Trial Outcomes & Findings for A Study to Test if Fremanezumab Reduces Headache in Participants With Posttraumatic Headache (PTH) (NCT NCT03347188)

NCT ID: NCT03347188

Last Updated: 2022-12-13

Results Overview

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.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

87 participants

Primary outcome timeframe

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

Results posted on

2022-12-13

Participant Flow

Participant milestones

Participant milestones
Measure
Fremanezumab
Participants received 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 double-blind (DB) treatment period. Participants who completed the DB treatment period and continued into the open-label (OL) treatment period received 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.
Placebo
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
Double-blind (DB) Period (12 Weeks)
STARTED
44
43
Double-blind (DB) Period (12 Weeks)
Received at Least 1 Dose of Study Drug
43
43
Double-blind (DB) Period (12 Weeks)
Full Analysis Set (FAS)
42
43
Double-blind (DB) Period (12 Weeks)
COMPLETED
29
26
Double-blind (DB) Period (12 Weeks)
NOT COMPLETED
15
17
Open-label (OL) Period (12 Weeks)
STARTED
35
35
Open-label (OL) Period (12 Weeks)
Entered in OL Period for Anti-drug Antibody (ADA) Only
26
28
Open-label (OL) Period (12 Weeks)
Received at Least 1 Dose of Study Drug
9
7
Open-label (OL) Period (12 Weeks)
COMPLETED
8
6
Open-label (OL) Period (12 Weeks)
NOT COMPLETED
27
29

Reasons for withdrawal

Reasons for withdrawal
Measure
Fremanezumab
Participants received 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 double-blind (DB) treatment period. Participants who completed the DB treatment period and continued into the open-label (OL) treatment period received 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.
Placebo
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
Double-blind (DB) Period (12 Weeks)
Protocol Violation
2
2
Double-blind (DB) Period (12 Weeks)
Withdrawal by Subject
4
8
Double-blind (DB) Period (12 Weeks)
Lost to Follow-up
7
4
Double-blind (DB) Period (12 Weeks)
Adverse Event
1
1
Double-blind (DB) Period (12 Weeks)
Other than specified
1
2
Open-label (OL) Period (12 Weeks)
Entered for ADA assessment only, not treated
26
28
Open-label (OL) Period (12 Weeks)
Withdrawal by Subject
1
0
Open-label (OL) Period (12 Weeks)
Other than specified
0
1

Baseline Characteristics

'Number analyzed' signifies participants evaluable for this baseline measure.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Fremanezumab
n=44 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
Total
n=87 Participants
Total of all reporting groups
Age, Continuous
42.6 years
STANDARD_DEVIATION 13.01 • n=44 Participants
43.8 years
STANDARD_DEVIATION 14.48 • n=43 Participants
43.2 years
STANDARD_DEVIATION 13.68 • n=87 Participants
Sex: Female, Male
Female
25 Participants
n=44 Participants
25 Participants
n=43 Participants
50 Participants
n=87 Participants
Sex: Female, Male
Male
19 Participants
n=44 Participants
18 Participants
n=43 Participants
37 Participants
n=87 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants
n=44 Participants
4 Participants
n=43 Participants
8 Participants
n=87 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
40 Participants
n=44 Participants
38 Participants
n=43 Participants
78 Participants
n=87 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=44 Participants
1 Participants
n=43 Participants
1 Participants
n=87 Participants
Race/Ethnicity, Customized
Race · White
41 Participants
n=44 Participants
39 Participants
n=43 Participants
80 Participants
n=87 Participants
Race/Ethnicity, Customized
Race · Black or African American
3 Participants
n=44 Participants
1 Participants
n=43 Participants
4 Participants
n=87 Participants
Race/Ethnicity, Customized
Race · Native Hawaiian or other Pacific Islander
0 Participants
n=44 Participants
1 Participants
n=43 Participants
1 Participants
n=87 Participants
Race/Ethnicity, Customized
Race · Other
0 Participants
n=44 Participants
2 Participants
n=43 Participants
2 Participants
n=87 Participants
Number of Headache Days of at Least Moderate Severity
18.7 days
STANDARD_DEVIATION 7.03 • n=43 Participants • 'Number analyzed' signifies participants evaluable for this baseline measure.
18.5 days
STANDARD_DEVIATION 6.12 • n=43 Participants • 'Number analyzed' signifies participants evaluable for this baseline measure.
18.6 days
STANDARD_DEVIATION 6.56 • n=86 Participants • 'Number analyzed' signifies participants evaluable for this baseline measure.

