Trial Outcomes & Findings for Comparison of Therapeutic Effects of Greater Occipital Nerve Block, Topiramate, and Flunarizine on Episodic Migraine (NCT NCT03712917)

NCT ID: NCT03712917

Last Updated: 2020-01-21

Results Overview

Range Pain 0-10, 0: No pain, 10: Worst Pain

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

120 participants

Primary outcome timeframe

Post treatment 4 weeks

Results posted on

2020-01-21

Participant Flow

Participant milestones

Participant milestones
Measure
Greater Occipital Nerve Block
The GONB solution is prepared with 1 ml triamcinolone (40mg), 2 ml bupivacaine (10 mg), and 1 ml 0,9% NaCl. The solution is administered using a 22G × 1¼" (0.7 × 40mm) injector with the patient lying prone on the table. Injection is applied to medial of the occipital artery localized at the medial one-third of the superior nuchal line between the occipital tubercle and mastoid process. The scalp is cleaned with iodine before the procedure, and the injections are performed bilaterally at a volume of 2 mL after negative aspiration for blood. Greater Occipital Nerve Block: An enjection to paralyze the occipital nerve.
Topiramate
Topiramate is administered twice a day at a dose of 25 mg/day, which is increased to 100 mg/day in the second week. Topiramate: An antiepileptic agent used for migraine prophylaxis.
Flunarizine
Flunarizine is introduced with a single dose of 10 mg/day. Flunarizine: A calcium overload blocker agent used for migraine prophylaxis.
Overall Study
STARTED
40
40
40
Overall Study
COMPLETED
31
32
31
Overall Study
NOT COMPLETED
9
8
9

Reasons for withdrawal

Reasons for withdrawal
Measure
Greater Occipital Nerve Block
The GONB solution is prepared with 1 ml triamcinolone (40mg), 2 ml bupivacaine (10 mg), and 1 ml 0,9% NaCl. The solution is administered using a 22G × 1¼" (0.7 × 40mm) injector with the patient lying prone on the table. Injection is applied to medial of the occipital artery localized at the medial one-third of the superior nuchal line between the occipital tubercle and mastoid process. The scalp is cleaned with iodine before the procedure, and the injections are performed bilaterally at a volume of 2 mL after negative aspiration for blood. Greater Occipital Nerve Block: An enjection to paralyze the occipital nerve.
Topiramate
Topiramate is administered twice a day at a dose of 25 mg/day, which is increased to 100 mg/day in the second week. Topiramate: An antiepileptic agent used for migraine prophylaxis.
Flunarizine
Flunarizine is introduced with a single dose of 10 mg/day. Flunarizine: A calcium overload blocker agent used for migraine prophylaxis.
Overall Study
Pregnancy
0
0
1
Overall Study
Adverse Event
0
4
3
Overall Study
Lost to Follow-up
9
4
5

Baseline Characteristics

Row population is the defined after the exclusion of patients from overall study population

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Greater Occipital Nerve Block
n=40 Participants
The GONB solution is prepared with 1 ml triamcinolone (40mg), 2 ml bupivacaine (10 mg), and 1 ml 0,9% NaCl. The solution is administered using a 22G × 1¼" (0.7 × 40mm) injector with the patient lying prone on the table. Injection is applied to medial of the occipital artery localized at the medial one-third of the superior nuchal line between the occipital tubercle and mastoid process. The scalp is cleaned with iodine before the procedure, and the injections are performed bilaterally at a volume of 2 mL after negative aspiration for blood. Greater Occipital Nerve Block: An enjection to paralyze the occipital nerve.
Topiramate
n=40 Participants
Topiramate is administered twice a day at a dose of 25 mg/day, which is increased to 100 mg/day in the second week. Topiramate: An antiepileptic agent used for migraine prophylaxis.
Flunarizine
n=40 Participants
Flunarizine is introduced with a single dose of 10 mg/day. Flunarizine: A calcium overload blocker agent used for migraine prophylaxis.
Total
n=120 Participants
Total of all reporting groups
Age, Continuous
30.2 years
STANDARD_DEVIATION 8.9 • n=31 Participants • Row population is the defined after the exclusion of patients from overall study population
31.5 years
STANDARD_DEVIATION 8.2 • n=32 Participants • Row population is the defined after the exclusion of patients from overall study population
30.9 years
STANDARD_DEVIATION 9.0 • n=31 Participants • Row population is the defined after the exclusion of patients from overall study population
30.9 years
STANDARD_DEVIATION 8.6 • n=94 Participants • Row population is the defined after the exclusion of patients from overall study population
Sex: Female, Male
Female
22 Participants
n=31 Participants • Row population is the defined after the exclusion of patients from overall study population
26 Participants
n=32 Participants • Row population is the defined after the exclusion of patients from overall study population
24 Participants
n=31 Participants • Row population is the defined after the exclusion of patients from overall study population
72 Participants
n=94 Participants • Row population is the defined after the exclusion of patients from overall study population
Sex: Female, Male
Male
9 Participants
n=31 Participants • Row population is the defined after the exclusion of patients from overall study population
6 Participants
n=32 Participants • Row population is the defined after the exclusion of patients from overall study population
7 Participants
n=31 Participants • Row population is the defined after the exclusion of patients from overall study population
22 Participants
n=94 Participants • Row population is the defined after the exclusion of patients from overall study population
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=120 Participants
Race (NIH/OMB)
Asian
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=120 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=120 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=120 Participants
Race (NIH/OMB)
White
40 Participants
n=40 Participants
40 Participants
n=40 Participants
40 Participants
n=40 Participants
120 Participants
n=120 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=120 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=40 Participants
0 Participants
n=120 Participants

