A Safety and Efficacy Study to Evaluate AMG 334 in Migraine Prevention

NCT ID: NCT02630459

Last Updated: 2022-10-12

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 475 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-01-06
• Study Completion Date: 2019-06-05

Brief Summary

Randomized, double-blind, placebo-controlled, parallel-group, multicenter study followed by an open-label treatment phase (OLTP). To evaluate the effect of erenumab (AMG 334) compared to placebo on the change from baseline in monthly migraine days.

Detailed Description

This is a Phase 2, randomized, double-blind, placebo-controlled study in participants with episodic migraine. The study's double blind treatment phase (DBTP) is designed to evaluate if treatment with erenumab once a month for 6 months compared with placebo is effective in reducing the mean monthly migraine days. Additionally, this study will continue to evaluate the efficacy and safety of erenumab during the OLTP where participants will continue to receive active treatment monthly.

The study also includes a clinical home use (CHU) sub-study to assess a participant's ability to self-administer 140 mg of erenumab. Participants will be randomized 1:1 to use either 2 pre-filled 70 mg/mL autoinjector (AI)/pens or 1 pre-filled 140 mg/mL AI/pen. Participation in the substudy is optional, and no additional samples will be collected for the sub-study.

After implementation of Protocol Amendment 2, the dose of erenumab in the OLTP increased from 70 mg to 140 mg QM. Participants who had already completed week 48 remain on 70 mg QM, participants not yet starting the OLTP, or not yet completing the week 48 visit receive erenumab 140 mg QM for the remainder of the OLTP.

Conditions

Migraine

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: TRIPLE

Study Groups

Double Blind Treatment Phase (DBTP): Placebo

Participants received placebo by subcutaneous injection on day 1 and at weeks 4, 8, 12, 16, and 20 in the double-blind treatment phase.

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DRUG

placebo via subcutaneous injection

DBTP: Erenumab 28 mg QM

Participants received erenumab 28 mg by subcutaneous injection on day 1 and at weeks 4, 8, 12, 16, and 20 in the double-blind treatment phase.

Group Type: EXPERIMENTAL

Erenumab

Intervention Type: DRUG

erenumab via subcutaneous injection

DBTP: Erenumab 70 mg QM

Participants received erenumab 70 mg by subcutaneous injection on day 1 and at weeks 4, 8, 12, 16, and 20 in the double-blind treatment phase.

Group Type: EXPERIMENTAL

Erenumab

Intervention Type: DRUG

erenumab via subcutaneous injection

DBTP: Erenumab 140 mg QM

Participants received erenumab 140 mg by subcutaneous injection on day 1 and at weeks 4, 8, 12, 16, and 20 in the double-blind treatment phase.

Group Type: EXPERIMENTAL

Erenumab

Intervention Type: DRUG

erenumab via subcutaneous injection

Open-Label Treatment Phase (OLTP): Erenumab 70-140 mg QM

Participants received an erenumab dose of 70 and/or 140 mg QM SC (depending on the participant's visit completion status after Institutional Review Board \[IRB\] approval of Protocol Amendment 2) in the OLTP for a total of 76 weeks.

Group Type: EXPERIMENTAL

Erenumab

Intervention Type: DRUG

erenumab via subcutaneous injection

CHU Sub-Study: Two 70 mg/mL AI/pens

A subset of participants in the OLTP randomized to self administer erenumab via two 70 mg/mL autoinjector (AI)/pens on day 29 and day 57 of the CHU Sub-Study

Group Type: EXPERIMENTAL

Erenumab

Intervention Type: DRUG

erenumab via autoinjector (AI)/pen

CHU Sub-Study: One 140 mg/mL AI/pen

A subset of participants in the OLTP randomized to self administer erenumab via one 140 mg/mL AI/pen on day 29 and day 57 of the CHU Sub-Study

Group Type: EXPERIMENTAL

Erenumab

Intervention Type: DRUG

erenumab via autoinjector (AI)/pen

Interventions

Placebo

placebo via subcutaneous injection

Intervention Type: DRUG

Erenumab

erenumab via subcutaneous injection

Intervention Type: DRUG

Erenumab

erenumab via autoinjector (AI)/pen

Intervention Type: DRUG

Other Intervention Names

AMG 334, Aimovig™; AMG 334, Aimovig™

Eligibility Criteria

Inclusion Criteria

• Provided informed consent prior to initiation of any study-specific activities/procedures
• History of migraine (with or without aura) for ≥ 12 months prior to screening according to the International Headache Society (IHS) Classification The International Classification of Headache Disorders (ICHD)-3 (Headache Classification Committee of the IHS, 2013),
• Migraine frequency: ≥ 4 and < 15 migraine days per month on average across the 3 months prior to screening,
• Headache frequency: < 15 headache days per month on average across the 3 months prior to screening.

