Ketamine + Magnesium for Chronic Cluster Headache (KETALGIA)

NCT ID: NCT04814381

Last Updated: 2025-07-16

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

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-15

Study Completion Date

2026-12-31

Brief Summary

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Chronic cluster headache (CCH) is a rare primary headache disorder, defined by episodic attacks that occur for more than one year with no remission period or with remission periods lasting \< 3 months (ICHD-3 criteria). In certain cases, CCH patients become drug-resistant and continue to suffer almost daily attacks.

Ketamine appears to be effective in a variety of chronic pain conditions, such as refractory headache, and can show an enhanced analgesic effect when combined with magnesium. A single infusion of ketamine-magnesium combination has been described to reduce attacks in 17 patients with rCCH. The main outcome was a comparison of the number of daily attacks two weeks prior to the infusion and one week after (days 7-8). The number of daily attacks decreased from 4.3±2.4 before treatment to 1.3±1.0 after treatment (p\<0.001). 13/17 had at least 50% response. Thus, the goal of this placebo-controlled study is to try to confirm these findings.

Detailed Description

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Chronic cluster headache (CCH) is a rare primary headache disorder, defined by episodic attacks that occur for more than one year with no remission period or with remission periods lasting \< 3 months (ICHD-3 criteria). In certain cases, CCH patients become drug-resistant and continue to suffer almost daily attacks.

Ketamine appears to be effective in a variety of chronic pain conditions, such as refractory headache, and can show an enhanced analgesic effect when combined with magnesium. A single infusion of ketamine-magnesium combination has been described to reduce attacks in 17 patients with rCCH. The main outcome was a comparison of the number of daily attacks two weeks prior to the infusion and one week after (days 7-8). The number of daily attacks decreased from 4.3±2.4 before treatment to 1.3±1.0 after treatment (p\<0.001). 13/17 had at least 50% response. Thus, the goal of this placebo-controlled study is to try to confirm these findings.

Conditions

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Refractory Chronic Cluster Headache

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

patients will be randomised with 1:1 ratio
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
infusion will be prepared by a nurse that is not blinded to the treatment and will not take part to patient evaluation. Active and control treatments are of transparent colour and will not be recognisable.

Study Groups

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Ketamine + Magnesium

patients in the experimental group will receive 0.5mg/kg of ketamine over 2 hours, diluted in 50cc of NaCl 0.9% and 3g of magnesium sulfate over 30 minutes diluted in 250cc of NaCl 0.9%.

Group Type EXPERIMENTAL

Ketamine + Magnesium sulfate (drug combination)

Intervention Type DRUG

A single infusion will be performed over 2 hours with 90 days follow-up.

Control

patients in the control group will receive 25mg of hydroxyzine over 2 hours, diluted in 50cc of NaCl 0.9% and 250cc of NaCl 0.9% over 30 minutes

Group Type ACTIVE_COMPARATOR

Ketamine + Magnesium sulfate (drug combination)

Intervention Type DRUG

A single infusion will be performed over 2 hours with 90 days follow-up.

Interventions

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Ketamine + Magnesium sulfate (drug combination)

A single infusion will be performed over 2 hours with 90 days follow-up.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age \>= 18 years
* Chronic cluster headache diagnosis made according to ICHD-3 criteria
* A mean of at least 2 attacks/day during the 14 days before infusion
* Insufficient efficacy or intolerance or contra-indication to the use of the 3 main validated treatments (verapamil, lithium and sub-occipital steroids injections)
* Stable preventive treatment for at least 7 days before infusion

Exclusion Criteria

* Pregnant or lactating woman
* Contra-indication to ketamine use (uncontrolled high blood pressure, stoke history, severe cardiac failure)
* Ketamine use during the previous year
* Hypersensitivity to the product or their metabolites
* Severe renal insufficiency (creatinine clearance \< 30ml/min)
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut National de la Santé Et de la Recherche Médicale, France

OTHER_GOV

Sponsor Role collaborator

University Hospital, Clermont-Ferrand

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Xavier MOISSET

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Clermont-Ferrand

Locations

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CH Annecy Genevois

Annecy, , France

Site Status RECRUITING

Polyclinique Jean Villar

Bruges, , France

Site Status RECRUITING

CHU de Clermont-Ferrand

Clermont-Ferrand, , France

Site Status RECRUITING

CHRU De Lille

Lille, , France

Site Status RECRUITING

Hospices civils de Lyon, Hôpital Pierre Wertheimer

Lyon, , France

Site Status RECRUITING

AP-HM Marseille

Marseille, , France

Site Status RECRUITING

Clinique Beau Soleil

Montpellier, , France

Site Status RECRUITING

CHU de Montpellier

Montpellier, , France

Site Status RECRUITING

CHU Nantes, Hopital Nord Laennec

Nantes, , France

Site Status RECRUITING

Hôpital Lariboisière

Paris, , France

Site Status RECRUITING

CHU Rouen

Rouen, , France

Site Status RECRUITING

Hopital de Hautepierre

Strasbourg, , France

Site Status RECRUITING

Hopital Pierre Paul Riquet

Toulouse, , France

Site Status RECRUITING

CHU Grenoble-Alpes

Voiron, , France

Site Status NOT_YET_RECRUITING

Countries

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France

Central Contacts

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Lise LACLAUTRE

Role: CONTACT

+33473754963

Facility Contacts

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Pierric Giraud

Role: primary

Virginie Corand, Medical Doctor

Role: primary

+33556164155

Lise Laclautre

Role: primary

+33473754963

Christian Lucas

Role: primary

Geneviève Demarquay

Role: primary

Anne Donnet

Role: primary

Nicolas Gaillard, Medical Doctor

Role: primary

0467759771

Anne Ducros

Role: primary

Solène De Gaalon

Role: primary

Caroline Roos

Role: primary

Evelyne Massardier

Role: primary

Mirela Muresan

Role: primary

Cedric Gollion, Medical Doctor

Role: primary

+33561772529

Gerard Mick, Medical Doctor

Role: primary

+33476671491

Other Identifiers

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2020-003604-14

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

RBHP 2020 MOISSET

Identifier Type: -

Identifier Source: org_study_id

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