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A Randomized, Sham-controlled Study of gammaCore ® (nVNS) for Prevention of Episodic Migraine

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.
 
ClinicalTrials.gov Identifier: NCT02378844
Recruitment Status : Completed
First Posted : March 4, 2015
Results First Posted : August 19, 2019
Last Update Posted : August 19, 2019
Sponsor:
Information provided by (Responsible Party):
ElectroCore INC

Brief Summary:
A prospective, double-blind, randomized, sham-controlled, multicentre investigation.

Condition or disease Intervention/treatment Phase
Migraine Device: gammaCore®-R Device: gammaCore®-R Sham Not Applicable

Detailed Description:

The study period will begin with a four week run-in period, during which there is no investigational treatment. The purpose of the run-in period will be observation for baseline comparison.

The run-in period will be, followed by a 12 week randomized period when the subjects will be randomized (1:1) to either active treatment or sham (inactive) treatment.

The randomized period will be followed by a 24 week open label period, where the subjects in the sham treatment group will switch in treatment assignment and receive a gammaCore®-R and the gammaCore®-R will continue to receive an active treatment.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 477 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Prevention
Official Title: A Randomized, Multicentre, Double-blind, Parallel, Sham-controlled Study of gammaCore®, a Non-invasive Vagal Nerve Stimulator (nVNS), for Prevention of Episodic Migraine
Actual Study Start Date : June 2015
Actual Primary Completion Date : February 1, 2018
Actual Study Completion Date : August 29, 2018

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Migraine

Arm Intervention/treatment
Active Comparator: gammaCore®-R
Subjects will be instructed to treat three times per day, 2 consecutive bilateral stimulations, upon waking, six to eight hours following the first daily treatment, and six to eight hours following the second daily treatment (one stimulation on the right side immediately followed by a second stimulation on the left side).
Device: gammaCore®-R
Subjects will be instructed to treat three times per day, 2 consecutive bilateral stimulations, upon waking, six to eight hours following the first daily treatment, and six to eight hours following the second daily treatment (one stimulation on the right side immediately followed by a second stimulation on the left side).

Sham Comparator: gammaCore®-R Sham
Subjects will be instructed to treat three times per day, 2 consecutive bilateral stimulations, upon waking, six to eight hours following the first daily treatment, and six to eight hours following the second daily treatment (one stimulation on the right side immediately followed by a second stimulation on the left side).
Device: gammaCore®-R Sham
Subjects will be instructed to treat three times per day, 2 consecutive bilateral stimulations, upon waking, six to eight hours following the first daily treatment, and six to eight hours following the second daily treatment (one stimulation on the right side immediately followed by a second stimulation on the left side).




Primary Outcome Measures :
  1. Change in the Number of Migraine Days [ Time Frame: last 4 weeks of the randomized/controlled period compared to the subject's own 4-week run-in period. ]
    Change in number of migraine days (as reported in subject diary), comparing the 4 week run-in period to the last 4 weeks in the randomized period.


Secondary Outcome Measures :
  1. Number of Participants With 50% Responder Rate [ Time Frame: The last four weeks in the randomization period compared to the four week run-in period. ]
    The number of subjects with a reduction of 50% or more in number of migraine days (as reported in the subject diary) from the run-in period to the last 4 weeks of the double-blind period.

  2. Mean Change in Number of Headache Days [ Time Frame: The last four weeks in the randomization period compared to the four week run-in period. ]
    The mean change in number of headache days (as reported in the subject diary) from the run-in period to the last 4 weeks of the double-blind period.

  3. Change in Number of Acute Medication Days [ Time Frame: The last four weeks in the randomization period compared to the four week run-in period. ]
    The mean change in number of acute medication days (as reported in the subject diary) from the run-in period to the last 4 weeks of the double-blind period

  4. Change in Headache Disability Using Headache Impact Test-6 [ Time Frame: From four week run-in period to last four weeks in the randomization period ]
    Change in headache disability from the 4 week run-in period to the last 4 weeks of the randomized period as measured using the Headache Impact Test-6 (HIT-6). The HIT-6 measures the impact if a subject's headaches on their ability to function at work, at home and in social situations. Subjects are presented with 6 questions about ability to function and normal daily life and for each question they rate the impact of their headaches as 'never' (6 points) or 'rarely' (9 points) or 'sometimes' (10 points) or 'very often' (11 points) or 'always' (13 points). Minimum score = 36, maximum score = 78. A higher score indicates more impact.

