Trial record 1 of 1 for:    Amitriptyline in the Prevention of Childhood Migraine
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The Childhood and Adolescent Migraine Prevention Study (CHAMP)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01581281
Recruitment Status : Terminated (Interim assessment provided sufficient data to answer study questions)
First Posted : April 20, 2012
Results First Posted : August 10, 2017
Last Update Posted : August 10, 2017
National Institute of Neurological Disorders and Stroke (NINDS)
Information provided by (Responsible Party):
Children's Hospital Medical Center, Cincinnati

Brief Summary:
The purpose of this research study is to test two medicines for migraine prevention in children and adolescents.

Condition or disease Intervention/treatment Phase
Migraine Migraine Disorders Headache Drug: Amitriptyline Drug: Topiramate Drug: Placebo Phase 3

Detailed Description:
The purpose of this research study is to test two medicines for migraine prevention in children and adolescents. The investigators want to see if amitriptyline and/or topiramate are better than placebo (sugar pill) in reducing headache frequency in children and adolescents ages 8 to 17 with migraines. At this time, there are no FDA approved medicines approved in the US for the prevention treatment of migraine headaches in children and adolescents.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 488 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: Amitriptyline and Topiramate in the Prevention of Childhood Migraine
Study Start Date : June 2012
Actual Primary Completion Date : April 2015
Actual Study Completion Date : January 2016

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Headache Migraine

Arm Intervention/treatment
Active Comparator: Amitriptyline
Drug to be administered twice daily.
Drug: Amitriptyline
Amitriptyline will be administered twice daily at home during the 8-week titration period followed by a 16 week maintenance phase of the highest tolerated dose. The morning dose is a placebo pill. Dosing of amitriptyline will be weight-based.

Active Comparator: Topiramate
Drug to be administered twice daily.
Drug: Topiramate
Topiramate will be administered twice daily at home during the 8-week titration period followed by a 16 week maintenance phase of the highest tolerated dose. Dosing of topiramate will be weight-based.

Placebo Comparator: Placebo
To be administered twice daily.
Drug: Placebo
Placebo will be administered twice daily at home during the 8-week titration period followed by a 16 week maintenance period.

Primary Outcome Measures :
  1. Number (Percentage) of Participants Reporting a ≥ 50% Reduction in Headache Days [ Time Frame: 4 week baseline period and last 4 weeks of the 24-week trial ]

    The primary endpoint was a ≥ 50% reduction in headache frequency from the 28 days (4 weeks) baseline period prior to randomization to the last 28 days (4 weeks) of the trial. Headache frequency was defined as the number of days with headache for a given four week 28 day (4 week) period. A headache day was defined as any day during which any headache occurs within a 24 hour period, starting and ending at midnight.

    For each participant, the primary endpoint involved a determination of whether a 50% or greater reduction in headache frequency was observed during the last 4 weeks of active treatment as compared with the headache frequency during the 4-week baseline period. Results were compared across the three treatment groups.

Secondary Outcome Measures :
  1. Change in Absolute Headache Disability Score on PedMIDAS [ Time Frame: baseline and 24 week endpoint ]

    The PedMIDAS scale which evaluated the impact of headaches in school, home, play, and social activities, is comprised of six items that pertain to days missed in various activities over the past 90 days. Questions were answered by the youth in consultation with their parents and reviewed by study staff. The PedMIDAS scale was administered at baseline (covering the three months prior to enrollment) and at the 24-week endpoint visit (the end of the maintenance period, covering three months of enrollment). A total PedMIDAS score (sum of items 1-6) was used in this trial. Scores range from 0-240; with a score of 0-10 indicating no disability, 11-30 mild disability, 31-50 moderate disability, and more than 50 severe disability in daily activities. The main outcome measure for this comparison will be the difference in the baseline and endpoint (24 week) PedMIDAS total scores for:

    1. Amitriptyline vs. Placebo
    2. Topiramate vs. Placebo
    3. Amitriptyline vs Topiramate

  2. Change in Number of Headache Days [ Time Frame: 4 week baseline period and last 4 weeks of the 24-week trial ]

    This outcomes measure examines whether the rate of absolute number of headache days, per 28 day period, differs between treatment groups over time. This was assessed longitudinally based on the actual number of headache days from the 28 days prior to randomization to the last 28 days of this 24 week trial. The change in absolute headache days was compared between:

    1. Amitriptyline vs. placebo
    2. Topiramate vs. placebo
    3. Amitriptyline vs. Topiramate

  3. Tolerability, as Indicated by the Number (Percentage) of Participants That Completed the 24-week Treatment Phase [ Time Frame: 24 weeks ]
    To assess tolerability, the percentage of subjects who complete the entire 24-week treatment period will be estimated in each of the three groups.

