MLD10 in the Prevention of Migraine in Adults

This is a multi-center, double-blind, randomized, placebo-controlled, parallel study of MLD10 for the prevention of migraine headache. The study population will consist of approximately 142 male and female subjects between 18 and 65 years of age with frequent episodic migraine as defined by International Classification of Headache Disorders-3beta criteria. Two MLD10 (243 mg (milligrams) of elemental magnesium) or placebo caplets will be taken twice daily for a total daily dose of 486 mg.

VISIT 1 - SCREENING

The following will be completed at Visit 1:

1. Obtain written Informed Consent. The informed consent will be obtained in accordance with Good Clinical Practices (GCP) and all applicable regulatory requirements from each subject prior to participation in the study.
2. Verify Inclusion/Exclusion Criteria. Subjects will meet all the inclusion and none of the exclusion criteria.
3. Obtain demographics (race, ethnicity, sex, date of birth)
4. Obtain medical, medication, and headache history. Data collected will include medical history and diagnoses, age at onset of migraine and other pertinent migraine/headache history, history of acute and prophylactic headache medications within the past 30 days, and history of other recent/concomitant medications.
5. Obtain date of last menstrual cycle and perform urine pregnancy test, if appropriate. Results of the pregnancy test must be negative to continue in study.
6. Perform physical and neurological examinations.
7. Measure vital signs (height, weight, resting heart rate, and blood pressure).
8. Review Baseline Headache Diary. Subjects will be instructed to complete a daily online headache diary. Assessments to be captured are start/stop time, severity, associated symptoms, use of rescue medications, and unusual symptoms.
9. Administer Columbia-Suicide Severity Rating Scale (C-SSRS).
10. Schedule Visit 2.

VISIT 2 - RANDOMIZATION

1. Verify Inclusion/Exclusion Criteria. Subjects must continue to meet all inclusion (including ≥ 3 days of migraine during baseline) and none of the exclusion criteria.
2. Perform urine pregnancy test, if appropriate. Results of the pregnancy test must be negative to continue in study.
3. Measure vital signs (weight, resting heart rate, and blood pressure).
4. Record any changes to concomitant medications.
5. Record any Serious Adverse Events (SAE) since signing the Informed Consent.
6. Review Baseline Headache Diary for completeness and continuing eligibility.
7. Randomize subject
8. Review Month 1 Headache Diary instructions (same instructions as those discussed for Baseline Headache Diary).
9. Dispense Month 1 study medication. Subjects will be instructed how to take study medication, prohibited medications/foods, dosage limitations of study medication, and storage requirements. Subjects will be instructed to return all used/partially used/unused study medication at next office visit and medications reconciliation will be performed to ensure a compliance of at least 80%. Subjects not complying at an 80% level will be withdrawn, unless otherwise approved by the Sponsor and/or Clinvest. (Estimated to be < 10%)
10. Administer C-SSRS.
11. Administer MIDAS.
12. Collect serum samples for electrolytes, creatinine, and ionized Mg.
13. Schedule Visit 3.

VISIT 3 - END OF TREATMENT PERIOD MONTH 1

1. Record any changes to concomitant medications.
2. Record any Non-Serious Adverse Events (NSAE) and/or SAEs.
3. Perform urine pregnancy test, if appropriate. Results of the pregnancy test must be negative to continue in study.
4. Measure vital signs (weight, resting heart rate, and blood pressure).
5. Review Month 1 Headache Diary for completeness.
6. Review instructions for Month 2 Headache Diary (same instructions as those discussed for Month 1 Headache Diary).
7. Collect Month 1 unused study medication and used packaging. Confirm 85% compliance of medication usage per study protocol.
8. Dispense Month 2 study medication and review the dosage limitations of study medication, storage requirements, and to return all used/partially used/unused study medication at next office visit.
9. Perform drug accountability.
10. Administer C-SSRS.
11. Collect serum samples for electrolytes, creatinine, and ionized Mg.
12. Schedule Visit 4.

VISIT 4 - END OF TREATMENT PERIOD MONTH 2

1. Record any changes to concomitant medications.
2. Record any NSAEs/SAEs.
3. Perform urine pregnancy test, if appropriate. Results of the pregnancy test must be negative to continue in study.
4. Measure vital signs (weight, resting heart rate, and blood pressure).
5. Review Month 2 Headache Diary for completeness.
6. Review instructions for Month 3 Headache Diary (same instructions as those discussed for Month 2 Headache Diary).
7. Collect Month 2 unused study medication and used packaging. Confirm 85% compliance for medication usage per study protocol.
8. Dispense Month 3 study medication and review the dosage limitations of study medication, storage requirements, and to return all used/partially used/unused study medication at next office visit.
9. Perform drug accountability.
10. Administer C-SSRS.
11. Collect serum samples for electrolytes, creatinine, and ionized Mg.
12. Schedule Visit 5.

VISIT 5 - END OF TREATMENT PERIOD MONTH 3

1. Record any changes to concomitant medications.
2. Record any NSAEs/SAEs.
3. Perform urine pregnancy test, if appropriate.
4. Measure vital signs (weight, resting heart rate, and blood pressure)
5. Perform physical/neurological examinations.
6. Collect Month 4 unused study medication and used packaging.
7. Perform drug accountability.
8. Administer SGIC & complete PGIC.
9. Administer MIDAS.
10. Administer C-SSRS.
11. Collect serum samples for electrolytes, creatinine, and ionized Mg.
12. Exit subject.