Gepant TreAtments: EffectIveNess and TolERability (GAINER)

NCT ID: NCT05903027

Last Updated: 2024-10-08

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

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-06-15

Study Completion Date

2025-06-15

Brief Summary

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The purpose of this prospective and multicentric study is to evaluate the effectiveness and tolerability of rimegepant as acute migraine treatment in a cohort of episodic or chronic migraine patients.

Detailed Description

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Rimegepant belongs to the gepants family, small molecules calcitonin gene-related peptide (CGRP) receptor antagonists. It is a new generation gepants, currently available as an orally disintegrating tablet at a single dose of 75 mg. It has a double indication both for acute treatment for migraine with and without aura and preventive treatment of episodic migraine. Previous randomized, placebo-controlled phase 3 trials and open label extensions demonstrated its effectiveness in the acute setting for a single migraine attack of both the oral tablet and the orally disintegrating tablet. Pooled analysis of previous randomized clinical trials also showed rimegepant effectiveness in patients with a history of insufficient response to triptans.

Previous studies also demonstrated a good tolerability profile. The most commonly reported adverse events were nausea, nasopharyngitis, upper respiratory tract infections and urinary tract infection.

In this prospective multicentric study we aim to evaluate Rimegepant effectiveness and tolerability as acute migraine treatment in a real-world setting.

Subjects who meet the inclusion criteria will be enrolled and will participate in the study. Baseline demographic and clinical data will be collected at the baseline. Patients will be asked to treat their next migraine attack with Rimegepant 75 mg orally disintegrating tablet.

Data will be collected at baseline, during at least 4 migraine attacks treated with Rimegepant and at 3 months follow-up.

Subjects will be asked to complete assessment of their migraine attack at baseline and at 30 - 60 - 90 and 120 minutes after administration of the acute treatment for at least four migraine attacks. A final timepoint at 24 hours post-dose will be assessed only for the first attack.

Data collection will focus on: i) demographic data, ii) migraine history, iii) pain level and evolution, iv) presence and evolution of migraine associated symptoms, most bothersome symptom and aura, v) migraine associated disability, vi) patients's global impression of change (PGIC) and evaluation on the acute treatment (Migraine-ACT), vii) tolerability and eventual treatment-emergent adverse events. The online database REDCap will be used for data collection.

Conditions

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Migraine Migraine with Aura Migraine Without Aura Chronic Migraine

Keywords

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Headache Medication overuse headache Pain Gepant Triptan

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Episodic migraine

Patients affected by an episodic pattern migraine(\< 15 monthly headache days) with or without aura according to ICHD-III criteria.

Rimegepant 75 MG Disintegrating Oral Tablet

Intervention Type DRUG

Patients using Rimegepant 75 mg orally disintegrating tablet to treat acute migraine attacks

Chronic migraine

Patients affected by chronic migraine according to ICHD-III criteria.

Rimegepant 75 MG Disintegrating Oral Tablet

Intervention Type DRUG

Patients using Rimegepant 75 mg orally disintegrating tablet to treat acute migraine attacks

Interventions

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Rimegepant 75 MG Disintegrating Oral Tablet

Patients using Rimegepant 75 mg orally disintegrating tablet to treat acute migraine attacks

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of migraine without aura, migraine with aura, or chronic migraine according to the 3rd edition of the International Classification of Headache Disorder (ICHD-III).
* At least 3 MMDs
* Good compliance to study procedures
* Availability of headache diary at least of the preceding months before enrollment

Exclusion Criteria

* Subjects with contraindications for use of gepants;
* Concomitant diagnosis of medical diseases and/or comorbidities that, in the Investigator's opinion might interfere with study assessments;
* medical comorbidities that could interfere with study results;
* Pregnancy and breastfeeding.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS National Neurological Institute "C. Mondino" Foundation

