- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02964338
A Study Comparing the Efficacy and Safety of Fremanezumab (TEV-48125) for the Prevention of Chronic Cluster Headache (CCH)
A Multicenter, Randomized, Double-Blind, Double-Dummy, Placebo-Controlled, Parallel-Group Study Comparing the Efficacy and Safety of 2 Dose Regimens (Intravenous/Subcutaneous and Subcutaneous) of TEV-48125 Versus Placebo for the Prevention of Chronic Cluster Headache
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Auchenflower, Australia, 4066
- Teva Investigational Site 78120
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Clayton, Australia, 3168
- Teva Investigational Site 78118
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Melbourne, Australia, 3004
- Teva Investigational Site 78123
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Parkville, Australia, 3050
- Teva Investigational Site 78122
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Randwick, Australia, 2031
- Teva Investigational Site 78121
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Calgary, Canada, T3M 1M4
- Teva Investigational Site 11130
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Toronto, Canada, H3A 2B4
- Teva Investigational Site 11131
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Ontario
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Newmarket, Ontario, Canada, L3Y5G8
- Teva Investigational Site 11132
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Helsinki, Finland, 00180
- Teva Investigational Site 40030
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Oulu, Finland, 90100
- Teva Investigational Site 40031
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Turku, Finland, 20100
- Teva Investigational Site 40029
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Berlin, Germany, 10117
- Teva Investigational Site 32666
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Bochum, Germany, 44787
- Teva Investigational Site 32667
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Essen, Germany, 45147
- Teva Investigational Site 32660
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Hamburg, Germany, 20246
- Teva Investigational Site 32665
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Kiel, Germany, 24149
- Teva Investigational Site 32662
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Konigstein im Taunus, Germany, 61462
- Teva Investigational Site 32661
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Rostock, Germany, 18147
- Teva Investigational Site 32663
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Ashkelon, Israel, 7830604
- Teva Investigational Site 80124
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Hadera, Israel, 3810101
- Teva Investigational Site 80122
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Holon, Israel, 58100
- Teva Investigational Site 80125
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Jerusalem, Israel, 9112001
- Teva Investigational Site 80121
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Netanya, Israel, 4244916
- Teva Investigational Site 80123
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Ramat Gan, Israel, 5265601
- Teva Investigational Site 80120
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Tel Aviv, Israel, 64239
- Teva Investigational Site 80127
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Tel-Aviv, Israel, 6812509
- Teva Investigational Site 80126
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Milan, Italy, 20133
- Teva Investigational Site 30190
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Modena, Italy, 41124
- Teva Investigational Site 30192
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Napoli, Italy, 80131
- Teva Investigational Site 30194
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Pavia, Italy, 27100
- Teva Investigational Site 30193
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Rome, Italy, 00161
- Teva Investigational Site 30191
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Rome, Italy, 163
- Teva Investigational Site 30189
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Leiden, Netherlands, 2333 ZA
- Teva Investigational Site 38118
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Nijmegen, Netherlands, 6532 SZ
- Teva Investigational Site 38119
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Zwolle, Netherlands, 8025 AB
- Teva Investigational Site 38117
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Bialystok, Poland, 15-402
- Teva Investigational Site 53380
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Krakow, Poland, 31-505
- Teva Investigational Site 53383
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Krakow, Poland, 33-332
- Teva Investigational Site 53379
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Lodz, Poland, 90-338
- Teva Investigational Site 53382
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Szczecin, Poland, 70-111
- Teva Investigational Site 53381
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Galdakao., Spain, 48960
- Teva Investigational Site 31211
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Madrid, Spain, 28034
- Teva Investigational Site 31214
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Sevilla, Spain, 41013
- Teva Investigational Site 31213
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Valladolid, Spain, 47003
- Teva Investigational Site 31212
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Zaragoza, Spain, 50009
- Teva Investigational Site 31215
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Huddinge, Sweden, 141 86
- Teva Investigational Site 42047
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Vallingby, Sweden, 162 68
- Teva Investigational Site 42045
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Glasgow, United Kingdom, G51 4TF
- Teva Investigational Site 34224
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London, United Kingdom, W6 8RF
- Teva Investigational Site 34220
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London, United Kingdom, WC1N 3BG
- Teva Investigational Site 34223
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Oxford, United Kingdom, OX2 6HE
- Teva Investigational Site 34221
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Arizona
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Phoenix, Arizona, United States, 85018
- Teva Investigational Site 13834
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California
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Canoga Park, California, United States, 91303
- Teva Investigational Site 13819
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Santa Monica, California, United States, 90404
- Teva Investigational Site 13811
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Stanford, California, United States, 94305