  4. Occurrence of Treatment Emergent Serious Adverse Events [ Time Frame: 24 weeks of the trial ]
    To determine if amitriptyline or topiramate differ from placebo on the occurrence of treatment emergent serious adverse events.

Information from the National Library of Medicine

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Ages Eligible for Study:   8 Years to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Migraine with or without aura (International Classification of Headache Disorders, 2nd Edition (ICHD-II) or chronic migraine (ICHD-II revised)
  • Migraine frequency based upon prospective headache diary of 28 days must be ≥ 4. Migraine frequency defined as any migraine during one day in the 28 day baseline period (1)
  • PedMIDAS Disability Score > 10, indicating at least mild disruption in daily activities and < 140, indicating extreme disability that may require more comprehensive, multi-component therapy
  • Females or males 8-17 years, inclusive

    1. Migraine frequency is defined as the period from the onset to the stop time of painful migraine symptoms not to exceed 24 hours with the clock starting at midnight. If painful symptoms last longer than 24 hours, this is considered a new and distinct migraine headache. If painful symptoms recur within 24 hours of initial onset, this is considered part of the initial migraine episode and would be counted as one migraine.

Exclusion Criteria:

  • Continuous migraine defined as an unrelenting headache for a 28 day period
  • Weight less than 30 kg or greater than 120 kg
  • Unwilling to avoid taking non-specific acute medication such as NSAIDS (e.g., ibuprofen), more than 3 times per week, or migraine specific acute medications such as triptans more than 6 times per month
  • Currently taking other prophylactic anti-migraine medication within a period equivalent to 2 weeks of that medication before entering the screening phase, or the use of Botulinum toxin (Botox®) within 3 months of entering the screening phase
  • Subjects who have previously failed an adequate trial of AMI or TPM for prophylaxis of at least 3 months duration at doses recommended for migraine relief because of lack of efficacy or adverse events(2)
  • Current use of disallowed medications/products: opioids, antipsychotics, antimanics, barbiturates, benzodiazepines, muscle relaxants, sedatives, tramadol, nutraceuticals, SSRIs, or SSNRIs
  • Known history of allergic reaction or anaphylaxis to AMI or TPM
  • Abnormal findings on ECG at baseline, particularly lengthening of the QT interval greater than or equal to 450 msec
  • Subject is pregnant or has a positive pregnancy test
  • Subject is sexually active and not using a medically acceptable form of contraception
  • Diagnosis of epilepsy or other neurological diseases
  • History of kidney stones
  • Inability to swallow pills after using behavioral techniques if indicated between screening visit and baseline visit (3)
  • Present psychiatric disease as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV) (e.g. psychosis, bipolar disorder, major depression, generalized anxiety disorder), alcohol or drug dependence, or documented developmental delays or impairments (e.g., autism, cerebral palsy, or mental retardation) that, in the opinion of the site investigator, would interfere with adherence to study requirements or safe participation in the trial
  • Any and all other diagnoses or conditions which in the opinion of the site investigator, that would prevent the patient from being a suitable candidate for the study or interfere with the medical care needs of the study subject

    (2)"Previously failed an adequate trial of AMI or TPM" is defined as: dosage of 1mg/kg/day of AMI or 2 mg/kg/day of TPM; trial of at least 3 months duration; efficacy of having at least a 50% decrease in migraine frequency in response to drug therapy; or unable to tolerate taking the medication due to treatment-related side effects.

    (3)Subjects who cannot swallow pills at the time of the screening visit will be given a training session using behavioral techniques. Upon return for baseline visit, if the subject continues to be unable to swallow pills, the subject will be excluded from the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01581281

  Hide Study Locations
United States, Arizona
Phoenix Children's Medical Group
Phoenix, Arizona, United States, 85016
United States, California
University of California-San Francisco Headache Center
San Francisco, California, United States, 94115
Stanford Hospital and Clinics
Stanford, California, United States, 94305
United States, Colorado
Children's Hospital Colorado
Aurora, Colorado, United States, 80045
Colorado Springs Neurological Associates
Colorado Springs, Colorado, United States, 80907
United States, District of Columbia
Children's National Medical Center
Washington, D.C., District of Columbia, United States, 20010
United States, Florida
Premiere Research Institute
West Palm Beach, Florida, United States, 33407
United States, Georgia
Atlanta Headache Specialists
Atlanta, Georgia, United States, 30342
United States, Indiana
Josephson Wallack Munshower Neurology Research
Indianapolis, Indiana, United States, 46237
United States, Kansas
Children's Mercy Hospital
Kansas City, Kansas, United States, 66160
United States, Kentucky
University of Louisville Health Sciences Center
Louisville, Kentucky, United States, 40292
United States, Maryland
University of Maryland School of Medicine
Baltimore, Maryland, United States, 21201
United States, Massachusetts
Children's Hospital of Boston
Waltham, Massachusetts, United States, 02453
New England Regional Headache Center
Worcester, Massachusetts, United States, 01605
United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
United States, Missouri
Saint Louis University
Saint Louis, Missouri, United States, 63104
United States, Nevada
University of Nevada
Reno, Nevada, United States, 89502
United States, New York
Dent Neurological Institute
Amherst, New York, United States, 14226
Winthrop University Hospital
Mineola, New York, United States, 11501
The Headache Institute at Roosevelt Hospital
New York, New York, United States, 10019
Schenectady Neurological Constultants, PC
Schenectady, New York, United States, 12308
United States, Ohio
Akron Children's Hospital
Akron, Ohio, United States, 44308
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States, 45229
The Children's Hospital, Cleveland Clinic
Cleveland, Ohio, United States, 44195
Nationwide Children's Hospital
Columbus, Ohio, United States, 43205
United States, Oklahoma
Oklahoma Health Sciences
Oklahoma City, Oklahoma, United States, 73104
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
Preferred Clinical Research
Pittsburgh, Pennsylvania, United States, 15236
United States, Tennessee
LeBonheur Children's Hospital
Memphis, Tennessee, United States, 38105
United States, Texas
Dallas Pediatric Neurology Associates
Dallas, Texas, United States, 75230
Scott and White Healthcare
Temple, Texas, United States, 76508
United States, Utah
Primary Children's Medical Center
Salt Lake City, Utah, United States, 84108
United States, Virginia
Eastern Virginia Medical School
Norfolk, Virginia, United States, 23510
United States, Washington
Seattle Children's Hospital
Seattle, Washington, United States, 98105
United States, Wisconsin
Marshfield Clinic
Marshfield, Wisconsin, United States, 54449
Sponsors and Collaborators
Children's Hospital Medical Center, Cincinnati
National Institute of Neurological Disorders and Stroke (NINDS)
Principal Investigator: Scott W. Powers, PhD Children's Hospital Medical Center, Cincinnati
Principal Investigator: Andrew D. Hershey, MD, PhD Children's Hospital Medical Center, Cincinnati
Principal Investigator: Christopher S. Coffey, PhD University of Iowa

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Children's Hospital Medical Center, Cincinnati Identifier: NCT01581281     History of Changes
Other Study ID Numbers: CIN-001
1U01NS076788-01 ( U.S. NIH Grant/Contract )
First Posted: April 20, 2012    Key Record Dates
Results First Posted: August 10, 2017
Last Update Posted: August 10, 2017
Last Verified: July 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: De-identified datasets and associated documentation will be submitted to NINDS for archiving and public access, consistent with current NINDS data sharing policy.

Keywords provided by Children's Hospital Medical Center, Cincinnati:

Additional relevant MeSH terms:
Migraine Disorders
Amitriptyline, perphenazine drug combination
Headache Disorders, Primary
Headache Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Neurologic Manifestations
Signs and Symptoms
Neuroprotective Agents
Protective Agents
Physiological Effects of Drugs
Anti-Obesity Agents
Antidepressive Agents, Tricyclic
Antidepressive Agents
Psychotropic Drugs
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents
Adrenergic Uptake Inhibitors
Neurotransmitter Uptake Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Adrenergic Agents