Migraine Study in Adolescent Patients

TXA107979: A Randomized, Multicenter, Placebo-Controlled, Parallel Group Study to Evaluate the Efficacy and Safety of a Combination Product Containing Sumatriptan and Naproxen Sodium for the Acute Treatment of Migraine in Adolescents

This study was designed to determine how well the combination medication, sumatriptan and naproxen sodium, treats migraine headache in adolescents 12-17 years old

Study Overview

• Status: Completed
• Conditions: Migraine Disorders
• Intervention / Treatment: Drug: Placebo; Drug: Sumatriptan and Naproxen Sodium

Detailed Description

The purpose of this study is to determine whether the combination product, sumatriptan and naproxen sodium, is effective compared to placebo in the treatment of acute migraine in adolescent subjects 12-17 years old. Subjects will treat two migraine attacks over a ~25 week period.

• Study Type: Interventional
• Enrollment (Actual): 589
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Gilbert, Arizona, United States, 85234
      • GSK Investigational Site
    • Litchfield Park, Arizona, United States, 85340
      • GSK Investigational Site
    • Phoenix, Arizona, United States, 85013
      • GSK Investigational Site
    • Phoenix, Arizona, United States, 85016
      • GSK Investigational Site
    • Phoenix, Arizona, United States, 85014
      • GSK Investigational Site
  • Arkansas
    • Conway, Arkansas, United States, 72034
      • GSK Investigational Site
    • Little Rock, Arkansas, United States, 72205
      • GSK Investigational Site
    • Little Rock, Arkansas, United States, 72202
      • GSK Investigational Site
  • California
    • Chico, California, United States, 95926
      • GSK Investigational Site
    • Fresno, California, United States, 93720
      • GSK Investigational Site
    • Fullteron, California, United States, 92835
      • GSK Investigational Site
    • Huntington Beach, California, United States, 92647
      • GSK Investigational Site
    • Newport Beach, California, United States, 92660
      • GSK Investigational Site
    • Roseville, California, United States, 95678
      • GSK Investigational Site
    • Sacramento, California, United States, 95816
      • GSK Investigational Site
    • Sacramento, California, United States, 95815
      • GSK Investigational Site
    • San Francisco, California, United States, 94109
      • GSK Investigational Site
    • Santa Monica, California, United States, 90404
      • GSK Investigational Site
  • Colorado
    • Colorado Springs, Colorado, United States, 80907
      • GSK Investigational Site
  • Connecticut
    • Fairfield, Connecticut, United States, 06824
      • GSK Investigational Site
  • Florida
    • Gainesville, Florida, United States, 32607
      • GSK Investigational Site
    • Hialeah, Florida, United States, 33010
      • GSK Investigational Site
    • Miami, Florida, United States, 33155-3009
      • GSK Investigational Site
    • Pensacola, Florida, United States, 32504
      • GSK Investigational Site
    • West Palm Beach, Florida, United States, 33407
      • GSK Investigational Site
  • Georgia
    • Atlanta, Georgia, United States, 30342
      • GSK Investigational Site
    • Savannah, Georgia, United States, 31405
      • GSK Investigational Site
    • Stockbridge, Georgia, United States, 30281
      • GSK Investigational Site
  • Illinois
    • Chicago, Illinois, United States, 60642
      • GSK Investigational Site
    • Oak Lawn, Illinois, United States, 60453
      • GSK Investigational Site
    • Park Ridge, Illinois, United States, 60068
      • GSK Investigational Site
  • Indiana
    • Anderson, Indiana, United States, 46011
      • GSK Investigational Site
    • Terre Haute, Indiana, United States, 47802
      • GSK Investigational Site
  • Kansas
    • Kansas City, Kansas, United States, 66160
      • GSK Investigational Site
    • Wichita, Kansas, United States, 67207
      • GSK Investigational Site
  • Kentucky
    • Bardstown, Kentucky, United States, 40004
      • GSK Investigational Site
    • Lexington, Kentucky, United States, 40509
      • GSK Investigational Site
  • Maryland
    • Pikesville, Maryland, United States, 21208
      • GSK Investigational Site
  • Massachusetts
