Use of the Tx360 Nasal Applicator in the Treatment of Chronic Migraine
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Purpose
Migraine imposes a substantial burden on patients in terms of diminished daily functioning, quality of life, and financial loss. Pain severity and duration correlates with reduced measures of daily functioning, and overall health status. The sphenopalatine ganglion (SPG) has been implicated in a variety of cephalalgias. This has been well represented in the literature dating back over a century. Access to this structure can be gained via a small area of mucosa just posterior and superior to the tail of the middle turbinate on the lateral nasal wall. At this aspect, there is no bony boundary to the SPG. Blocking the SPG using local anesthetics relieves pain. Unfortunately, many current interventions are cumbersome, invasive, and expensive. The purpose of this study is to evaluate the efficacy of the Tx360™, a new nasal applicator device, in the treatment of head and face pain and to examine the economic implications. The Tx360™ is a single use device designed to deliver a topical local anesthetic to the specific area of mucosa associated with the SPG. A total of 30 study participants will be accepted into this double-blind placebo-controlled study. 20 will receive SPG blocks using a 0.3 mL of a 0.5% solution of Marcaine delivered by the Tx360™ while 10 will receive a placebo of saline substituted for the Marcaine. Both patient sets will also be given a piece of lemon hard candy as a taste distractor. Participants must have a chronic migraine history with over 15 symptomatic days per month over the past three months. The treatment plan consists of six weeks of treatment, two times per week. Short and longer term assessments will be retrieved and analyzed as detailed in the Study Design.
| Condition | Intervention | Phase |
|---|---|---|
|
Chronic Migraine |
Drug: Marcaine |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Treatment |
| Official Title: | Use of the Tx360 Nasal Applicator for Transnasal Sphenopalatine Ganglion Block in the Treatment of Chronic Migraine: A Double-blind Placeo-controlled Study |
- Compare Numeric Rating Scale (NRS) score Before Procedure vs. 15-minute vs. 30-minute vs. 24-hour After Procedure scores for each of 12 treatments (Group A vs. Group B) [ Time Frame: 6 Weeks ] [ Designated as safety issue: No ]
- Compare change in Numeric Rating Scale (NRS) score from Before Procedure to 15-minute vs. Before Procedure to 30-minute vs. Before Procedure to 24-hour After Procedure scores for each of 12 treatments (Group A vs. Group B) [ Time Frame: 6 Weeks ] [ Designated as safety issue: No ]
- Compare 24-hour After Procedure Patient's Global Impression of Change (PGIC) score for each of 12 treatments (Group A vs. Group B) [ Time Frame: 6 Weeks ] [ Designated as safety issue: No ]
- Compare Modified Brief Pain Inventory scores Before Procedure vs. 24-hour After Procedure vs. 1-Month Follow Up vs. 6-Month Follow Up Questionnaires for each of 12 treatments (Group A vs. Group B) [ Time Frame: 6 Months ] [ Designated as safety issue: No ]
- Compare change in the number of migraine headache days per month reported in Baseline Period Diary vs. Treatment Period Diary vs. Post-Treatment Period Diary. [ Time Frame: 14 Weeks ] [ Designated as safety issue: No ]
- Acute medications usage (type and dose) (Group A vs. Group B) [ Time Frame: 14 Weeks ] [ Designated as safety issue: No ]
- Adverse effects (Group A vs. Group B) [ Time Frame: 6 Months ] [ Designated as safety issue: No ]
- HIT-6 headache impact scores pre-treatment at Visit 2 vs. following final treatment (Treatment 12) and at 1-Month Post-Treatment (Group A vs. Group B) [ Time Frame: 10 Weeks ] [ Designated as safety issue: No ]
- Satisfaction questionnaire scores pre-treatment at Visit 2 vs. following treatment (Treatment 12) and at 1-Month Post-Treatment (Group A vs. Group B) [ Time Frame: 10 Weeks ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 20 |
| Study Start Date: | September 2012 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Group A
Group A will receive treatment with 0.3 mL of 0.5% Marcaine delivered bilaterally with the Tx360™ device to the mucosa associated with the Sphenopalatine Ganglion (SPG)
|
Drug: Marcaine
Marcaine used as a topical local anesthetic to block the SPG by delivering Marcaine directly to the specific area of mucosa associated with the SPG.
