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- Essai clinique NCT07633067
Safety and Efficacy of Middle Meningeal Artery Embolization for the Treatment of Migraine. (FAST-EM-2)
5 juin 2026 mis à jour par: Zeguang Ren, The Affiliated Hospital Of Guizhou Medical University
Safety and Efficacy of Middle Meningeal Artery Embolization for the Treatment of Migraine: A Multicenter, Prospective, Double-blind, Multigroup, Randomized Controlled Trial.
This study is a multicenter, prospective, double-blind, multi-arm, randomized controlled trial that investigates whether middle meningeal artery embolization is superior to current standard pharmacotherapy for migraine.
The main objectives of the study are to explore whether middle meningeal artery embolization can reduce migraine patients' dependence on migraine medications and to assess the safety of middle meningeal artery embolization with coils.
Aperçu de l'étude
Statut
Pas encore de recrutement
Les conditions
Description détaillée
This study is a multicenter, prospective, double-blind, multi-arm, randomized controlled trial that investigates whether middle meningeal artery embolization is superior to current standard pharmacotherapy for migraine.
The main objectives of the study are to explore whether middle meningeal artery embolization can reduce migraine patients' dependence on migraine medications and to assess the safety of middle meningeal artery embolization with coils.This study will enroll 150 subjects with a long history of headache from multiple clinical centers, who will be randomly assigned using a stratified randomization method via computer and web-based software.
Stratified randomization will be performed according to study centers (different sub-centers).
Subjects will be randomly allocated in a 1:1:1 ratio to the unilateral embolization group, bilateral embolization group, or conventional pharmacotherapy group (hereinafter referred to as the "control group"), with 50 subjects in each group.
The unilateral embolization group will receive unilateral MMA interventional embolization plus conventional pharmacotherapy, the bilateral embolization group will receive bilateral MMA interventional embolization plus conventional pharmacotherapy, and the control group will receive only conventional standard pharmacotherapy.
Baseline data prior to randomization and data on primary and secondary endpoint scores will be collected for all enrolled subjects.
Regular follow-up will be conducted to evaluate the recovery of headache.
Type d'étude
Interventionnel
Inscription (Estimé)
150
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Coordonnées de l'étude
- Nom: Junshuan Cui, MD.
- Numéro de téléphone: +8615761600325
- E-mail: junshuan2306@163.com
Sauvegarde des contacts de l'étude
- Nom: Zeguang Ren, MD. PhD.
- Numéro de téléphone: +86 0851-86770232.
- E-mail: renzem@gmail.com
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Non
La description
Inclusion Criteria:
- Age 18~80 years old (inclusive), regardless of gender.
- Voluntary written informed consent.
- Migraine diagnosed by neurologists/pain specialists according to the current International Classification of Headache Disorders, 3rd Edition (ICHD-3) criteria for migraine with or without aura.
- Migraine attack frequency of no less than 4 days per month within one month prior to enrollment.
- History of pharmacotherapy for migraine prophylaxis or treatment for at least 6 months.
Exclusion Criteria:
- Findings on cerebral angiography indicating secondary headache due to intracranial vascular disorders, including dural arteriovenous fistula, arteriovenous malformation, venous malformation, or other relevant cerebrovascular lesions; Moyamoya disease; or high-risk vascular anatomical variants unsuitable for safe vascular access or contraindicating MMA embolization.