    • Worcester, Massachusetts, United States, 01605
      • GSK Investigational Site
  • Michigan
    • Ann Arbor, Michigan, United States, 48104
      • GSK Investigational Site
  • Minnesota
    • Plymouth, Minnesota, United States, 55441
      • GSK Investigational Site
  • Missouri
    • Springfield, Missouri, United States, 65807
      • GSK Investigational Site
    • St. Louis, Missouri, United States, 63141
      • GSK Investigational Site
  • Nebraska
    • Omaha, Nebraska, United States, 68130
      • GSK Investigational Site
  • Nevada
    • Henderson, Nevada, United States, 89014
      • GSK Investigational Site
  • New Jersey
    • Vorhees, New Jersey, United States, 08043
      • GSK Investigational Site
    • Willingboro, New Jersey, United States, 08046
      • GSK Investigational Site
  • New Mexico
    • Albuquerque, New Mexico, United States, 87108
      • GSK Investigational Site
  • New York
    • Amherst, New York, United States, 14226
      • GSK Investigational Site
    • Mineola, New York, United States, 11501
      • GSK Investigational Site
    • Mount Vernon, New York, United States, 10550
      • GSK Investigational Site
    • Schenectady, New York, United States, 12308
      • GSK Investigational Site
  • North Carolina
    • Raleigh, North Carolina, United States, 27607
      • GSK Investigational Site
  • Ohio
    • Cincinnati, Ohio, United States, 45229
      • GSK Investigational Site
    • Cincinnati, Ohio, United States, 45245
      • GSK Investigational Site
    • Cleveland, Ohio, United States, 44195
      • GSK Investigational Site
    • West Chester, Ohio, United States, 45069
      • GSK Investigational Site
    • Westerville, Ohio, United States, 43081
      • GSK Investigational Site
  • Oklahoma
    • Oklahoma City, Oklahoma, United States, 73112
      • GSK Investigational Site
  • Oregon
    • Eugene, Oregon, United States, 97401
      • GSK Investigational Site
    • Portland, Oregon, United States, 97210
      • GSK Investigational Site
    • Salem, Oregon, United States, 97301
      • GSK Investigational Site
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19139
      • GSK Investigational Site
    • Pittsburgh, Pennsylvania, United States, 15236
      • GSK Investigational Site
  • South Carolina
    • Greer, South Carolina, United States, 29651
      • GSK Investigational Site
    • Simpsonville, South Carolina, United States, 29681
      • GSK Investigational Site
  • Tennessee
    • Bristol, Tennessee, United States, 37620
      • GSK Investigational Site
    • Clarksville, Tennessee, United States, 37043
      • GSK Investigational Site
  • Texas
    • Dallas, Texas, United States, 75230
      • GSK Investigational Site
    • Houston, Texas, United States, 77030-2303
      • GSK Investigational Site
    • San Antonio, Texas, United States, 78258
      • GSK Investigational Site
  • Utah
    • Salt Lake City, Utah, United States, 84107
      • GSK Investigational Site
  • Virginia
    • Charlottesville, Virginia, United States, 22902
      • GSK Investigational Site
    • Norfolk, Virginia, United States, 23510
      • GSK Investigational Site
  • Washington
    • Seattle, Washington, United States, 98195-6097
      • GSK Investigational Site
    • Vancouver, Washington, United States, 98686
      • GSK Investigational Site
    • Wenatchee, Washington, United States, 98801
      • GSK Investigational Site
  • Wisconsin
    • Madison, Wisconsin, United States, 53715
      • GSK Investigational Site
    • Middleton, Wisconsin, United States, 53562-2215
      • GSK Investigational Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 17 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria: Subjects eligible for enrollment in the study must meet all of the following criteria:

1. Subject is >/=12 years of age and </=17 years of age at the Screening Visit.
2. Subject has migraine with or without aura (ICHD-II criteria, 1.2.1 or 1.1). A history of at least two, but no more than eight attacks per month, for the six months prior to the Screening Visit is required. Attacks should last a minimum of three hours and be associated with moderate-to-severe headache pain.
3. Subject is able to distinguish migraine from other headaches (i.e., tension-type headaches).