PRIMARY outcome

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

Population: Full analysis set (FAS) included all randomized participants who received at least 1 dose of the study drug and had at least 1 post-baseline efficacy assessment on the primary endpoint.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=42 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
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
-3.6 days
Standard Error 0.99
-5.1 days
Standard Error 1.01

SECONDARY outcome

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

Population: FAS included all randomized participants who received at least 1 dose of the study drug and had at least 1 post-baseline efficacy assessment on the primary endpoint.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=42 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
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
5 Participants
4 Participants

SECONDARY outcome

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

Population: FAS included all randomized participants who received at least 1 dose of the study drug and had at least 1 post-baseline efficacy assessment on the primary endpoint.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=42 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
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
9 Participants
11 Participants

SECONDARY outcome

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

Population: FAS included all randomized participants who received at least 1 dose of the study drug and had at least 1 post-baseline efficacy assessment on the primary endpoint. Here, 'Number analyzed' signifies participants evaluable for this outcome measure at specified timepoints.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=42 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
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)
Month 2
8 Participants
14 Participants
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)
Month 1
8 Participants
11 Participants
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)
Month 3
14 Participants
12 Participants

SECONDARY outcome

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

Population: FAS included all randomized participants who received at least 1 dose of the study drug and had at least 1 post-baseline efficacy assessment on the primary endpoint. Here, 'Number analyzed' signifies participants evaluable for this outcome measure at specified timepoints.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=42 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
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)
Change at Month 1
-3.6 days
Standard Error 0.97
-4.0 days
Standard Error 0.99
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)
Change at Month 2
-3.7 days
Standard Error 1.06
-6.7 days
Standard Error 1.06
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)
Change at Month 3
-5.2 days
Standard Error 1.20
-7.2 days
Standard Error 1.21

SECONDARY outcome

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

Population: FAS included all randomized participants who received at least 1 dose of the study drug and had at least 1 post-baseline efficacy assessment on the primary endpoint. Here, 'Overall number of participants analyzed' signifies participants evaluable for this outcome measure.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=35 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=37 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
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
-6.9 units on a scale
Standard Error 4.54
-10.8 units on a scale
Standard Error 4.65

SECONDARY outcome

Timeframe: Weeks 4, 8, and 12

Population: FAS included all randomized participants who received at least 1 dose of the study drug and had at least 1 post-baseline efficacy assessment on the primary endpoint.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=42 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
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
Week 4 · Responder
12 Participants
11 Participants
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
Week 4 · Non-Responder
24 Participants
26 Participants
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
Week 4 · Missing
6 Participants
6 Participants
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
Week 8 · Responder
14 Participants
17 Participants
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
Week 8 · Non-Responder
20 Participants
21 Participants
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
Week 8 · Missing
8 Participants
5 Participants
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
Week 12 · Responder
11 Participants
16 Participants
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
Week 12 · Non-Responder
20 Participants
16 Participants
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
Week 12 · Missing
11 Participants
11 Participants

SECONDARY outcome

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

Population: DB safety analysis set included all randomized participants who received at least 1 dose of study drug during the DB treatment period.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=43 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
DB Period: Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
31 Participants
35 Participants

SECONDARY outcome

Timeframe: Week 12 up to Week 24

Population: OL-ITT analysis set included only participants who received at least 1 dose of study drug during the open-label treatment period.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=9 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=7 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
OL Period: Number of Participants With TEAEs
8 Participants
6 Participants

SECONDARY outcome

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

Population: DB safety analysis set included all randomized participants who received at least 1 dose of study drug during the DB treatment period.

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

Outcome measures

Outcome measures
Measure
Fremanezumab
n=43 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
DB Period: Number of Participants Who Did Not Complete the Study
Discontinued study due to any reason
15 Participants
17 Participants
DB Period: Number of Participants Who Did Not Complete the Study
Discontinued study due to AEs
1 Participants
1 Participants

SECONDARY outcome

Timeframe: Week 12 up to Week 24

Population: OL-ITT analysis set included only participants who received at least 1 dose of study drug during the open-label treatment period.

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

Outcome measures

Outcome measures
Measure
Fremanezumab
n=9 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=7 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
OL Period: Number of Participants Who Did Not Complete the Study
Discontinued study due to any reason
1 Participants
1 Participants
OL Period: Number of Participants Who Did Not Complete the Study
Discontinued study due to AEs
0 Participants
0 Participants

SECONDARY outcome

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

Population: DB safety analysis set included all randomized participants who received at least 1 dose of study drug during the DB treatment period.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=43 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
DB Period: Number of Participants Who Received Concomitant Medications
43 Participants
42 Participants

SECONDARY outcome

Timeframe: Week 12 up to Week 24

Population: OL-ITT analysis set included only participants who received at least 1 dose of study drug during the open-label treatment period.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=9 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=7 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
OL Period: Number of Participants Who Received Concomitant Medications
9 Participants
7 Participants

SECONDARY outcome

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

Population: Safety analysis set included all randomized participants who received at least 1 dose of study drug.