- Complicated with cervical spondylosis and secondary headache of otogenic, rhinogenic, odontogenic origin; patients with a history of trigeminal autonomic cephalalgias; headache with other definite etiologies or secondary headache;
- Imaging diagnosis shows acute or chronic subdural hematoma, other acute intracranial lesions and other space-occupying lesions;
- Patients planning to undergo surgery within 90 days;
- Patients with a life expectancy of less than 12 months;
- Patients with a definite history of contrast media allergy;
- Patients with a history of opioid addiction;
- Breastfeeding or pregnant women, or patients with fertility plans within half a year;
- Subjects who participated in other clinical trials of drugs or medical devices before enrollment and did not reach the time limit of the primary study endpoint;
- Unable to understand headache-related assessment data such as headache diaries and requiring assistance from others to complete them;
- Patients with poor compliance judged by the investigator and unable to complete the study as required;
- Patients with a definite history of allergy to embolization materials such as nitinol alloy and/or cobalt-based alloy, platinum-tungsten alloy, etc.;
- Subjects with other comorbidities that restrict their participation in the study, prevent compliance with follow-up, or affect the scientific integrity of the study;
- Other conditions in which the investigator considers the patient inappropriate to participate in this study.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Double
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Unilateral Middle Meningeal Artery Embolization + Standard Pharmacotherapy
Subjects in this arm will receive unilateral middle meningeal artery embolization with coils plus conventional standard pharmacotherapy for migraine.
|
Middle meningeal artery embolization with coils.
Conventional standard pharmacotherapy for migraine
|
|
Expérimental: Bilateral Middle Meningeal Artery Embolization + Standard Pharmacotherapy
Subjects in this arm will receive bilateral middle meningeal artery embolization with coils plus conventional standard pharmacotherapy for migraine.
|
Middle meningeal artery embolization with coils.
Conventional standard pharmacotherapy for migraine
|
|
Comparateur actif: Conventional Standard Pharmacotherapy
Subjects in this arm will receive only conventional standard pharmacotherapy for migraine, without any middle meningeal artery embolization intervention.
|
Conventional standard pharmacotherapy for migraine
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Migraine attack frequency (days / month)
Délai: :At baseline,within 90 days, 90-day, 180-day after treatment
|
Change from baseline in the mean number of migraine days per month within 90 days, at the 90-day visit, and at the 180-day visit after randomization.
|
:At baseline,within 90 days, 90-day, 180-day after treatment
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Migraine attack frequency (times / month)
Délai: At baseline, within 90 days, 90-day, 180-day after treatment
|
Change from baseline in the mean number of migraine attacks per month within 90 days, at the 90-day visit, and at the 180-day visit after randomization.
|
At baseline, within 90 days, 90-day, 180-day after treatment
|
|
Total headache frequency (days / month)
Délai: At baseline, within 90 days after treatment
|
Change from baseline in the mean number of all headache days per month within 90 days after randomization.
|
At baseline, within 90 days after treatment
|
|
Migraine medication use frequency (days / month)
Délai: At baseline, within 90 days, 90-day, 180-day after treatment
|
Change from baseline in the mean number of migraine medication use days per month within 90 days, at the 90-day visit, and at the 180-day visit after randomization.
|
At baseline, within 90 days, 90-day, 180-day after treatment
|
|
Proportion of ≥50% reduction in migraine days (days/month)
Délai: At baseline, within 90 days, 90-day, 180-day after treatment
|
Proportion of participants with at least a 50% reduction from baseline in the mean number of migraine days per month within 90 days, at the 90-day visit, and at the 180-day visit after randomization.
|
At baseline, within 90 days, 90-day, 180-day after treatment
|
|
Numerical Rating Scale for migraine pain severity (NRS) (score/month)
Délai: At baseline, within 90 days, 180 days after treatment
|
Change from baseline in the mean monthly Migraine Pain Severity Score (NRS) within 90 days and within 180 days after randomization.
|
At baseline, within 90 days, 180 days after treatment
|
|
Migraine Disability Assessment Questionnaire (MIDAS) (score/month)
Délai: At baseline, within 90 days, 180 days after treatment
|
Change from baseline in the mean monthly Migraine Disability Assessment Score (MIDAS) within 90 days and within 180 days after randomization.
|
At baseline, within 90 days, 180 days after treatment
|
|
Clinical Global Impression Scale (CGI) (score/month)
Délai: At baseline, within 90 days, 180 days after treatment
|
Change from baseline in the mean monthly Clinical Global Impression (CGI) Scale score within 90 days and within 180 days after randomization.
|
At baseline, within 90 days, 180 days after treatment
|
|
Headache Impact Test (HIT-6) (score/month)
Délai: At baseline, within 90 days, 180 days after treatment
|
Change from baseline in the mean monthly Headache Impact Test-6 (HIT-6) score within 90 days and within 180 days after randomization.