4. Male or female subjects. Female subjects are eligible for participation in the study if they are:

   1. Females of non-childbearing potential; or
   2. Females of childbearing potential, and who have a negative urine pregnancy test at screening, and agree to use one of the GlaxoSmithKline (GSK)-specified highly effective methods for avoiding pregnancy
5. Any subject taking oral contraceptives at enrollment must be on a stable regimen for at least 2 months prior to screening.
6. Subject and subject's parent or legal guardian are able to read and write English or Spanish.
7. Subject is able to read, comprehend, and complete subject diaries.
8. Subject's parent or legal guardian is willing and able to provide Informed Consent prior to subject entry into the study.

9. Subject is willing and able to provide Informed Assent prior to entry into the study (if required).

   -

Exclusion Criteria:

• Subjects meeting any of the following criteria must not be enrolled in the study:

  1. Subject is < 74 pounds (33.3 kg).
  2. Subject has ≥15 headache days per month in total (migraine, probable migraine, or tension-type), retinal (ICHD-II 1.4), basilar (ICHD-II 1.2.6), or hemiplegic migraine (ICHD-II 1.2.4), or secondary headaches.
  3. Subject, in the investigator's opinion is likely to have unrecognized cardiovascular or cerebrovascular disease.
  4. Subject has uncontrolled hypertension at screening or is taking any angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker.
  5. Subject has a history of congenital heart disease, cardiac arrhythmias requiring medication, or a history of a clinically significant electrocardiogram abnormality that, in the investigator's opinion, contraindicates participation in this study.
  6. Subject has evidence or history of any ischemic vascular diseases including: ischemic heart disease, ischemic abdominal syndromes, peripheral vascular disease, or signs/symptoms consistent with any of the above.
  7. Subject has evidence or history of central nervous system pathology including stroke and/or transient ischemic attacks (TIAs), epilepsy or structural brain lesions which lower the convulsive threshold, or has been treated with an antiepileptic drug for seizure control within 5 years prior to screening.
  8. Subject has a history of impaired hepatic or renal function that, in the investigator's opinion, contraindicates participation in this study.
  9. Subject has hypersensitivity, allergy, intolerance, or contraindication to the use of any triptan, NSAID, or aspirin (including all sumatriptan and naproxen preparations) or has nasal polyps and asthma.
  10. Subject has used an ergot medication in the previous three months for migraine prophylaxis or is taking a medication that is not stabilized (i.e., change of dose within the past 2 months) for either chronic or intermittent migraine prophylaxis or for a co-morbid condition that is not stabilized.
  11. Subject has a recent history of regular use of opioids or barbiturates for treatment of their migraine headache and/or other non-migraine pain. Regular use is defined as an average of 4 days per month over the last 6 months.
  12. Subject has taken, or plans to take, a monoamine oxidase inhibitor (MAOI), including herbal preparations containing St. John's Wort (Hypericum perforatum), anytime within the two weeks prior to screening through two weeks post treatment.
  13. Subject has a history of any bleeding disorder or is currently taking any anti-coagulant or any antiplatelet agent.
  14. Subject has evidence or history of any gastrointestinal surgery, GI ulceration, or perforation in the past six months, gastrointestinal bleeding in the past year, or evidence or history of inflammatory bowel disease.
  15. Subject is pregnant, actively trying to become pregnant, or breast feeding or subject is not willing to have pregnancy test(s).
  16. Subject tests positive for illicit substances on toxicology screen, or has evidence of alcohol or substance abuse within the last year, or any concurrent medical or psychiatric condition which, in the investigator's judgment, will likely interfere with the study conduct, subject cooperation, or evaluation and interpretation of the study results, or which otherwise contraindicates participation in this clinical trial.
  17. Subject has participated in any investigational drug trial within the previous 4 weeks or plans to participate in another study at any time during this study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo; Placebo to match	Drug: Placebo; Placebo to match
Experimental: Sumatriptan and Naproxen 1; Sumatriptan succinate and naproxen sodium combination 10mg/60mg	Drug: Sumatriptan and Naproxen Sodium; Sumatriptan succinate and naproxen sodium
Experimental: Sumatriptan and Naproxen 2; Sumatriptan succinate and naproxen sodium combination 30mg/180mg	Drug: Sumatriptan and Naproxen Sodium; Sumatriptan succinate and naproxen sodium
Experimental: Sumatriptan and Naproxen 3; Sumatriptan succinate and naproxen sodium combination 85mg/500mg	Drug: Sumatriptan and Naproxen Sodium; Sumatriptan succinate and naproxen sodium

