorded in the associated trial documentation. A full medication history along with other therapies (including alternative therapies) will also be recorded.

No new treatment or therapy will start while the participant is enrolled in this trial.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Migraine Headache

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Active RhinoChill

Following the initial 30 days (and minimum of 2 separate migraine attacks) of data collection the patient will be trained in the use and self administration of the RhinoChill device.

At the onset of an acute migraine, the patient will insert the RhinoChill Migraine Intranasal catheters and commence a 10 minute treatment on the Low Flow setting of the device.

During this time the patient will complete the basic data record sheets to document current symptoms and changes in severity throughout the period of treatment and then at specific time points thereafter.

The patient remains in the trial until two separate migraines have been treated.

Group Type ACTIVE_COMPARATOR

Active RhinoChill

Intervention Type DEVICE

The device is intended for use for the reduction of temperature via the nasal cavity.

The RhinoChill® System is a British Standards Institution Kite-Marked device that is currently commercially available in Europe. The RhinoChill® device is intended for temperature reduction in patients via the nasal cavity.

Placebo RhinoChill

The same procedure will be followed for the placebo comparator as in the active comparator. The RhinoChill device looks identical and functions in a very similar way to the active device however through some minor design changes the device has been altered to provide a sufficient placebo treatment.

At the onset of an acute migraine headache the patient will insert the RhinoChill Migraine Intranasal catheters and the 10 minute treatment is commenced on Low Flow.

During this time the patient will complete the basic data record sheets to document current symptoms and changes in severity throughout the period of treatment and then at specific time points thereafter.

The patient remains in the trial until two separate migraines have been treated.

Group Type PLACEBO_COMPARATOR

Placebo RhinoChill

Intervention Type DEVICE

The placebo RhinoChill device looks and functions in an identical way to the active RhinoChill. All components are used, however through some minor changes in the design of the device it now provides a sufficient placebo treatment to the patient.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Active RhinoChill

The device is intended for use for the reduction of temperature via the nasal cavity.

The RhinoChill® System is a British Standards Institution Kite-Marked device that is currently commercially available in Europe. The RhinoChill® device is intended for temperature reduction in patients via the nasal cavity.

Intervention Type DEVICE

Placebo RhinoChill

The placebo RhinoChill device looks and functions in an identical way to the active RhinoChill. All components are used, however through some minor changes in the design of the device it now provides a sufficient placebo treatment to the patient.

Intervention Type DEVICE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

RhinoChill RhinoChill

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* 18 Years or over and ≤70 years of age.
* Migraine diagnosis of at least 1 year.
* Migraine attacks between 1 and 15 per month.
* Onset of first migraine \< 50 years of age.
* Migraine prophylaxis medication unchanged for 3 months prior to enrollment
* Meets International Classification for Headache Disorders (2nd Edition) criteria for diagnosis of Episodic Migraine with or without aura
* Able to attend and understand a short training session on the practical use of the RhinoChill device and agrees to only use the device as instructed and as laid out in the official instructions for use.

Exclusion Criteria

* \< 18 and \>70 years of age
* Known oxygen dependency to maintain SaO2 \>95%
* Diagnosed Hypertensive and currently uncontrolled with Systolic BP \> 140mmHg and Diastolic BP \> 90mmHg on baseline assessment.
* Marked nasal septal deviation, recurrent epistaxis or chronic Rhino-Sinusitis
* Intranasal obstruction preventing full insertion of nasal catheter
* Known acute base of skull fracture or facial trauma
* Concurrent sinus/intranasal surgery
* Diagnosed with thromobocytopenia.
* Previous Stroke or Myocardial Infarction
* Unable to fully understand the consent process and provide informed consent due to either language barriers or mental capacity
* Previously enrolled into the COOLHEAD 1 trial
* No recorded migraine following initial 30 day data collection period
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

BeneChill, Inc

INDUSTRY

Sponsor Role collaborator

Cumbria Partnership NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Jitka Vanderpol, MD FRCP

Role: PRINCIPAL_INVESTIGATOR

Cumbria Partnership NHS Foundation Trust

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Neurosciences department, Penrith Hospital, Cumbria Partnership NHS Foundation Trust

Penrith, Cumbria, United Kingdom

Site Status

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST, 11 Norfolk Street, Sunderland SR1 1EA

Sunderland, Tyne and Wear, United Kingdom

Site Status

The James Cook University Hospital, South Tees Hospitals NHS Foundation Trust

Middlesbrough, , United Kingdom

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United Kingdom

References

Explore related publications, articles, or registry entries linked to this study.

Zanchin G, Maggioni F, Granella F, Rossi P, Falco L, Manzoni GC. Self-administered pain-relieving manoeuvres in primary headaches. Cephalalgia. 2001 Sep;21(7):718-26. doi: 10.1046/j.1468-2982.2001.00199.x.