Other Name: Bupivicane (generic)
|
|
Placebo Comparator: Group B
Group B will receive saline placebo delivered bilaterally with the Tx360TM device to the mucosa associated with the SPG.
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Is male or female, in otherwise good health, 18 to 80 years of age.
- Has history of chronic migraine (with or without aura) according to the criteria proposed by the Headache Classification Committee of the International Headache Society for at least 3 months prior to enrollment.
- Has onset of migraine before age 50.
- Is able to differentiate migraine from any other headache they may experience (e.g., tension-type headache).
- Is not currently taking a migraine preventive or has been taking preventive for at least 30 days prior to screening and agrees to not start, stop, or change medication and/or dosage during the study period.
If female of childbearing potential, agrees to use, for the duration of the study, a medically acceptable form of contraception as determined by the Investigator.
- Complete abstinence from intercourse from 2 weeks prior to administration of study drug throughout the study, and for a time interval after completion or premature discontinuation from the study to account for elimination of the study drug; or,
- Surgically sterile (hysterectomy or tubal ligation or otherwise incapable of pregnancy); or,
- Sterilization of male partner; or,
- Intrauterine device with published data showing lowest expected failure rate is less than 1% per year; or,
- Double barrier method (i.e., 2 physical barriers OR 1 physical barrier plus spermicide) for a least 1 month prior to Visit 1 and throughout study; or,
- Hormonal contraceptives for at least 3 months prior to Visit 1 and throughout study.
- Has pain presentation in frontal, temporal, ophthalmic, maxillary, mandibular, facial, or intraoral location.
Exclusion Criteria:
- Is male or female, in otherwise good health, 18 to 80 years of age.
- Has history of chronic migraine (with or without aura) according to the criteria proposed by the Headache Classification Committee of the International Headache Society for at least 3 months prior to enrollment.
- Has onset of migraine before age 50.
- Is able to differentiate migraine from any other headache they may experience (e.g., tension-type headache).
- Is not currently taking a migraine preventive or has been taking preventive for at least 30 days prior to screening and agrees to not start, stop, or change medication and/or dosage during the study period.
If female of childbearing potential, agrees to use, for the duration of the study, a medically acceptable form of contraception as determined by the Investigator.
- Complete abstinence from intercourse from 2 weeks prior to administration of study drug throughout the study, and for a time interval after completion or premature discontinuation from the study to account for elimination of the study drug; or,
- Surgically sterile (hysterectomy or tubal ligation or otherwise incapable of pregnancy); or,
- Sterilization of male partner; or,
- Intrauterine device with published data showing lowest expected failure rate is less than 1% per year; or,
- Double barrier method (i.e., 2 physical barriers OR 1 physical barrier plus spermicide) for a least 1 month prior to Visit 1 and throughout study; or,
- Hormonal contraceptives for at least 3 months prior to Visit 1 and throughout study.
- Has pain presentation in frontal, temporal, ophthalmic, maxillary, mandibular, facial, or intraoral location.
Contacts and Locations| Contact: Jeanne G Tarrasch, BSN, RN | 417-841-3673 | jtarrasch@clinvest.com |
| Contact: Michele Everett | 417-841-3620 | meverett@banyangroupinc.com |
| United States, Michigan | |
| Michigan Head Pain & Neurological Institute | Recruiting |
| Ann Arbor, Michigan, United States, 48104 | |
| Principal Investigator: Joel Saper, MD | |
| United States, Missouri | |
| Clinvest/A Division of Banyan Group, Inc. | Recruiting |
| Springfield, Missouri, United States, 65807 | |
| Principal Investigator: Roger K Cady, MD | |
| Sub-Investigator: John K Dexter, MD | |
| Principal Investigator: | Tian Xia, MD | Tian Medical Inc. |
More Information
Additional Information:
Publications:
| Responsible Party: | Tian Medical Inc. |
| ClinicalTrials.gov Identifier: | NCT01709708 History of Changes |
| Other Study ID Numbers: | 12-004TI |
| Study First Received: | October 16, 2012 |
| Last Updated: | January 30, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Tian Medical Inc.:
|
Migraine Headache Chrnoic Migraine Marcaine Tx360 |
Additional relevant MeSH terms:
|
Migraine Disorders Headache Disorders, Primary Headache Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Bupivacaine Anesthetics, Local |
Anesthetics Central Nervous System Depressants Physiological Effects of Drugs Pharmacologic Actions Sensory System Agents Peripheral Nervous System Agents Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 17, 2013