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants Who Were Pain Free at 2 Hours Post-dose	Participants were evaluated (self-assessment) for pain intensity by using a 4-point rating scale: 0=none, 1=mild, 2=moderate, and 3=severe. Participants with pain-free response were considered as those who had a reduction in migraine headache pain from moderate (score=2) or severe (score=3) at baseline to none (score=0) post-treatment, without the use of rescue medication (additional medication taken by participants for the treatment of migraine pain or associated symptoms) prior to or at 2 hours post-dose.	2 hours after single dose of double-blind treatment (Randomization through Week 13)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants Sustained Pain-free From 2-24 Hours	Participants with sustained pain-freedom were defined as those with pain-freedom at 2 hours post-dose that was maintained up to 24 hours post-treatment without the use of rescue medication.	2 to 24 hours after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Photophobia-free at 2 Hours Post-dose	The number of participants who did not have photophobia (sensitivity to light) at 2 hours post dose was analyzed.	2 hours after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Phonophobia-free at 2 Hours Post-dose	The number of participants who did not have phonophobia (sensitivity to sound) at 2 hours post dose was analzyed.	2 hours after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Pain-free at 1 Hour Post-dose	Participants with a pain-free response at 1 hour post-dose were considered as those who had a reduction in migraine headache pain from moderate (a score of 2) or severe (a score of 3) at baseline to none (a score of 0) post-treatment, without the use of rescue medication prior to or at 1 hour post dose.	1 hour after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Sustained Photophobia-free From 2-24 Hours	Participants with sustained freedom from photophobia were those with an absence of photophobia (sensitivity to light) from 2 to 24 hours post-dose without the use of rescue medication.	2 to 24 hours after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Sustained Phonophobia-free From 2-24 Hours	Participants with sustained freedom from phonophobia were those with an absence of phonophobia (sensitivity to sound) from 2 to 24 hours post-dose without the use of rescue medication.	2 to 24 hours after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Sustained Nausea-free From 2-24 Hours	Participants with sustained freedom from nausea were those with an absence of nausea from 2 to 24 hours post-dose without the use of rescue medication.	2 to 24 hours after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Who Used Rescue Medication From 2 to 24 Hours Post Dose	Rescue medication was defined as an additional medication taken by participants for the treatment of migraine pain or associated symptoms within 24 hours of dosing with investigational product. Permitted rescue medications included oral naproxen sodium (maximum 15 mg/kg), oral over-the-counter pain reliever, and anti-emetics. This outcome measure included only participants who rescued from 2 to 24 hours post-dose, inclusive.	2 to 24 hours after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Who Used Their First Dose of Rescue Medication Through the Indicated Time Points	Rescue medication was defined as an additional medication taken by participants for the treatment of migraine pain or associated symptoms within 24 hours of dosing with double-blind treatment. In addition to participants who rescued from 2 to 24 hours post-dose, inclusive, this outcome measure also included nine protocol violators who rescued < 2 hours post-treatment.	Dosing to 24 hours after single dose of double-blind treatment (Randomization through Week 13)
Number of Participants Nausea-free at 2 Hours Post-dose	The number of participants who did not have nausea at 2 hours post dose was analzyed.	2 hours after single dose of double-blind treatment (Randomization through Week 13)