|
At baseline, within 90 days, 180 days after treatment
|
|
Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQ v2.1) (score/month)
Délai: At baseline, within 90 days, 180 days after treatment
|
Change from baseline in the mean monthly Migraine-Specific Quality of Life Questionnaire (MSQ Version 2.1) score within 90 days and within 180 days after randomization.
|
At baseline, within 90 days, 180 days after treatment
|
Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Collaborateurs
Les enquêteurs
- Chaise d'étude: Zeguang Ren, MD. PhD., The Affiliated Hospital of Guizhou Medical University
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- Tempaku A, Yamauchi S, Ikeda H, Tsubota N, Furukawa H, Maeda D, Kondo K, Nishio A. Usefulness of interventional embolization of the middle meningeal artery for recurrent chronic subdural hematoma: Five cases and a review of the literature. Interv Neuroradiol. 2015 Jun;21(3):366-71. doi: 10.1177/1591019915583224. Epub 2015 May 26.
- Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, Vickers A, White AR. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev. 2016 Jun 28;2016(6):CD001218. doi: 10.1002/14651858.CD001218.pub3.
- Steiner TJ, Jensen R, Katsarava Z, Linde M, MacGregor EA, Osipova V, Paemeleire K, Olesen J, Peters M, Martelletti P. Aids to management of headache disorders in primary care (2nd edition) : on behalf of the European Headache Federation and Lifting The Burden: the Global Campaign against Headache. J Headache Pain. 2019 May 21;20(1):57. doi: 10.1186/s10194-018-0899-2.
- Asghar MS, Hansen AE, Kapijimpanga T, van der Geest RJ, van der Koning P, Larsson HB, Olesen J, Ashina M. Dilation by CGRP of middle meningeal artery and reversal by sumatriptan in normal volunteers. Neurology. 2010 Oct 26;75(17):1520-6. doi: 10.1212/WNL.0b013e3181f9626a.
- Chaibi A, Benth JS, Tuchin PJ, Russell MB. Chiropractic spinal manipulative therapy for migraine: a three-armed, single-blinded, placebo, randomized controlled trial. Eur J Neurol. 2017 Jan;24(1):143-153. doi: 10.1111/ene.13166. Epub 2016 Oct 2.
- Burch R, Rizzoli P, Loder E. The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies. Headache. 2018 Apr;58(4):496-505. doi: 10.1111/head.13281. Epub 2018 Mar 12.
- Ferrari MD, Goadsby PJ, Burstein R, Kurth T, Ayata C, Charles A, Ashina M, van den Maagdenberg AMJM, Dodick DW. Migraine. Nat Rev Dis Primers. 2022 Jan 13;8(1):2. doi: 10.1038/s41572-021-00328-4.
- Robbins MS. Diagnosis and Management of Headache: A Review. JAMA. 2021 May 11;325(18):1874-1885. doi: 10.1001/jama.2021.1640.
- Becker WJ, Findlay T, Moga C, Scott NA, Harstall C, Taenzer P. Guideline for primary care management of headache in adults. Can Fam Physician. 2015 Aug;61(8):670-9.
- Gustavsson A, Svensson M, Jacobi F, Allgulander C, Alonso J, Beghi E, Dodel R, Ekman M, Faravelli C, Fratiglioni L, Gannon B, Jones DH, Jennum P, Jordanova A, Jonsson L, Karampampa K, Knapp M, Kobelt G, Kurth T, Lieb R, Linde M, Ljungcrantz C, Maercker A, Melin B, Moscarelli M, Musayev A, Norwood F, Preisig M, Pugliatti M, Rehm J, Salvador-Carulla L, Schlehofer B, Simon R, Steinhausen HC, Stovner LJ, Vallat JM, Van den Bergh P, van Os J, Vos P, Xu W, Wittchen HU, Jonsson B, Olesen J; CDBE2010Study Group. Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011 Oct;21(10):718-79. doi: 10.1016/j.euroneuro.2011.08.008. Epub 2011 Sep 15.