OTHER

Sponsor Role collaborator

Società Italiana per lo Studio delle Cefalee

OTHER

Sponsor Role collaborator

Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari

OTHER

Sponsor Role collaborator

Università degli Studi dell'Aquila

OTHER

Sponsor Role collaborator

University of Roma La Sapienza

OTHER

Sponsor Role collaborator

Azienda Ospedaliero Universitaria Policlinico Modena

OTHER

Sponsor Role collaborator

Ospedale di Piove di Sacco

UNKNOWN

Sponsor Role collaborator

Azienda Ospedaliero-Universitaria di Parma

OTHER

Sponsor Role collaborator

Azienda Ospedaliera S. Maria della Misericordia

OTHER

Sponsor Role collaborator

A.O.U. Città della Salute e della Scienza

OTHER

Sponsor Role collaborator

Cliniche Humanitas Gavazzeni

OTHER

Sponsor Role collaborator

University of Campania Luigi Vanvitelli

OTHER

Sponsor Role collaborator

Ospedale Santo Stefano

OTHER

Sponsor Role collaborator

Azienda Policlinico Umberto I

OTHER

Sponsor Role collaborator

Auxologico San Luca

OTHER

Sponsor Role collaborator

Asst Degli Spedali Civili Di Brescia

OTHER

Sponsor Role collaborator

Carlo Besta Neurological Institute

OTHER

Sponsor Role collaborator

University of Florence

OTHER

Sponsor Role lead

Responsible Party

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Luigi Francesco Iannone

Researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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SOD Centro Cefalee e Farmacologia Clinica, AOU Careggi

Florence, Florence, Italy

Site Status RECRUITING

IRCCS National Neurological Institute "C. Mondino" Foundation

Pavia, Pavia, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Luigi F Iannone, MD

Role: CONTACT

Phone: +393896969606

Email: [email protected]

Roberto De Icco, MD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Luigi F Iannone, MD

Role: primary

Roberto De Icco, MD

Role: primary

References

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Lipton RB, Croop R, Stock EG, Stock DA, Morris BA, Frost M, Dubowchik GM, Conway CM, Coric V, Goadsby PJ. Rimegepant, an Oral Calcitonin Gene-Related Peptide Receptor Antagonist, for Migraine. N Engl J Med. 2019 Jul 11;381(2):142-149. doi: 10.1056/NEJMoa1811090.

Reference Type BACKGROUND
PMID: 31291516 (View on PubMed)

Croop R, Goadsby PJ, Stock DA, Conway CM, Forshaw M, Stock EG, Coric V, Lipton RB. Efficacy, safety, and tolerability of rimegepant orally disintegrating tablet for the acute treatment of migraine: a randomised, phase 3, double-blind, placebo-controlled trial. Lancet. 2019 Aug 31;394(10200):737-745. doi: 10.1016/S0140-6736(19)31606-X. Epub 2019 Jul 13.

Reference Type BACKGROUND
PMID: 31311674 (View on PubMed)

Lipton RB, Blumenfeld A, Jensen CM, Croop R, Thiry A, L'Italien G, Morris BA, Coric V, Goadsby PJ. Efficacy of rimegepant for the acute treatment of migraine based on triptan treatment experience: Pooled results from three phase 3 randomized clinical trials. Cephalalgia. 2023 Feb;43(2):3331024221141686. doi: 10.1177/03331024221141686.

Reference Type BACKGROUND
PMID: 36739511 (View on PubMed)

Iannone LF, Vaghi G, Sebastianelli G, Casillo F, Russo A, Silvestro M, Pistoia F, Volta GD, Cortinovis M, Chiarugi A, Montisano DA, Prudenzano MP, Cevoli S, Mampreso E, Avino G, Romozzi M, Valente M, Fasano C, Battistini S, Granato A, Piella EM, Rainero I, Ornello R, De Icco R; Italian Headache Registry (RICe) Study Group. Effectiveness and tolerability of rimegepant in the acute treatment of migraine: a real-world, prospective, multicentric study (GAINER study). J Headache Pain. 2025 Jan 6;26(1):4. doi: 10.1186/s10194-024-01935-8.

Reference Type DERIVED
PMID: 39762740 (View on PubMed)

Other Identifiers

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RICe_1

Identifier Type: -

Identifier Source: org_study_id