• Demonstrated at least 80% compliance with the electronic Diary (eDiary),
• Migraine frequency: ≥ 4 and < 15 migraine days during the baseline phase based on the eDiary calculations,
• Headache frequency: < 15 headache days during the baseline phase based on the eDiary calculations.

• Subjects must have provided informed consent for the substudy. Subjects enrolling in the CHU substudy must have received open-label 140 mg erenumab for at least 1 dose.

Exclusion Criteria

• Older than 50 years of age at migraine onset,
• History of cluster headache or hemiplegic migraine headache,
• Unable to differentiate migraine from other headaches,
• No therapeutic response with > 2 of the following 7 medication categories for prophylactic treatment of migraine after an adequate therapeutic trial: Category 1: Divalproex sodium, sodium valproate, Category 2: Topiramate, Category 3: Beta blockers (for example: atenolol, bisoprolol, metoprolol, nadolol, nebivolol, pindolol, propranolol, timolol), Category 4: Tricyclic antidepressants (for example: amitriptyline, nortriptyline, protriptyline),Category 5: Serotonin-norepinephrine reuptake inhibitors (for example: venlafaxine, desvenlafaxine, duloxetine, milnacipran), Category 6: Flunarizine, verapamil, lomerizine, Category 7: Lisinopril, candesartan,
• Used a prohibited medication, device or procedure within 2 months prior to the start of the baseline phase or during the baseline phase,
• Received botulinum toxin in the head and/or neck region within 4 months prior to the start of the baseline phase or during the baseline phase,
• Taken the following for any indication in any month during the 2 months prior to the start of the baseline phase: Ergotamines or triptans on ≥ 10 days per month, or Simple analgesics (nonsteroidal anti-inflammatory drugs [NSAIDs], acetaminophen) on ≥ 15 days per month, or Opioid- or butalbital-containing analgesics on ≥ 4 days per month,
• Anticipated to require any excluded medication, device or procedure during the study,
• Active chronic pain syndromes (such as fibromyalgia and chronic pelvic pain),
• History of major psychiatric disorder (such as schizophrenia and bipolar disorder), or current evidence of depression based on a Beck Depression Inventory (BDI)-II total score > 19 at screening. Subjects with anxiety disorder and/or major depressive disorder are permitted in the study if they are considered by the investigator to be stable and are taking no more than 1 medication for each disorder. Subjects must have been on a stable dose within the 3 months prior to the start of the baseline phase,
• History of seizure disorder or other significant neurological conditions other than migraine. Note: A single childhood febrile seizure is not exclusionary,
• Malignancy within the 5 years prior to screening, except non melanoma skin cancers, cervical or breast ductal carcinoma in situ,
• Human immunodeficiency virus (HIV) infection by history,
• Hepatic disease by history, or total bilirubin (TBL) ≥ 2.0 x upper limit of normal (ULN) or alanine transaminase (ALT) or aspartate aminotransferase (AST) ≥ 3.0 x ULN, as assessed by the central laboratory at initial screening, or evidence of acute or chronic hepatitis B or hepatitis C virus. Hepatitis status will be evaluated by testing for hepatitis B surface antigen (HepBsAg), total hepatitis B core antibody (HepBcAb) and hepatitis C antibody by the central laboratory at initial screening. Polymerase chain reaction (PCR) should be performed to confirm active disease only if total HepBcAb is positive and HepBsAg is negative or if C antibody is positive,
• Myocardial infarction, stroke, transient ischemic attack (TIA), unstable angina, or coronary artery bypass surgery or other revascularization procedure within 12 months prior to screening,
• History or evidence of any other unstable or clinically significant medical condition that, in the opinion of the investigator, would pose a risk to subject safety or interfere with the study evaluation, procedures or completion,
• Subject has any clinically significant vital sign, laboratory, or electrocardiogram (ECG) abnormality during screening that, in the opinion of the investigator, could pose a risk to subject safety or interfere with the study evaluation,
• The subject is at risk of self-harm or harm to others as evidenced by past suicidal behavior or endorsing items 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS) assessed at screening,
• Evidence of drug or alcohol abuse or dependence within 12 months prior to screening, based on medical records, patient self-report, or positive urine drug test performed during screening (with the exception of prescribed medications such as opioids or barbiturates),
• Pregnant or breastfeeding, or is a female expecting to conceive during the study, including through 16 weeks after the last dose of investigational product,
• Female subject of childbearing potential who is unwilling to use an acceptable method of effective contraception during treatment with investigational product through 16 weeks after the last dose of investigational product,
• Currently receiving treatment in another investigational device or drug study, or less than 90 days prior to screening since ending treatment on another investigational device or drug study(-ies),
• Known sensitivity to any component of the investigational product (Refer to the Investigational Product Instruction Manual [IPIM] for details),
• Previously randomized into an erenumab study,
• Member of investigational site staff or relative of the investigator,
• Unlikely to be able to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures (eg, independent completion of eDiary items) to the best of the subject's and investigator's knowledge.