- Luedtke K, Allers A, Schulte LH, May A. Efficacy of interventions used by physiotherapists for patients with headache and migraine-systematic review and meta-analysis. Cephalalgia. 2016 Apr;36(5):474-92. doi: 10.1177/0333102415597889. Epub 2015 Jul 30.
- Levy D, Moskowitz MA. Meningeal Mechanisms and the Migraine Connection. Annu Rev Neurosci. 2023 Jul 10;46:39-58. doi: 10.1146/annurev-neuro-080422-105509. Epub 2023 Mar 13.
- Lam A, Selvarajah D, Htike SS, Chan S, Lalloo S, Lock G, Redmond K, Leggett D, Mews P. The efficacy of postoperative middle meningeal artery embolization on chronic subdural hematoma - A multicentered randomized controlled trial. Surg Neurol Int. 2023 May 12;14:168. doi: 10.25259/SNI_208_2023. eCollection 2023.
- Xu K, Cui J, Demiraj F, Chen G, Wang Q, Mokin M, Yan Z, Peng H, Huang Y, Peng Z, Xiang X, Chu L, Wu S, Song S, Zheng Y, Wang L, Cai J, Shao Y, Yao Y, Yang H, Ren Z. Middle meningeal artery embolization for migraine headaches - a prospective self-control cohort trial. Int J Surg. 2026 Feb 1;112(2):3399-3411. doi: 10.1097/JS9.0000000000003714. Epub 2025 Nov 4.
- Catapano JS, Karahalios K, Srinivasan VM, Baranoski JF, Rutledge C, Cole TS, Ducruet AF, Albuquerque FC, Jadhav AP. Chronic headaches and middle meningeal artery embolization. J Neurointerv Surg. 2022 Mar;14(3):301-303. doi: 10.1136/neurintsurg-2021-017602. Epub 2021 Apr 22.
- Valdueza JM, Dreier JP, Woitzik J, Dohmen C, Sakowitz O, Platz J, Leistner-Glaess S, Witt VD. Course of Preexisting Migraine Following Spontaneous Subarachnoid Hemorrhage. Front Neurol. 2022 Jul 11;13:880856. doi: 10.3389/fneur.2022.880856. eCollection 2022.
- Fan Z, Fan Z, Wang H. New surgical approach for migraine. Otol Neurotol. 2006 Aug;27(5):713-5. doi: 10.1097/01.mao.0000226304.66822.6d.
- Mancuso-Marcello M, Qureshi AI, Nikola C, Stoian I, Jia Y, Saeed D, Bhogal P. Intra-arterial lidocaine therapy via the middle meningeal artery for migraine headache: Theory, current practice and future directions. Interv Neuroradiol. 2026 Feb;32(1):104-108. doi: 10.1177/15910199231195470. Epub 2023 Aug 13.
- Qureshi AI, Pfeiffer K, Babar S, Huang W, Lobanova I, Ishfaq MF, French BR, Siddiq F, Gomez CR. Intra-arterial injection of lidocaine into middle meningeal artery to treat intractable headaches and severe migraine. J Neuroimaging. 2021 Nov;31(6):1126-1134. doi: 10.1111/jon.12918. Epub 2021 Aug 13.
- Qureshi AI, Qureshi MH, Khan AA, Suri MF. Effect of intra-arterial injection of lidocaine and methyl-prednisolone into middle meningeal artery on intractable headaches. J Vasc Interv Neurol. 2014 Dec;7(5):69-72.
- Asghar MS, Hansen AE, Amin FM, van der Geest RJ, Koning Pv, Larsson HB, Olesen J, Ashina M. Evidence for a vascular factor in migraine. Ann Neurol. 2011 Apr;69(4):635-45. doi: 10.1002/ana.22292. Epub 2011 Mar 17.
- Vanzin JR, Manzato LB. Chronic migraine and bilateral occlusion of the middle meningeal artery. Interv Neuroradiol. 2025 Jun 2:15910199251337520. doi: 10.1177/15910199251337520. Online ahead of print.