PRIMARY outcome

Timeframe: Post treatment 4 weeks

Range Pain 0-10, 0: No pain, 10: Worst Pain

Outcome measures

Outcome measures
Measure
Greater Occipital Nerve Block
n=31 Participants
The GONB solution is prepared with 1 ml triamcinolone (40mg), 2 ml bupivacaine (10 mg), and 1 ml 0,9% NaCl. The solution is administered using a 22G × 1¼" (0.7 × 40mm) injector with the patient lying prone on the table. Injection is applied to medial of the occipital artery localized at the medial one-third of the superior nuchal line between the occipital tubercle and mastoid process. The scalp is cleaned with iodine before the procedure, and the injections are performed bilaterally at a volume of 2 mL after negative aspiration for blood. Greater Occipital Nerve Block: An enjection to paralyze the occipital nerve.
Topiramate
n=32 Participants
Topiramate is administered twice a day at a dose of 25 mg/day, which is increased to 100 mg/day in the second week. Topiramate: An antiepileptic agent used for migraine prophylaxis.
Flunarizine
n=31 Participants
Flunarizine is introduced with a single dose of 10 mg/day. Flunarizine: A calcium overload blocker agent used for migraine prophylaxis.
Visual Analog Scale
Pretreatment
8.1 score on a scale
Standard Deviation 1.0
7.9 score on a scale
Standard Deviation 0.9
7.9 score on a scale
Standard Deviation 0.9
Visual Analog Scale
Posttreatment
5.9 score on a scale
Standard Deviation 1.6
5.5 score on a scale
Standard Deviation 2.1
5.3 score on a scale
Standard Deviation 1.7

PRIMARY outcome

Timeframe: Post treatment 4 weeks

Number of headaches patients suffer in a month.

Outcome measures

Outcome measures
Measure
Greater Occipital Nerve Block
n=31 Participants
The GONB solution is prepared with 1 ml triamcinolone (40mg), 2 ml bupivacaine (10 mg), and 1 ml 0,9% NaCl. The solution is administered using a 22G × 1¼" (0.7 × 40mm) injector with the patient lying prone on the table. Injection is applied to medial of the occipital artery localized at the medial one-third of the superior nuchal line between the occipital tubercle and mastoid process. The scalp is cleaned with iodine before the procedure, and the injections are performed bilaterally at a volume of 2 mL after negative aspiration for blood. Greater Occipital Nerve Block: An enjection to paralyze the occipital nerve.
Topiramate
n=32 Participants
Topiramate is administered twice a day at a dose of 25 mg/day, which is increased to 100 mg/day in the second week. Topiramate: An antiepileptic agent used for migraine prophylaxis.
Flunarizine
n=31 Participants
Flunarizine is introduced with a single dose of 10 mg/day. Flunarizine: A calcium overload blocker agent used for migraine prophylaxis.
Attack Frequencies
Pretreatment
8.6 headaches per month
Standard Deviation 2.6
8.0 headaches per month
Standard Deviation 2.7
8.0 headaches per month
Standard Deviation 2.4
Attack Frequencies
Posttreatment
3.3 headaches per month
Standard Deviation 1.0
2.7 headaches per month
Standard Deviation 2.3
2.8 headaches per month
Standard Deviation 1.4

Adverse Events

Flunarizine

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Greater Occipital Nerve Block

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

Topiramate

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Flunarizine
n=40 participants at risk
Flunarizine is introduced with a single dose of 10 mg/day. Flunarizine: A calcium overload blocker agent used for migraine prophylaxis.
Greater Occipital Nerve Block
n=40 participants at risk
The GONB solution is prepared with 1 ml triamcinolone (40mg), 2 ml bupivacaine (10 mg), and 1 ml 0,9% NaCl. The solution is administered using a 22G × 1¼" (0.7 × 40mm) injector with the patient lying prone on the table. Injection is applied to medial of the occipital artery localized at the medial one-third of the superior nuchal line between the occipital tubercle and mastoid process. The scalp is cleaned with iodine before the procedure, and the injections are performed bilaterally at a volume of 2 mL after negative aspiration for blood. Greater Occipital Nerve Block: An enjection to paralyze the occipital nerve.
Topiramate
n=40 participants at risk
Topiramate is administered twice a day at a dose of 25 mg/day, which is increased to 100 mg/day in the second week. Topiramate: An antiepileptic agent used for migraine prophylaxis.
Nervous system disorders
Sedation
7.5%
3/40 • Number of events 3 • From the start of the study till the end (one month)
0.00%
0/40 • From the start of the study till the end (one month)
0.00%
0/40 • From the start of the study till the end (one month)
Nervous system disorders
Fatique
0.00%
0/40 • From the start of the study till the end (one month)
0.00%
0/40 • From the start of the study till the end (one month)
2.5%
1/40 • Number of events 1 • From the start of the study till the end (one month)
Nervous system disorders
paresthesia
0.00%
0/40 • From the start of the study till the end (one month)
0.00%
0/40 • From the start of the study till the end (one month)
2.5%
1/40 • Number of events 1 • From the start of the study till the end (one month)
Nervous system disorders
memory difficulties
0.00%
0/40 • From the start of the study till the end (one month)
0.00%
0/40 • From the start of the study till the end (one month)
5.0%
2/40 • Number of events 2 • From the start of the study till the end (one month)

Additional Information

Mustafa Ceylan

Ataturk University

Phone: +905062773216

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place