Reference Type BACKGROUND
PMID: 11594999 (View on PubMed)

Ucler S, Coskun O, Inan LE, Kanatli Y. Cold Therapy in Migraine Patients: Open-label, Non-controlled, Pilot Study. Evid Based Complement Alternat Med. 2006 Dec;3(4):489-93. doi: 10.1093/ecam/nel035. Epub 2006 Jun 15.

Reference Type BACKGROUND
PMID: 17173113 (View on PubMed)

Diamond S, Freitag FG. Cold as an adjunctive therapy for headache. Postgrad Med. 1986 Jan;79(1):305-9. doi: 10.1080/00325481.1986.11699255.

Reference Type BACKGROUND
PMID: 3941818 (View on PubMed)

Robbins LD. Cryotherapy for headache. Headache. 1989 Oct;29(9):598-600. doi: 10.1111/j.1526-4610.1989.hed2909598.x.

Reference Type BACKGROUND
PMID: 2584002 (View on PubMed)

Lance JW. The controlled application of cold and heat by a new device (Migra-lief apparatus) in the treatment of headache. Headache. 1988 Aug;28(7):458-61. doi: 10.1111/j.1526-4610.1988.hed2807458.x. No abstract available.

Reference Type BACKGROUND
PMID: 3243707 (View on PubMed)

Friedman MH, Peterson SJ, Behar CF, Zaidi Z. Intraoral chilling versus oral sumatriptan for acute migraine. Heart Dis. 2001 Nov-Dec;3(6):357-61. doi: 10.1097/00132580-200111000-00003.

Reference Type BACKGROUND
PMID: 11975819 (View on PubMed)

Sprouse-Blum AS, Gabriel AK, Brown JP, Yee MH. Randomized controlled trial: targeted neck cooling in the treatment of the migraine patient. Hawaii J Med Public Health. 2013 Jul;72(7):237-41.

Reference Type BACKGROUND
PMID: 23901394 (View on PubMed)

ABRAMSON DI. PHYSIOLOGIC BASIS FOR THE USE OF PHYSICAL AGENTS IN PERIPHERAL VASCULAR DISORDERS. Arch Phys Med Rehabil. 1965 Mar;46:216-44. No abstract available.

Reference Type BACKGROUND
PMID: 14271050 (View on PubMed)

Swenson C, Sward L, Karlsson J. Cryotherapy in sports medicine. Scand J Med Sci Sports. 1996 Aug;6(4):193-200. doi: 10.1111/j.1600-0838.1996.tb00090.x.

Reference Type BACKGROUND
PMID: 8896090 (View on PubMed)

Dolan MG, Thornton RM, Fish DR, Mendel FC. Effects of cold water immersion on edema formation after blunt injury to the hind limbs of rats. J Athl Train. 1997 Jul;32(3):233-7.

Reference Type BACKGROUND
PMID: 16558455 (View on PubMed)

Deal DN, Tipton J, Rosencrance E, Curl WW, Smith TL. Ice reduces edema. A study of microvascular permeability in rats. J Bone Joint Surg Am. 2002 Sep;84(9):1573-8.

Reference Type BACKGROUND
PMID: 12208913 (View on PubMed)

De Jong RH, Hershey WN, Wagman IH. Nerve conduction velocity during hypothermia in man. Anesthesiology. 1966 Nov-Dec;27(6):805-10. doi: 10.1097/00000542-196611000-00013. No abstract available.

Reference Type BACKGROUND
PMID: 5924554 (View on PubMed)

Merrick MA. Secondary injury after musculoskeletal trauma: a review and update. J Athl Train. 2002 Apr;37(2):209-17.

Reference Type BACKGROUND
PMID: 16558673 (View on PubMed)

Zachariassen KE. Hypothermia and cellular physiology. Arctic Med Res. 1991;50 Suppl 6:13-7.

Reference Type BACKGROUND
PMID: 1811567 (View on PubMed)

Numazaki M, Tominaga M. Nociception and TRP Channels. Curr Drug Targets CNS Neurol Disord. 2004 Dec;3(6):479-85. doi: 10.2174/1568007043336789.

Reference Type BACKGROUND
PMID: 15578965 (View on PubMed)

Zenker W, Kubik S. Brain cooling in humans--anatomical considerations. Anat Embryol (Berl). 1996 Jan;193(1):1-13. doi: 10.1007/BF00186829.

Reference Type BACKGROUND
PMID: 8838492 (View on PubMed)

Van den Brande P, De Coninck A, Lievens P. Skin microcirculation responses to severe local cooling. Int J Microcirc Clin Exp. 1997 Mar-Apr;17(2):55-60. doi: 10.1159/000179207.