- Teva Investigational Site 13823
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Colorado
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Aurora, Colorado, United States, 80045
- Teva Investigational Site 13837
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Colorado Springs, Colorado, United States, 80918
- Teva Investigational Site 13814
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Denver, Colorado, United States, 80218
- Teva Investigational Site 13836
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Englewood, Colorado, United States, 80113
- Teva Investigational Site 13813
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Connecticut
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New Haven, Connecticut, United States, 06510-2483
- Teva Investigational Site 13821
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Stamford, Connecticut, United States, 06905
- Teva Investigational Site 13812
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Florida
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Gainesville, Florida, United States, 32607
- Teva Investigational Site 13810
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Orlando, Florida, United States, 32806
- Teva Investigational Site 13815
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Ormond Beach, Florida, United States, 32174
- Teva Investigational Site 13829
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Saint Petersburg, Florida, United States, 33709
- Teva Investigational Site 13830
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Tampa, Florida, United States, 33634
- Teva Investigational Site 13840
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Georgia
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Augusta, Georgia, United States, 30901
- Teva Investigational Site 34222
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Columbus, Georgia, United States, 31904
- Teva Investigational Site 13833
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Illinois
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Chicago, Illinois, United States, 60614
- Teva Investigational Site 13826
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Michigan
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Ann Arbor, Michigan, United States, 48104
- Teva Investigational Site 13818
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Nevada
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Las Vegas, Nevada, United States, 89106
- Teva Investigational Site 13835
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Las Vegas, Nevada, United States, 89113
- Teva Investigational Site 13832
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New Hampshire
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Lebanon, New Hampshire, United States, 03756
- Teva Investigational Site 13831
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New Jersey
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Princeton, New Jersey, United States, 08540
- Teva Investigational Site 13820
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New Mexico
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Albuquerque, New Mexico, United States, 87102
- Teva Investigational Site 13827
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New York
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Amherst, New York, United States, 14226
- Teva Investigational Site 13816
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New York, New York, United States, 10019
- Teva Investigational Site 13817
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North Carolina
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Raleigh, North Carolina, United States, 27607
- Teva Investigational Site 13809
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Salisbury, North Carolina, United States, 28144
- Teva Investigational Site 13839
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Ohio
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Cleveland, Ohio, United States, 44195
- Teva Investigational Site 13825
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19107
- Teva Investigational Site 13824
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Texas
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Richmond, Texas, United States, 77307
- Teva Investigational Site 13841
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Virginia
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Virginia Beach, Virginia, United States, 23454
- Teva Investigational Site 13822
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- The participant has a history of CCH according to the International Classification of Headache Disorders - 3 beta criteria (Headache Classification Committee of the International Headache Society [IHS] 2013) for greater than or equal to (≥)12 months prior to screening.
- The participant has a total body weight of ≥45 kilograms (kg) (99 pounds [lbs]).
- The participant is in good health in the opinion of the Investigator.
- Women of childbearing potential (WOCBP) whose male partners are potentially fertile (that is, no vasectomy) must use highly effective birth control methods for the duration of the study.
- Men must be sterile, or if they are potentially fertile/reproductively competent (not surgically [for example, vasectomy] or congenitally sterile) and their female partners are of childbearing potential, must agree to use, together with their female partners, acceptable birth control.
If a participant is receiving Botox, it should be in a stable dose regimen, which is considered as having ≥2 cycles of Botox prior to screening. The participant should not receive Botox during the run-in period up to the evaluation period (12 weeks) where the primary endpoint is evaluated.
- Additional criteria apply, please contact the Investigator for more information.
Exclusion Criteria:
- The participant has used systemic steroids for any medical reason (including treatment of the current cluster headache (CH) cycle within less than or equal to (≤)7 days prior to screening. The participant has used an intervention/device (for example, scheduled nerve blocks) for headache during the 4 weeks prior to screening.
- The participant has clinically significant hematological, renal, endocrine, immunologic, pulmonary, gastrointestinal, genitourinary, cardiovascular, neurologic, hepatic, or ocular disease at the discretion of the Investigator.
- The participant has evidence or medical history of clinically significant psychiatric issues determined at the discretion of the Investigator.
- The participant has a past or current history of cancer or malignant tumor in the past 5 years, except for appropriately treated non-melanoma skin carcinoma.
- The participant is pregnant or lactating.