- Christensen CE, Younis S, Lindberg U, Boer VO, de Koning P, Petersen ET, Paulson OB, Larsson HBW, Amin FM, Ashina M. Ultra-high field MR angiography in human migraine models: a 3.0 T/7.0 T comparison study. J Headache Pain. 2019 May 6;20(1):48. doi: 10.1186/s10194-019-0996-x.
- Christensen CE, Younis S, Lindberg U, de Koning P, Tolnai D, Paulson OB, Larsson HBW, Amin FM, Ashina M. Intradural artery dilation during experimentally induced migraine attacks. Pain. 2021 Jan;162(1):176-183. doi: 10.1097/j.pain.0000000000002008.
- Shevel E. Middle meningeal artery dilatation in migraine. Headache. 2009 Nov-Dec;49(10):1541-3. doi: 10.1111/j.1526-4610.2009.01495.x. Epub 2009 Jul 27.
- Hargreaves R. New migraine and pain research. Headache. 2007 Apr;47 Suppl 1:S26-43. doi: 10.1111/j.1526-4610.2006.00675.x.
- Lipton RB, Fanning KM, Serrano D, Reed ML, Cady R, Buse DC. Ineffective acute treatment of episodic migraine is associated with new-onset chronic migraine. Neurology. 2015 Feb 17;84(7):688-95. doi: 10.1212/WNL.0000000000001256. Epub 2015 Jan 21.
- Lipton RB, Buse DC, Friedman BW, Feder L, Adams AM, Fanning KM, Reed ML, Schwedt TJ. Characterizing opioid use in a US population with migraine: Results from the CaMEO study. Neurology. 2020 Aug 4;95(5):e457-e468. doi: 10.1212/WNL.0000000000009324. Epub 2020 Jun 11.
- American Headache Society. The American Headache Society Position Statement On Integrating New Migraine Treatments Into Clinical Practice. Headache. 2019 Jan;59(1):1-18. doi: 10.1111/head.13456. Epub 2018 Dec 10.
- Sharpe L, Dudeney J, Williams ACC, Nicholas M, McPhee I, Baillie A, Welgampola M, McGuire B. Psychological therapies for the prevention of migraine in adults. Cochrane Database Syst Rev. 2019 Jul 2;7(7):CD012295. doi: 10.1002/14651858.CD012295.pub2.
- Reuter U, McClure C, Liebler E, Pozo-Rosich P. Non-invasive neuromodulation for migraine and cluster headache: a systematic review of clinical trials. J Neurol Neurosurg Psychiatry. 2019 Jul;90(7):796-804. doi: 10.1136/jnnp-2018-320113. Epub 2019 Mar 1.
- Amundsen S, Nordeng H, Nezvalova-Henriksen K, Stovner LJ, Spigset O. Pharmacological treatment of migraine during pregnancy and breastfeeding. Nat Rev Neurol. 2015 Apr;11(4):209-19. doi: 10.1038/nrneurol.2015.29.
- Silberstein SD. Migraine pathophysiology and its clinical implications. Cephalalgia. 2004;24 Suppl 2:2-7. doi: 10.1111/j.1468-2982.2004.00892.x.
- Raggi A, Leonardi M, Scaratti C, Sansone E, Grazzi L, D'Amico D. Gender and education inequalities in the cost of medication-overuse headache. Neurol Sci. 2018 Jun;39(Suppl 1):117-119. doi: 10.1007/s10072-018-3374-6. No abstract available.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Estimé)
15 juin 2026
Achèvement primaire (Estimé)
31 décembre 2028
Achèvement de l'étude (Estimé)
31 décembre 2028
Dates d'inscription aux études
Première soumission
3 juin 2026
Première soumission répondant aux critères de contrôle qualité
5 juin 2026
Première publication (Réel)
8 juin 2026
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
8 juin 2026
Dernière mise à jour soumise répondant aux critères de contrôle qualité
5 juin 2026
Dernière vérification
1 juin 2026
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- FAST-EM-2
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
NON
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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