Menstrually Associated Migraine
Conditions
Brief summary
The primary objective of this study was to determine whether frovatriptan was effective in the prevention of menstrually associated migraine (MAM) headaches when compared to placebo. Secondary objectives included determining the effectiveness of frovatriptan in reducing the incidence, severity and duration of MAM headaches and associated symptoms, to evaluate the safety and tolerability of the two frovatriptan dosing regimens and to compare the effectiveness of these regimens in the prevention of MAM headaches. In this cross-over study, patients treated each of 3 perimenstrual periods (PMPs) with placebo, frovatriptan 2.5 mg daily (QD) and 2.5 mg twice daily (BID) for 6 days, starting 2 days before the anticipated onset of a MAM headache. A statistically significant reduction in the incidence of MAM headache (p\<0.0001) was observed with both dosing regimens of frovatriptan when compared to placebo. Additionally, the frovatriptan BID regimen was superior to the frovatriptan QD regimen in the prevention of MAM headache (p\<0.001). Significant reductions in MAM headache severity and duration, the incidence of associated symptoms and characteristics, and the use of rescue medication were observed when the PMP was treated with frovatriptan, compared to placebo. Both dose regimens of frovatriptan were equally well tolerated and no cardiovascular or other safety and tolerability concerns arose with repeated administration of frovatriptan over a 6 day period.
Interventions
DRUGFrovatriptan
2.5 mg tablet administered once daily for 6 days starting 2 days before the anticipated onset of a MAM headache
DRUGPlacebo
placebo tablet administered for 6 days, starting 2 days before the anticipated onset of a MAM headache.
Sponsors
Vernalis (R&D) Ltd
Endo Pharmaceuticals
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
DOUBLE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Females aged 18 years and over * 12 month or more documented history of menstrual migraine headache, according to International Headache Society classification * An average frequency of MAM attacks in at lease 3 out of 4 menstrual cycles * Regular predictable menstrual periods * Able to accurately predict the onset of MAM headaches occurring between Day -2 and Day +4 of menses * Able and willing to sign informed consent to comply with study procedures, including completion of diary cards
Exclusion criteria
* More than three migraine attacks per month that were not MAM attacks * Coronary artery disease including coronary vasospasm * Significant cerebrovascular disease including basilar or hemiplegic migraine * Uncontrolled hypertension * Severe hepatic or renal insufficiency * More than 15 headache days per month * Any other condition or serious illness which would interfere with optimal participation in the study * History of clinically relevant allergy, including that to frovatriptan or other triptans * Pregnant or breast feeding or intending to become pregnant or to breast-feed during study period * Participated in other frovatriptan menstrual migraine prevention studies * Use of another investigation drug within 30 days or 5 half-lives (whichever is longer) before the screening visit
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Incidence of menstrually associated migraine (MAM) headache in the treated peri-menstrual period (PMP) | — |
Secondary
| Measure | Time frame |
|---|---|
| Incidence of severe MAM headaches | — |
| Duration of MAM headaches | — |
| Maximum headache intensity | — |
| Incidence of MAM headache associated symptoms and characteristics | — |
| Duration of MAM headache associated symptoms | — |
| Maximum functional impairment score during MAM headache | — |
| Incidence of moderate or severe MAM headaches | — |
| Duration of moderate or severe functional impairment during MAM headache | — |
| Incidence of use of rescue medication for the treatment of a MAM headache | — |
| Patient satisfaction score at the end of each 6 day treated PMP | — |
| Adverse events | — |
| Standard hematology and biochemistry | — |
| 12-lead ECGs, physical exam, vital signs | — |
| Incidence of moderate or severe functional impairment during MAM headache | — |
Countries
United States
Outcome results
None listed