Comparison of the Effectiveness of First-line Preventive Treatment of Migraine in Primary Care

NCT ID: NCT06499116

Last Updated: 2024-07-12

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

NOT_YET_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

460 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-31

Study Completion Date

2026-12-31

Brief Summary

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This study, which is aimed at comparing the effectiveness of the most frequently used drugs in the first line in primary care for the preventive treatment of migraine (amitriptyline, flunarizine, topiramate and propranolol), is a multicentre, pragmatic, parallel group, open randomised trial. Adults (≥18) candidates for preventive treatment for migraine; those with a frequency of ≥4 monthly migraine days, and who agree to participate in the clinical trial, will be randomised to one of the 4 groups. Sample: 460 patients. The primary outcome will be the reduction in monthly migraine days, comparing amitriptyline, flunarizine and topiramate with propranolol.

Detailed Description

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Conditions

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Migraine

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Topiramate

25-100 mg/12h, V.O., during 12 weeks

Group Type EXPERIMENTAL

Topiramate

Intervention Type DRUG

Treatment will be prescribed for GPs and they will decide the specific dosage 25-100 mg/12h.

Flunarizine

2,5-10 mg/24h, V.O., during 12 weeks

Group Type EXPERIMENTAL

Flunarizine

Intervention Type DRUG

Treatment will be prescribed for GPs and they will decide the specific dosage 2,5-10 mg mg/24h.

Amitriptyline

10-75 mg/24h, V.O., during 12 weeks

Group Type EXPERIMENTAL

Amitriptyline

Intervention Type DRUG

Treatment will be prescribed for GPs and they will decide the specific dosage 10-75 mg/24h.

Propranolol

20-120 mg/12h, V.O., during 12 weeks

Group Type ACTIVE_COMPARATOR

Propranolol

Intervention Type DRUG

Treatment will be prescribed for GPs and they will decide the specific dosage 20-120 mg/12h.

Interventions

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Topiramate

Treatment will be prescribed for GPs and they will decide the specific dosage 25-100 mg/12h.

Intervention Type DRUG

Flunarizine

Treatment will be prescribed for GPs and they will decide the specific dosage 2,5-10 mg mg/24h.

Intervention Type DRUG

Amitriptyline

Treatment will be prescribed for GPs and they will decide the specific dosage 10-75 mg/24h.

Intervention Type DRUG

Propranolol

Treatment will be prescribed for GPs and they will decide the specific dosage 20-120 mg/12h.

Intervention Type DRUG

Other Intervention Names

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Acomicil Sibelium Tryptizol Sumial

Eligibility Criteria

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Inclusion Criteria

\- Adults (≥18) candidates for preventive treatment for migraine; those with a frequency of ≥4 monthly migraine days, and who agree to participate in the clinical trial.

Exclusion Criteria

* People diagnosed with migraine who are not candidates for preventive migraine treatment
* People diagnosed with chronic migraine (\>15 days of headache per month, of which 8 are monthly migraine days)
* Not having a smartphone
* Simultaneous participation in another clinical trial
* Pregnancy or expected pregnancy during the next 3 months
* Lactation
* People with migraine who already receive preventive treatment.
* People on chronic treatment with opioids or other analgesics or NSAIDs that are not used for the symptomatic treatment of migraine, for example, osteoarthritis.
* People who, in the opinion of the clinician, have an absolute contraindication to one of the study drugs or who cannot perform the trial procedures:

Hypersensitivity to any of the study drugs / Heart block or severe bradycardia / Concomitant treatment with verapamil or diltiazem / Active cardiovascular pathology (recent heart attack, angina, Raynaud's phenomenon) / Major depression or active treatment with antidepressants (including monoamine oxidase inhibitors and St. John's wort) / Other psychiatric illnesses or active treatment with antipsychotics or lithium / Severe liver disease or kidney failure / Parkinson's disease or other extrapyramidal disorders / Epilepsy (diagnosis and/or active treatment) / Any other contraindication that, in the opinion of the clinician, prevents participation in the clinical trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Català de la Salut

OTHER

Sponsor Role collaborator

Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

OTHER

Sponsor Role collaborator

Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Central Contacts

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Maria Giner-Soriano

Role: CONTACT

+34 93 482 4110

Ana Garcia-Sangenis

Role: CONTACT

+34 93 482 4651

References

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Giner-Soriano M, Morros R, Monfa R, Ouchi D, Fernandez-Garcia S, Vedia C, Bonet Monne S, Calvo Martinez EM, Copetti Fanlo S, Morollon N, Belvis Nieto R, Delgado-Espinoza CE, Garcia-Sangenis A. Comparison of the effectiveness of first-line preventive treatment of migraine in primary care: study protocol for a pragmatic clinical trial (PREMI study). Trials. 2025 Aug 26;26(1):311. doi: 10.1186/s13063-025-08961-0.

Reference Type DERIVED
PMID: 40859286 (View on PubMed)

Other Identifiers

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2024-513597-22-00

Identifier Type: CTIS

Identifier Source: secondary_id

IJG-PREMI-2024

Identifier Type: -

Identifier Source: org_study_id

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