- The participant has a history of hypersensitivity reactions to injected proteins, including monoclonal antibodies.
- The participant has participated in a clinical study of a monoclonal antibody within 3 months or 5 half-lives before administration of the first dose of the investigational medicinal product (IMP), whichever is longer, unless it is known that the participant received placebo during the study.
- The participant has a history of prior exposure to a monoclonal antibody targeting the calcitonin gene-related peptide (CGRP) pathway (AMG 334, ALD304, LY2951742, or fremanezumab). If participant has participated in a clinical study with any of these monoclonal antibodies, it has to be confirmed that the participant received placebo in order to be eligible for this study.
- The participant is an employee of the sponsor/participating study center who is directly involved in the study or is the relative of such an employee.
- The participant has an active implant for neurostimulation used in the treatment of CH.
- The participant is a member of a vulnerable population (for example, people kept in detention).
The participant has a history of alcohol abuse prior to screening and/or drug abuse that in the Investigator's opinion could interfere with the study evaluations or the participant's safety.
- Additional criteria apply, please contact the Investigator for more information.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Placebo Comparator: Placebo
Participants received placebo via an approximately 1-hour intravenous infusion and as 3 subcutaneous injections at Week 0 followed by placebo administered as single subcutaneous injections at Weeks 4 and 8.
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Placebo matching to fremanezumab will be administered as per the schedule specified in the respective arms.
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Experimental: Fremanezumab 675/225/225 mg
Participants received placebo via an approximately 1-hour intravenous infusion and fremanezumab at 675 milligrams (mg) as 3 subcutaneous injections (225 mg/1.5 milliliters [mL]) at Week 0 followed by fremanezumab at 225 mg administered as single subcutaneous injections (225 mg/1.5 mL) at Weeks 4 and 8.
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Fremanezumab will be administered as per the dose and schedule specified in the respective arms.
Other Names:
Placebo matching to fremanezumab will be administered as per the schedule specified in the respective arms.
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Experimental: Fremanezumab 900/225/225 mg
Participants received fremanezumab at 900 mg via an approximately 1-hour intravenous infusion and placebo administered as 3 subcutaneous injections at Week 0 followed by fremanezumab at 225 mg administered as single subcutaneous injections (225 mg/1.5 mL) at Weeks 4 and 8.
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Fremanezumab will be administered as per the dose and schedule specified in the respective arms.
Other Names:
Placebo matching to fremanezumab will be administered as per the schedule specified in the respective arms.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Mean Change From Baseline in the Overall Monthly Average Number of CH Attacks Up to Week 12
Time Frame: Baseline Period (from at least Week -4 to Week 0), Up to Week 12
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A CH attack was defined as a severe or very severe unilateral orbital, supraorbital, and/or temporal pain lasting 15 to 180 minutes with either or both of the following 2 categories: 1) at least 1 of the following symptoms or signs, ipsilateral to the headache: -conjunctival injection and/or lacrimation; -nasal congestion and/or rhinorrhea; -eyelid edema; -forehead and facial sweating; -forehead and facial flushing; -sensation of fullness in the ear; -miosis and/or ptosis.
2) a sense of restlessness or agitation.
Least Squares (LS) mean calculated using analysis of covariance (ANCOVA) model with baseline preventive medication use (yes or no), sex, region (United States [US]/Canada or other), and treatment as fixed effects and the baseline number of CH attacks as a covariate.
Change from baseline in the overall monthly average number of CH attacks during the 12-week period after administration of the first dose of study drug (based on Week 0 to 12 data) is reported.
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Baseline Period (from at least Week -4 to Week 0), Up to Week 12
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Number of Participants With Shift From Baseline to Endpoint in Coagulation Laboratory Test Results
Time Frame: Baseline up to Week 12
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Coagulation parameters included: prothrombin time (PT) (seconds) and prothrombin international normalized ratio (INR).
Shifts represented as Baseline - endpoint value (last observed post-baseline value).
Shifts from baseline to endpoint were summarized using participant counts grouped into three categories: - Low (below normal range) - Normal (within the normal range of 9.4 to 12.5 seconds) - High (above normal range).
Missing PT and prothrombin INR shift data are also presented.
A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
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Baseline up to Week 12
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Number of Participants With Suicidal Ideation and Suicidal Behavior as Assessed by the Electronic Columbia Suicide Severity Rating Scale (eC-SSRS)
Time Frame: Baseline up to Week 12
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eC-SSRS is a questionnaire to assess suicidal ideation and suicidal behavior.
