Episodic and Chronic Migraine MedDRA version: 21.1 Level: LLT Classification code 10066636 Term: Chronic migraine System Organ Class: 10029205 - Nervous system disorders MedDRA version: 22.0 Level: LLT Classification code 10082019 Term: Episodic migraine System Organ Class: 10029205 - Nervous system disorders
Conditions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: Participants Rolling Over from the Pivotal Efficacy Trials may be included only if they meet all of the following criteria: a. Completion of the pivotal efficacy trial and in the opinion of the Investigator/Sponsor able to complete the trial in a safe and compliant way b. Participant’s parent(s) or legal guardian(s) must give written informed consent, and the participant must give assent (in accordance with local regulations) Note: In some countries, participants aged 15 to 17 years (inclusive) may give written informed consent; however, the participant’s parent(s) or legal guardian(s) must be informed, per local regulations. c. Participant may continue with a stable dose/regimen of the preventive medication they were taking during the pivotal efficacy trials d. Willing and able to comply with trial restrictions and to remain at the clinic for the required duration during the trial period and willing to return to the clinic for the follow-up evaluation as specified in this protocol e. Participant continues to meet appropriate criteria carried forward from the pivotal efficacy trial, as follows: f. Females who are postmenarchal or =12 years of age may be included only if they have a negative beta-human chorionic gonadotropin (ß-HCG) test before day 1 or are sterile g. Females who are postmenarchal or =12 years of age and sexually active must use highly effective birth control methods with their male partners for the duration of the trial (ie, at least 2 months before day 1) and for 6 months after the last dose of IMP. Males who are sexually active with female partners must use a condom for the duration of the trial and for 6 months after the last administration of IMP h. Receipt of all recommended age-appropriate vaccines according to local standard of care and schedule i. Good health, determined by a medical and psychiatric history, medical examination, 12-lead ECG, serum chemistry, hematology, coagulation, urinalysis, and serology j. Weight of at least 17.0 kg on the day of trial enrollment k. BMI ranging from the 5th to 120& of the 95th percentile, incl. at day 1, based on the local standard Participants Rolling Over from Trial TV48125-CNS-10141: may be included only if they meet all of the following criteria a. Participant is male/female, 6 - 17 years old (inclusive) b. Written informed consent is obtained from each participant's parent or legal guardian and written assent (according to local regulations) is obtained from each participant. Note: In some countries, participants aged 15 to 17 years (inclusive) may give written informed consent; however, the participant’s parent(s) or legal guardian(s) must be informed, per local regulations. c. The participant/caregiver has demonstrated compliance with the electronic headache diary during the 28-day baseline period by entry of headache data on a minimum of 21 out of 28 days (approximately 75% diary compliance) d. Females who are postmenarchal or =12 years of age may be included only if they have a negative ß-HCG test before day 1 or are sterile e. Females who are postmenarchal or =12 years of age and sexually active must use highly effective birth control methods with their male partners for the duration of the trial (ie, at least 2 months before day 1) and for 6 months after the last dose of the IMP. Males who are sexually active with female partners must use a condom for the duration of the trial and for 6 months after the last administration of the IMP f. The participant has re
Exclusion criteria
Exclusion criteria: Participants from Pivotal Efficacy Trials (any criteria met): a. Significant abnormal finding on trial entry (e.g. hematology), repeat abnormal tests for confirmation b. Pregnant or nursing c. Abnormal clinically significant finding on day 1 12-lead ECG d. One of the following criteria is met: e. Use of medications containing opioids (incl. codeine), barbiturates (incl. Fiorinal®, any other combination containing butalbital) for migraine treatment during the 3 months prior to screening visit day f. Use of intervention/device (eg, scheduled nerve block or transcr. mag. stim.) for migraine treatment or in head or neck area for any condition during the 2 months prior to day 1 g. Any clinically significant disease (eg cardiovascular) or complications of an infection h. History of clinically significant psychiatric condition/history of suicide attempt/history of suicidal ideation with a specific plan within the past 2 years, at the discretion of the investigator. i. Ongoing infection/known history of e.g. HIV infection/tuberculosis, Lyme disease, chronic hepatitis B or C or a known infection of coronavirus disease 2019 (COVID-19) j. Past or current history of cancer k. History of hypersensitivity reactions to injected proteins, incl. mAbs, history