• Unreliability as a study participant based on the investigator's (or designee's) knowledge of the subject (eg, unwillingness to adhere to the protocol, unwilling to self-inject using an autoinjector (AI)/pen after review of the Instructions for Use). Subjects receiving erenumab 70 mg in the open-label phase are not eligible.

• Minimum Eligible Age: 20 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Amgen

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

MD

Role: STUDY_DIRECTOR

Amgen

Locations

Research Site

Kamogawa-shi, Chiba, Japan

Research Site

Saijo-shi, Ehime, Japan

Research Site

Ota-shi, Gunma, Japan

Research Site

Hiroshima, Hiroshima, Japan

Research Site

Sapporo, Hokkaido, Japan

Research Site

Sapporo, Hokkaido, Japan

Research Site

Sapporo, Hokkaido, Japan

Research Site

Kobe, Hyōgo, Japan

Research Site

Tsukuba, Ibaraki, Japan

Research Site

Kahoku-gun, Ishikawa-ken, Japan

Research Site

Morioka, Iwate, Japan

Research Site

Kagoshima, Kagoshima-ken, Japan

Research Site

Kawasaki-shi, Kanagawa, Japan

Research Site

Kawasaki-shi, Kanagawa, Japan

Research Site

Kawasaki-shi, Kanagawa, Japan

Research Site

Kumamoto, Kumamoto, Japan

Research Site

Kumamoto, Kumamoto, Japan

Research Site

Kyoto, Kyoto, Japan

Research Site

Sendai, Miyagi, Japan

Research Site

Osaka, Osaka, Japan

Research Site

Osakasayama-shi, Osaka, Japan

Research Site

Toyonaka-shi, Osaka, Japan

Research Site

Saga, Saga-ken, Japan

Research Site

Iruma-gun, Saitama, Japan

Research Site

Saitama-shi, Saitama, Japan

Research Site

Tokorozawa-shi, Saitama, Japan

Research Site

Shizuoka, Shizuoka, Japan

Research Site

Shimotsuga-gun, Tochigi, Japan

Research Site

Bunkyo-ku, Tokyo, Japan

Research Site

Bunkyo-ku, Tokyo, Japan

Research Site

Chofu-shi, Tokyo, Japan

Research Site

Chuo-ku, Tokyo, Japan

Research Site

Hachioji-shi, Tokyo, Japan

Research Site

Minato-ku, Tokyo, Japan

Research Site

Minato-ku, Tokyo, Japan

Research Site

Shibuya-ku, Tokyo, Japan

Research Site

Shinjuku-ku, Tokyo, Japan

Research Site

Shinjuku-ku, Tokyo, Japan

Research Site

Yonago, Tottori, Japan

Research Site

Toyama, Toyama, Japan

Research Site

Toyama, Toyama, Japan

Research Site

Hofu-shi, Yamaguchi, Japan

Research Site

Yamaguchi, Yamaguchi, Japan

Research Site

Kai-shi, Yamanashi, Japan

Countries

Japan

References

Sakai F, Takeshima T, Tatsuoka Y, Hirata K, Lenz R, Wang Y, Cheng S, Hirama T, Mikol DD. A Randomized Phase 2 Study of Erenumab for the Prevention of Episodic Migraine in Japanese Adults. Headache. 2019 Nov;59(10):1731-1742. doi: 10.1111/head.13652. Epub 2019 Oct 14.

Reference Type: BACKGROUND

PMID: 31612482 (View on PubMed)

Zhou Y, Zhang F, Starcevic Manning M, Hu Z, Hsu CP, Chen PW, Peng C, Loop B, Mytych DT, Paiva da Silva Lima G. Immunogenicity of erenumab: A pooled analysis of six placebo-controlled trials with long-term extensions. Cephalalgia. 2022 Jul;42(8):749-760. doi: 10.1177/03331024221075621. Epub 2022 Mar 10.

Reference Type: BACKGROUND

PMID: 35272533 (View on PubMed)

Hiramatsu K, Onizuka Y, Hasebe M, Yoshida R, Numachi Y. Novel Drug for Migraine Prophylaxis: Mode of Action, Efficacy and Safety of Erenumab. Shinryo to Shinyaku (Med Cons New-Remed) 2021:58(11):797-832

Reference Type: BACKGROUND

Sakai F, Takeshima T, Tatsuoka Y, Hirata K, Cheng S, Numachi Y, Peng C, Xue F, Mikol DD. Long-term efficacy and safety during open-label erenumab treatment in Japanese patients with episodic migraine. Headache. 2021 Apr;61(4):653-661. doi: 10.1111/head.14096. Epub 2021 Mar 25.

Reference Type: BACKGROUND

PMID: 33764538 (View on PubMed)

Provided Documents

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

http://www.amgentrials.com

AmgenTrials clinical trials website

Other Identifiers

20120309

Identifier Type: -

Identifier Source: org_study_id