Suicidal behavior was defined as a "yes" answer to any of 5 suicidal behavior questions: preparatory acts or behavior, aborted attempt, interrupted attempt, actual attempt, and completed suicide.
Suicidal ideation was defined as a "yes" answer to any one of 5 suicidal ideation questions: wish to be dead, non-specific active suicidal thoughts, active suicidal ideation with methods without intent to act or some intent to act, without specific plan or with specific plan and intent, any self-injurious behavior with no suicidal intent.
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Baseline up to Week 12
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Percentage of Participants With a ≥50% Reduction From Baseline in the Monthly Average Number of CH Attacks Up to Week 12
Time Frame: Baseline Period (from at least Week -4 to Week 0) up to Week 12
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A CH attack was defined as a severe or very severe unilateral orbital, supraorbital, and/or temporal pain lasting 15 to 180 minutes with either or both of the following 2 categories: 1) at least 1 of the following symptoms or signs, ipsilateral to the headache: -conjunctival injection and/or lacrimation; -nasal congestion and/or rhinorrhea; -eyelid edema; -forehead and facial sweating; -forehead and facial flushing; -sensation of fullness in the ear; -miosis and/or ptosis.
2) a sense of restlessness or agitation.
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Baseline Period (from at least Week -4 to Week 0) up to Week 12
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Mean Change From Baseline in the Monthly Average Number of CH Attacks at Week 4 and Week 12
Time Frame: Baseline Period (from at least Week -4 to Week 0), Week 4 and Week 12
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A CH attack was defined as a severe or very severe unilateral orbital, supraorbital, and/or temporal pain lasting 15 to 180 minutes with either or both of the following 2 categories: 1) ≥1 of the following symptoms or signs, ipsilateral to the headache: -conjunctival injection and/or lacrimation; -nasal congestion and/or rhinorrhea; -eyelid edema; -forehead and facial sweating; -forehead and facial flushing; -sensation of fullness in the ear; -miosis and/or ptosis.
2) a sense of restlessness or agitation.
Mean change from baseline in monthly average number of CH attacks during 4-week period after administration of first dose of study drug (based on Week 0 to 4 data) and during 4-week period after administration of third dose of study drug (based on Week 8 to 12 data) is reported.
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Baseline Period (from at least Week -4 to Week 0), Week 4 and Week 12
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Mean Change From Baseline in the Overall Weekly Average Number of Days With Use of Cluster-Specific Acute Headache Medications (Triptans and Ergot Compounds) Up to Week 12
Time Frame: Baseline Period (from at least Week -4 to Week 0), Up to Week 12
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A maximum of 2 concomitant preventive medications for CH were allowed during the study.
Participants must have been on a stable dose and regimen of the concomitant medication for at least 2 weeks before screening and throughout the study.
Baseline data and the mean change from baseline in the overall weekly average number of days with the use of cluster-specific acute headache medications (triptans and ergot compounds) during the 12-week period after administration of the first dose of study drug (based on Week 0 to 12 data) is reported.
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Baseline Period (from at least Week -4 to Week 0), Up to Week 12
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Mean Change From Baseline in the Weekly Average Number of Days Oxygen Was Used to Treat CCH Up to Week 12
Time Frame: Baseline Period (from at least Week -4 to Week 0), Up to Week 12
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Baseline data and the mean change from baseline in the overall weekly average number of days oxygen was used to treat CCH during the 12-week period after administration of the first dose of study drug (based on Week 0 to 12 data) is reported.
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Baseline Period (from at least Week -4 to Week 0), Up to Week 12
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Number of Participants Who Perceived Improvement of CH-Associated Pain From Baseline as Measured by the Patient-Perceived Satisfactory Improvement (PPSI) Scale at Weeks 1, 4, 8, and 12
Time Frame: Baseline and Weeks 1, 4, 8, and 12
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The PPSI assessment was developed to measure pain intensity and was adjusted for CH symptoms improvement.
Participants marked the level of CH-associated pain and indicated if pain is "1=much worse," "2=moderately worse," "3=slightly worse," "4=unchanged," "5=slightly improved," "6=moderately improved," or "7=much improved" compared with 4 weeks prior.
PPSI was defined as the change in pain that corresponds with a minimal rating of "5=slightly improved."
Data at Week 1 was recorded on Day 7 in the electronic diary device at home.
Week 12 data also included assessment at the early withdrawal visit for participants who discontinued the study early.
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Baseline and Weeks 1, 4, 8, and 12
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Number of Participants With Adverse Events (AEs)
Time Frame: Baseline up to Week 12
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An AE was defined as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to the study drug.