Reference Type BACKGROUND
PMID: 9253681 (View on PubMed)

Boller M, Lampe JW, Katz JM, Barbut D, Becker LB. Feasibility of intra-arrest hypothermia induction: A novel nasopharyngeal approach achieves preferential brain cooling. Resuscitation. 2010 Aug;81(8):1025-30. doi: 10.1016/j.resuscitation.2010.04.005. Epub 2010 Jun 9.

Reference Type BACKGROUND
PMID: 20538402 (View on PubMed)

Wang H, Barbut D, Tsai MS, Sun S, Weil MH, Tang W. Intra-arrest selective brain cooling improves success of resuscitation in a porcine model of prolonged cardiac arrest. Resuscitation. 2010 May;81(5):617-21. doi: 10.1016/j.resuscitation.2010.01.027. Epub 2010 Mar 6.

Reference Type BACKGROUND
PMID: 20207471 (View on PubMed)

Yu T, Barbut D, Ristagno G, Cho JH, Sun S, Li Y, Weil MH, Tang W. Survival and neurological outcomes after nasopharyngeal cooling or peripheral vein cold saline infusion initiated during cardiopulmonary resuscitation in a porcine model of prolonged cardiac arrest. Crit Care Med. 2010 Mar;38(3):916-21. doi: 10.1097/CCM.0b013e3181cd1291.

Reference Type BACKGROUND
PMID: 20081534 (View on PubMed)

Tsai MS, Barbut D, Tang W, Wang H, Guan J, Wang T, Sun S, Inderbitzen B, Weil MH. Rapid head cooling initiated coincident with cardiopulmonary resuscitation improves success of defibrillation and post-resuscitation myocardial function in a porcine model of prolonged cardiac arrest. J Am Coll Cardiol. 2008 May 20;51(20):1988-90. doi: 10.1016/j.jacc.2007.12.057. No abstract available.

Reference Type BACKGROUND
PMID: 18482670 (View on PubMed)

Guan J, Barbut D, Wang H, Li Y, Tsai MS, Sun S, Inderbitzen B, Weil MH, Tang W. A comparison between head cooling begun during cardiopulmonary resuscitation and surface cooling after resuscitation in a pig model of cardiac arrest. Crit Care Med. 2008 Nov;36(11 Suppl):S428-33. doi: 10.1097/ccm.0b013e31818a8876.

Reference Type BACKGROUND
PMID: 20449906 (View on PubMed)

Abou-Chebl A, Sung G, Barbut D, Torbey M. Local brain temperature reduction through intranasal cooling with the RhinoChill device: preliminary safety data in brain-injured patients. Stroke. 2011 Aug;42(8):2164-9. doi: 10.1161/STROKEAHA.110.613000. Epub 2011 Jun 16.

Reference Type BACKGROUND
PMID: 21680904 (View on PubMed)

Busch HJ, Eichwede F, Fodisch M, Taccone FS, Wobker G, Schwab T, Hopf HB, Tonner P, Hachimi-Idrissi S, Martens P, Fritz H, Bode Ch, Vincent JL, Inderbitzen B, Barbut D, Sterz F, Janata A. Safety and feasibility of nasopharyngeal evaporative cooling in the emergency department setting in survivors of cardiac arrest. Resuscitation. 2010 Aug;81(8):943-9. doi: 10.1016/j.resuscitation.2010.04.027. Epub 2010 Jun 2.

Reference Type BACKGROUND
PMID: 20627524 (View on PubMed)

Castren M, Nordberg P, Svensson L, Taccone F, Vincent JL, Desruelles D, Eichwede F, Mols P, Schwab T, Vergnion M, Storm C, Pesenti A, Pachl J, Guerisse F, Elste T, Roessler M, Fritz H, Durnez P, Busch HJ, Inderbitzen B, Barbut D. Intra-arrest transnasal evaporative cooling: a randomized, prehospital, multicenter study (PRINCE: Pre-ROSC IntraNasal Cooling Effectiveness). Circulation. 2010 Aug 17;122(7):729-36. doi: 10.1161/CIRCULATIONAHA.109.931691. Epub 2010 Aug 2.

Reference Type BACKGROUND
PMID: 20679548 (View on PubMed)

Tfelt-Hansen P, Pascual J, Ramadan N, Dahlof C, D'Amico D, Diener HC, Hansen JM, Lanteri-Minet M, Loder E, McCrory D, Plancade S, Schwedt T; International Headache Society Clinical Trials Subcommittee. Guidelines for controlled trials of drugs in migraine: third edition. A guide for investigators. Cephalalgia. 2012 Jan;32(1):6-38. doi: 10.1177/0333102411417901. No abstract available.

Reference Type BACKGROUND
PMID: 22384463 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

3414

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Cooling to Alleviate Migraine #3
NCT06874361 ACTIVE_NOT_RECRUITING NA
A Study of Wearable Devices to Predict Migraines
NCT05755945 ENROLLING_BY_INVITATION NA