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.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=43 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
Number of Participants With Positive Findings on Electronic Columbia Suicide Severity Rating Scale (eC-SSRS)
0 Participants
0 Participants

SECONDARY outcome

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

Population: ITT analysis set included all randomized participants.

Number of participants with treatment-emergent antidrug antibodies reported.

Outcome measures

Outcome measures
Measure
Fremanezumab
n=44 Participants
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 Participants
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
Number of Participants With Treatment-Emergent Antidrug Antibodies (ADA)
0 Participants
0 Participants

Adverse Events

Fremanezumab

Serious events: 2 serious events
Other events: 28 other events
Deaths: 0 deaths

Placebo

Serious events: 1 serious events
Other events: 29 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Fremanezumab
n=43 participants at risk
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 participants at risk
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
Gastrointestinal disorders
Gastrointestinal haemorrhage
2.3%
1/43 • Number of events 1 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
0.00%
0/43 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
General disorders
Non-cardiac chest pain
0.00%
0/43 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
2.3%
1/43 • Number of events 1 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Hepatobiliary disorders
Cholelithiasis
0.00%
0/43 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
2.3%
1/43 • Number of events 1 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Lung neoplasm malignant
2.3%
1/43 • Number of events 1 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
0.00%
0/43 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Vascular disorders
Hypotension
2.3%
1/43 • Number of events 1 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
0.00%
0/43 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.

Other adverse events

Other adverse events
Measure
Fremanezumab
n=43 participants at risk
Participants received fremanezumab 675 mg administered as 3 SC injections (225 mg/1.5 mL each) at randomization (Week 0), Weeks 4, and 8 during the DB treatment period. Participants who completed the DB treatment period and continued into the OL treatment period received 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.
Placebo
n=43 participants at risk
Participants received placebo matched 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 completed the DB treatment period and continued into the OL treatment period received 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.
Gastrointestinal disorders
Diarrhoea
7.0%
3/43 • Number of events 4 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
4.7%
2/43 • Number of events 2 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Gastrointestinal disorders
Nausea
9.3%
4/43 • Number of events 6 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
4.7%
2/43 • Number of events 2 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
General disorders
Injection site erythema
25.6%
11/43 • Number of events 30 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
32.6%
14/43 • Number of events 41 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
General disorders
Injection site induration
41.9%
18/43 • Number of events 60 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
32.6%
14/43 • Number of events 49 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
General disorders
Injection site pain
32.6%
14/43 • Number of events 48 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
34.9%
15/43 • Number of events 47 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
General disorders
Injection site pruritus
9.3%
4/43 • Number of events 8 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
4.7%
2/43 • Number of events 2 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Infections and infestations
Influenza
7.0%
3/43 • Number of events 3 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
2.3%
1/43 • Number of events 2 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Infections and infestations
Nasopharyngitis
4.7%
2/43 • Number of events 3 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
9.3%
4/43 • Number of events 4 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Infections and infestations
Pneumonia
7.0%
3/43 • Number of events 3 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
0.00%
0/43 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Infections and infestations
Sinusitis
9.3%
4/43 • Number of events 5 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
7.0%
3/43 • Number of events 4 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Infections and infestations
Upper respiratory tract infection
2.3%
1/43 • Number of events 1 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
11.6%
5/43 • Number of events 5 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Investigations
International normalised ratio increased
9.3%
4/43 • Number of events 4 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
2.3%
1/43 • Number of events 1 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Nervous system disorders
Dizziness
9.3%
4/43 • Number of events 4 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
4.7%
2/43 • Number of events 2 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
Nervous system disorders
Headache
14.0%
6/43 • Number of events 7 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.
4.7%
2/43 • Number of events 3 • Baseline (Day -28 to Day -1) up to Week 24
Safety analysis set included all randomized participants who received at least 1 dose of the study drug.

Additional Information

Director, Clinical Research

Teva Branded Pharmaceutical Products R&D, Inc.

Phone: 1-888-483-8279

Results disclosure agreements

  • Principal investigator is a sponsor employee Sponsor has the right 60 days before submission for publication to review/provide comments. If the Sponsor's review shows that potentially patentable subject matter would be disclosed, publication or public disclosure shall be delayed for up to 90 additional days in order for the Sponsor, or Sponsor's designees, to file the necessary patent applications. In multicenter trials, each PI will postpone single center publications until after disclosure or publication of multicenter data.
  • Publication restrictions are in place

Restriction type: OTHER