of Stevens-Johnson Syndrome, toxic epidermal necrolysis syndrome or the participant in concomitantly using lamotrigine. l. Current participation in another IMP/medical device trial m. Hepatic enzymes (ALT, AST, ALP) > 1.5× ULN after a repeat test confirmation, or suspected hepatocellular damage (fulfilling Hy’s law) n. Serum creatinine > 1.5× the ULN, clinically significant proteinuria (urine dipstick +4), an estimated glomerular filtration rate of <75 mL/min/1.73m2, as calculated by the revised Schwartz formula (eGFR=[0.413xHt]/Serum Creatinine), or evidence of renal disease o. Participant cannot fully participate in/successfully complete the trial for its full duration for any of the following reasons: -In custody due to administrative or a legal decision or in residential treatment -Participant/caregiver unable to be contacted in case of emergency -Presence of any other condition which makes the participant inappropriate for trial inclusion -Participant is a relative of a trial center or sponsor employee who is directly involved in the study p. Vulnerable participants (eg, people in detention) that are vulnerable due to other conditions than age q. Receipt of a live attenuated vaccine (eg intranasal flu vaccine) within the 12-week period prior to day 1. Note: If a medical need arises during the trial, the participant may receive a live attenuated vaccine. r. The participant has a known hypersensitivity to the active substance or to any of the excipients of the trial drug. s. The participant has a current or past medical history of hemiplegic migraine. Participants from Study TV48125-CNS-10141 (any criteria met): a. Use of an intervention/device (eg, scheduled nerve block) for the migraine treatment or in the head or neck area for any condition during the 2 months prior to day 1. b. Any clinically significant disease (e.g. cardiovascular)/complications of an infection c. Current history of clinically significant psychiatric condition/history of a suicide attempt/suicidal ideation with a specific plan within the past 2 years, at discretion of investigator d. Ongoing infection/known history of e.g. HIV infection/tuberculosis/Lyme disease/chronic hepatitis B or C, COVID-19 e. Past or current histor
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Main Objective: To evaluate the long-term safety and tolerability of subcutaneous test IMP in the preventive treatment of migraine in pediatric participants 6 to 17 years of age (inclusive at enrollment in the pivotal trial);Secondary Objective: -To evaluate the efficacy of subcutaneous test IMP in pediatric participants with migraine -To evaluate the immunogenicity of test IMP and the impact of ADAs on clinical outcomes in pediatric participants exposed to test IMP;Primary end point(s): Safety: -Occurrence of adverse events throughout the trial, including local injection site reactions/pain -Changes from baseline in clinical laboratory (serum chemistry, hematology, coagulation, and urinalysis) test results and height and weight measurements taken at V5, V8, and at the end of treatment (V11) -Abnormal standard 12-lead electrocardiogram findings at each trial visit up to the end of treatment (V11) -Changes from baseline in vital signs (pulse, systolic and diastolic blood pressure, temperature, and respiratory rate) at each trial visit up to the end of treatment (V11) -Abnormal physical examination findings at trial visits V6, V7, V11, and V12 -Suicidal ideation and behavior as suggested by the Columbia-Suicide Severity Rating Scale throughout the trial ;Timepoint(s) of evaluation of this end point: -Safety will be assessed throughout the trial | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary end point(s): Efficacy: -Mean change from baseline (defined as the original baseline from the EM and CM studies) in the number of headache days of at least moderate severity during the 4-week periods after V2, V6, and V10 -Mean change from baseline (defined as the original baseline from the EM and CM studies) in the number of migraine days during the 4-week periods after V2, V6, and V10 -Proportion of participants reaching at least 50% reduction in the number of migraine days during the 4-week periods after V2, V6, and V10 -Proportion of participants reaching at least 50% reduction in the number of headache days of at least moderate severity during the 4-week periods after V2, V6, and V10 -Mean change from baseline (defined as the original baseline from the EM and CM studies) in the number of days of use of any acute headache medications during the 4-week periods after V2, V6, and V10 -Mean change from baseline (day 1) in migraine-related disability score, as measured by the PedMIDAS questionnaire at V5, V8, V11, and V12 -Proportion of participants developing ADAs throughout the trial. The impact of ADAs on safety and efficacy will be analyzed if the number of ADA-positive participants allows ;Timepoint(s) of evaluation of this end point: -Efficacy will be assessed through V11 (end of treatment) | — |
Countries
Canada, Finland, Germany, Israel, Italy, Netherlands, Poland, Spain, United States
Contacts
Merckle GmbH