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mean Age of Participants at Baseline Categorized by Age Group	The mean age of participants at baseline was calculated for all participants in the 12 to 14 year and 15 to 17 year age groups.	Baseline
Number of Participants Randomized to Double-blind Treatment in the Indicated Age Categories at Baseline	The number of participants receiving double-blind treatment were reported according to age.	Baseline
Number of Female and Male Participants Categorized by Age Group	The gender of participants at baseline was reported for all participants in the 12 to 14 year and 15 to 17 year age groups.	Baseline
Number of Participants of the Indicated Race Categorized by Age Group	The race of participants at baseline was reported for all participants in the 12 to 14 year and 15 to 17 year age groups.	Baseline
Mean Weight of Participants at Baseline Categorized by Age Group	The mean weight of participants at baseline was calculated for all participants in the 12 to 14 year and 15 to 17 year age groups.	Baseline
Mean Body Mass Index of Participants at Baseline Categorized by Age Group	The mean body mass index of participants at baseline was calculated for all participants in the 12 to 14 year and 15 to 17 year age groups. Body mass index is calculated as: weight (kilograms [kg]) divided by height (meters [m]^2).	Baseline

Collaborators and Investigators

• Sponsor: GlaxoSmithKline

Publications and helpful links

General Publications

• Brandes JL, Kudrow D, Stark SR, O'Carroll CP, Adelman JU, O'Donnell FJ, Alexander WJ, Spruill SE, Barrett PS, Lener SE. Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA. 2007 Apr 4;297(13):1443-54. doi: 10.1001/jama.297.13.1443.
• Derosier FJ, Lewis D, Hershey AD, Winner PK, Pearlman E, Rothner AD, Linder SL, Goodman DK, Jimenez TB, Granberry WK, Runken MC. Randomized trial of sumatriptan and naproxen sodium combination in adolescent migraine. Pediatrics. 2012 Jun;129(6):e1411-20. doi: 10.1542/peds.2011-2455. Epub 2012 May 14.

Helpful Links

• Researchers can use this site to request access to anonymised patient level data and/or supporting documents from clinical studies to conduct further research.

Study record dates

Study Major Dates

• Study Start: December 1, 2008
• Primary Completion (Actual): May 1, 2010
• Study Completion (Actual): June 1, 2010

Study Registration Dates

• First Submitted: February 12, 2009
• First Submitted That Met QC Criteria: February 12, 2009
• First Posted (Estimate): February 13, 2009

Study Record Updates

• Last Update Posted (Estimate): January 18, 2017
• Last Update Submitted That Met QC Criteria: November 30, 2016
• Last Verified: November 1, 2016

More Information

Terms related to this study

• Keywords: Migraine; Migraine headache; Naproxen sodium; Adolescent migraine; Migraine, acute; Sumatriptan succinate; Migraine with or without aura; Migraine efficacy; TREXIMET
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Headache Disorders, Primary; Headache Disorders; Migraine Disorders; Physiological Effects of Drugs; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Peripheral Nervous System Agents; Enzyme Inhibitors; Analgesics; Sensory System Agents; Anti-Inflammatory Agents, Non-Steroidal; Analgesics, Non-Narcotic; Anti-Inflammatory Agents; Antirheumatic Agents; Cyclooxygenase Inhibitors; Serotonin Agents; Serotonin 5-HT1 Receptor Agonists; Serotonin Receptor Agonists; Gout Suppressants; Vasoconstrictor Agents; Naproxen; Sumatriptan
• Other Study ID Numbers: 107979

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Patient-level data for this study will be made available through www.clinicalstudydatarequest.com following the timelines and process described on this site.

Study Data/Documents

1. Dataset Specification
   Information identifier: 107979
   Information comments: For additional information about this study please refer to the GSK Clinical Study Register
2. Statistical Analysis Plan
   Information identifier: 107979
   Information comments: For additional information about this study please refer to the GSK Clinical Study Register
3. Study Protocol
   Information identifier: 107979
   Information comments: For additional information about this study please refer to the GSK Clinical Study Register
4. Informed Consent Form
   Information identifier: 107979
   Information comments: For additional information about this study please refer to the GSK Clinical Study Register
5. Annotated Case Report Form
   Information identifier: 107979
   Information comments: For additional information about this study please refer to the GSK Clinical Study Register
6. Individual Participant Data Set
   Information identifier: 107979
   Information comments: For additional information about this study please refer to the GSK Clinical Study Register
7. Clinical Study Report
   Information identifier: 107979
   Information comments: For additional information about this study please refer to the GSK Clinical Study Register