Severity was rated by the Investigator on a scale of mild, moderate and severe, with severe as an AE that prevents usual activities.
Relationship of AE to treatment was determined by the Investigator.
Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, or an important medical event that jeopardized the participant and required medical intervention to prevent the previously listed serious outcomes.
A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
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Baseline up to Week 12
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Number of Participants With Potentially Clinically Significant Laboratory (Serum Chemistry, Hematology, and Urinalysis) Abnormal Results
Time Frame: Baseline up to Week 12
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Serum chemistry, hematology, urinalysis laboratory tests with potentially clinically significant abnormal findings included: Alanine Aminotransferase (units/liter [U/L]) ≥3*upper limit of normal (ULN); Aspartate Aminotransferase (U/L) ≥3*ULN; Bilirubin (Total) ≥34.2 micromole/liter (umol/L); Blood Urea Nitrogen ≥10.71 millimole (mmol)/L; Creatinine ≥177 umol/L; Gamma Glutamyl Transferase (U/L) ≥3*ULN; hemoglobin less than (<)115 grams (g)/L (males) or less than or equal to (≤)95 g/L (females); leukocytes ≥20*10^9/L or ≤3*10^9/L; Eosinophils/Leukocytes ≥10%; Hematocrit <0.37 L/L (males) and <0.32 L/L (females); platelets ≥700*10^9/L or ≤75*10^9/L; blood ≥2 unit increase from baseline; urine glucose (milligrams/decilitre [mg/dL]) ≥2 U increase from baseline; ketones (mg/dL) ≥2 U increase from baseline; urine protein (mg/dL) ≥2 U increase from baseline.
A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
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Baseline up to Week 12
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Number of Participants With Potentially Clinically Significant Abnormal Vital Signs Values
Time Frame: Baseline up to Week 12
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Potentially clinically significant abnormal vital signs findings included: pulse rate ≤50 beats/minute (bpm) and decrease of ≥15 bpm, or ≥120 bpm and increase of ≥15 bpm; systolic blood pressure ≤90 millimeters of mercury (mmHg) and decrease of ≥20 mmHg, or ≥180 mmHg and increase of ≥20 mmHg; diastolic blood pressure ≤50 mmHg and decrease of ≥15 mmHg, or ≥105 mmHg and increase of ≥15 mmHg; respiratory rate <10 breaths/minute; and body temperature ≥38.3 degrees centigrade and change of ≥1.1 degrees centigrade.
A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
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Baseline up to Week 12
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Number of Participants With Shift From Baseline to Endpoint (Last Assessment) in Electrocardiogram (ECG) Parameters
Time Frame: Baseline to Week 12
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ECG parameters included: heart rate, PR interval, QRS interval, QT interval corrected using the Fridericia formula (QTcF), QT interval corrected using the Bazett's formula (QTcB) and RR interval.
Shifts represented as Baseline - endpoint value (last observed post-baseline value).
Abnormal NCS indicated an abnormal but not clinically significant finding.
Abnormal CS indicated an abnormal and clinically significant finding.
Missing ECG shift data are also presented.
A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
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Baseline to Week 12
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Number of Participants With Injection Site Reactions
Time Frame: Baseline up to Week 12
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Number of participants who reported treatment-emergent injection site reactions are summarized.
Preferred terms from Medical Dictionary for Regulatory Activities (MedDRA) version 18.1 were offered without a threshold applied.
Injection site reactions included injection site erythema, induration, pain, haemorrhage, bruising, hypersensitivity, swelling, rash, and flushing.
A summary of other non-serious AEs and all serious AEs, regardless of causality is located in Reported AE section.
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Baseline up to Week 12
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- TV48125-CNS-30057
- 2016-003171-21 (EudraCT Number)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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-
Teva Branded Pharmaceutical Products R&D, Inc.Withdrawn
-
Teva Branded Pharmaceutical Products R&D, Inc.CompletedMigraineUnited States, Canada, Czechia, Finland, Israel, Japan, Poland, Russian Federation, Spain
-
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-
Teva Branded Pharmaceutical Products R&D, Inc.CompletedMigraineUnited States, Canada, Finland, Germany, Israel, Italy, Netherlands, Poland, Spain
-
Teva Branded Pharmaceutical Products R&D, Inc.CompletedMigraine ProphylaxisUnited States, Belgium, Czechia, Denmark, Finland, France, Germany, Italy, Netherlands, Poland, Spain, Sweden, Switzerland, United Kingdom