  5. Number of Participants According to Grade on the Migraine Disability Assessment (MIDAS) Before and After Randomized Period [ Time Frame: 3 months - end of run-in period to end of randomized period ]

    Migraine Disability Assessment (MIDAS) score from the end of run-in period to the end of randomized period. The MIDAS assessment measures the effect of headaches on a subject's daily functioning. It takes into account the past 3 months and is comprised of five questions. A lower score indicated less disability, a higher score indicates more disability. The scores are graded:

    0-5, MIDAS Grade I, little disability 6-10, MIDAS Grade II, mild disability 11 to 20 MIDAS Grade III, moderate disability 21+ MIDAS Grade IV, severe disability


  6. Compare Changes in Quality of Life EuroQol Questionnaire 5 Dimensions and 5 Levels (EQ-5D-5L) [ Time Frame: From four week run-in period to last four weeks in the randomization period ]

    The descriptive system comprises five dimensions (5D): mobility, self-care, usual activities, pain/discomfort and anxiety/depression.

    Each dimension has 5 levels (5L): no problems (1) , slight problems (2), moderate problems (3), severe problems (4) and extreme problems (5).

    Minimum score is 5 (no problems) and maximum score is 25 (extreme problems)

    An overall health question is asked using a visual analogue scale(VAS) from 0-100 where 0 is bad health and 100 good health


  7. Change in Migraine Days in the Open Label Period (Adjusted ANCOVA) [ Time Frame: The 6 month open-label period compared to the four week run-in period ]
    Change in number of migraine days (as reported in subject diary) during the 6 month open label period compared to the baseline run-in period.

  8. Number of Participants With Adverse Events [ Time Frame: up to Week 36 ]
    Adverse Effects were collected for all subjects for the duration of the study.

  9. Change in Headache Days in the Open Label Period [ Time Frame: The 6 month open-label period compared to the four week run-in period ]
    The mean change in number of headache days (as reported in the subject diary) during the open label period compared to the base-line run-in period



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Is between the ages of 18 and 75 years.
  2. Has been previously diagnosed with migraine (with or without aura) in accordance with the International Classification of Headache Disorders (ICHD)-3 Beta Classification criteria.
  3. Experience between 5 and 12 migraine days per month (over the last 4 months) with at least 2 of the migraines lasting more than 4 hours.
  4. Has age of onset of migraine less than 50 years old.
  5. Agrees not to use any migraine prevention treatments (including Botox injections) and/or medications (exclusive of medications taken for acute relief of migraine symptoms).
  6. Agrees to refrain from initiating or changing the type, dosage or frequency of any prophylactic medications for indications other than migraine that in the opinion of the clinician may interfere with the study objectives (e.g. antidepressant, anti convulsant, beta blockers, etc.).
  7. Agrees to use the gammaCore®-R device as intended, follow all of the requirements of the study including follow-up visit requirements, record required study data in the subject dairy, and other self-assessment questionnaires.
  8. Is able to provide written Informed Consent.

Exclusion Criteria:

  1. Has a concomitant medical condition that will require oral or injectable steroids during the study.
  2. Has a history of any intracranial aneurysm, intracranial haemorrhage, brain tumour or significant head trauma.
  3. Has a structural abnormality at the gammaCore®-R treatment site (e.g lymphadenopathy previous surgery or abnormal anatomy).
  4. Has pain at the gammaCore®-R treatment site (e.g.dysesthesia, neuralgia and/or cervicalgia).
  5. Has other significant pain problem (e.g.cancer pain, fibromyalgia or other head or facial disorder) that in the opinion of the investigator may confound the study assessments
  6. Has know or suspected severe cardiac disease(e.g. symptomatic coronary artery disease, prior myocardial infarction, congestive heart failure (CHF)).
  7. Has known or suspected severe cerebrovascular disease, (e.g. prior stroke or transient ischemic attack, symptomatic carotid artery disease, prior carotid endarterectomy or other vascular neck surgery).
  8. Has an abnormal baseline Electrocardiogram (ECG) e.g. second and third degree heart block, prolonged QT interval, atrial fibrillation, atrial flutter, history of ventricular tachycardia or ventricular fibrillation, or clinically significant premature ventricular contraction).
  9. Has had a cervical vagotomy.
  10. Has uncontrolled high blood pressure (systolic >160 diastolic > 100 after 3 repeated measurements within 24 hours).
  11. Is currently implanted with an electrical and/or neurostimulator device (e.g. cardiac pacemaker or defibrillator, vagal neurostimulator, deep brain stimulator, spinal stimulator, bone growth stimulator cochlear implant, Sphenopalatine ganglion stimulator or Occipital nerve stimulator).
  12. Has been implanted with metal cervical spine hardware or has a metallic implant near the gammaCore®-R stimulation site.
  13. Has a known history of suspicion of secondary headache.
  14. Has a history of syncope (within the last five years).
  15. Has a history of seizures (within the last five years).
  16. Has a known or suspicion of substance abuse or addiction (within the last 5 years).
  17. Is using marijuana (including medical marijuana) for any indications, more than twice a month.
  18. Currently takes simple analgesics or non-steroidal anti-inflammatory drugs (NSAIDs) greater than 15 days per month or triptans, ergots or combined analgesics greater than 10 days per month for headaches or other body pain.
  19. Currently takes prescription opioids greater than 2 days per month for headaches or body pain.
  20. Has taken medications for migraine prophylaxis in the previous 30 days.
  21. Has previous diagnosis of medication overuse headache (MoH) , which has reverted to episodic migraine within the last 6 months.
  22. Meets the ICHD-3 Beta Classification criteria for chronic migraine (> 15 headache days per month).
  23. Has failed an adequate trial (two months or greater) of at least 3 classes of a drug therapy for the prophylaxis of migraine .
  24. Has had surgery for migraine prevention.
  25. Has undergone nerve block (occipital or other) in the head or neck within the last 2 months.
  26. Has received Botox injections within the last 6 months.
  27. Is pregnant or thinking of becoming pregnant during the study period, or of childbearing years and is unwilling to use and accepted form of birth control.
  28. Is participating in any other therapeutic clinical investigation or has participated in a clinical trial in the preceding 30 days.
  29. Belongs to a vulnerable population or has any condition such that his or her ability to provide informed consent, comply with the follow-up requirements, or provide self- assessments is compromised (e.g. homeless, developmentally disabled and prisoner).
  30. Is a relative of or an employee of the investigator or the clinical study site.
  31. Has psychiatric or cognitive disorder and/or behavioural problems which in the opinion of the clinician may interfere with the study.
  32. Has previously used the gammaCore® device.

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 ClinicalTrials.gov identifier (NCT number): NCT02378844


Locations
Show Show 22 study locations
Sponsors and Collaborators
ElectroCore INC
Investigators
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Principal Investigator: Hans-Christoph Diener, Professor Universtätsklinikum Essen
  Study Documents (Full-Text)

Documents provided by ElectroCore INC:
Study Protocol  [PDF] September 1, 2017
Statistical Analysis Plan  [PDF] September 5, 2017

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: ElectroCore INC
ClinicalTrials.gov Identifier: NCT02378844    
Other Study ID Numbers: GM-11
First Posted: March 4, 2015    Key Record Dates
Results First Posted: August 19, 2019
Last Update Posted: August 19, 2019
Last Verified: July 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Results from the whole study will published but not individual participant data.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Migraine Disorders
Headache Disorders, Primary
Headache Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases