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Erenumab - Comprehensive Assessment of Efficacy in (High-Frequency) Episodic Migraine

Comprehensive Assessment of Erenumab Efficacy in Subjects With High Frequency Episodic Migraine With at Least 1 Previously Failed Preventive Treatment: a Global, Double-blind, Placebo-controlled Phase 4 Study

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04252742
Acronym
EMBRACE
Enrollment
512
Registered
2020-02-05
Start date
2020-09-15
Completion date
2023-10-26
Last updated
2026-03-31

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Migraine

Brief summary

The primary objective of this study is to evaluate the treatment benefit of erenumab on headache duration of at least moderate pain intensity.

Interventions

DRUGErenumab

140 mg, 2 consecutive injections of 70 mg

DRUGPlacebo

2 consecutive injections

Sponsors

Amgen
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Key inclusion criteria include: * Age greater than or equal to 18 years upon entry into initial screening. * Documented history of migraine with or without aura according to the International Headache Society (IHS) International Classification of Headache Disorders, Third Edition (ICHD-III) for greater than or equal to 12 months. * Have high-frequency episodic migraine (HFEM): Defined as history of ≥ 7 to \< 15 migraine days and \< 15 headache days per month on average during the 3 months prior to screening. * History of ≥ 4 migraine attacks of at least moderate severity per month on average during the 3 months prior to screening. * History of treatment failure with at least 1 preventive treatment for migraine. Failure of preventive treatment for migraine is defined as treatment discontinuation due to lack of efficacy, adverse event, or general poor tolerability. * Regular use of an oral triptan (using only eletriptan, rizatriptan, sumatriptan, or zolmitriptan) for acute migraine treatment, and typically initiating acute treatment with an oral triptan on \> 50% of attacks of at least moderate pain intensity. Regular use is defined as ≥ 4 days of oral triptan use per month during the 3 months prior to screening. Key

Exclusion criteria

include: * History of hemiplegic migraine, cluster headache, or other trigeminal autonomic cephalalgia. * Has any medical contraindication to the use of an oral triptan. * Previously treated with erenumab. * Previously treated with a gepant (small molecule calcitonin gene related peptide receptor \[CGRP-R\] antagonist) in a preventive fashion in a manner consistent with migraine prevention that either: 1. In the opinion of the investigator, did not offer any evidence of a therapeutic response or 2. Was discontinued for less than 12 weeks from the date of initial screening or 3. Was previously discontinued due to a known adverse drug reaction * Currently being treated with lasmiditan and/or a gepant in the acute setting. * No therapeutic response with greater than 4 of the defined medication categories after an adequate therapeutic trial. * Currently has a history of consistent excellent response to oral triptans, defined as achievement of pain-freedom in ≤ 1 hour for ≥ 50% of treated attacks of at least moderate pain intensity during the 3 months prior to screening. * Use of triptans administered via a non-oral (e.g. subcutaneous \[SC\] or intranasal delivery systems) or sublingual route at the time of screening, during the run-in and baseline periods, and throughout the study duration.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Mean Monthly Hours of at Least Moderate Headache Pain Intensity Over Months 1, 2, and 3Baseline, Month 1, Month 2, and Month 3At least moderate headache pain intensity was defined as headache pain intensity reported as 'Moderate' or 'Severe' based on the 3-level headache pain intensity scale. Worst or peak pain intensity during a headache was collected using the e-diary in 3-levels (mild, moderate or severe). The duration of headaches with at least moderate pain intensity was collected. A negative change from baseline indicates a reduction in mean monthly hours of at least moderate headache pain intensity. Change from baseline in mean monthly measurement is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The least squares mean (LSM) estimates of change from baseline in reported headache pain intensity utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Secondary

MeasureTime frameDescription
Change From Baseline in Mean Monthly Physical Function Domain Score as Measured by the Migraine Functional Impact Questionnaire (MFIQ) Over Months 1, 2, and 3Baseline, Month 1, Month 2, and Month 3The MFIQ is a self-administered 26-item instrument measuring the impact of migraine on broader functioning including on Physical Functioning (5 items). Participants responded to items using a 5-point scale assigned scores from 1 to 5, with 5 representing the greatest burden. Each domain score was calculated as the sum of the item responses and rescaled to a 0 to 100 scale, with higher scores representing greater burden. The recall period was the past 7 days. A negative change from baseline indicates an improvement in burden. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.
Change From Baseline in Mean Monthly Usual Activities Domain Score as Measured by the MFIQ Over Months 1, 2, and 3Baseline, Month 1, Month 2, and Month 3The MFIQ is a self-administered 26-item instrument measuring the impact of migraine on broader functioning including Impact on Usual Activities (10 items). Participants responded to items using a 5-point scale assigned scores from 1 to 5, with 5 representing the greatest burden. Each domain score was calculated as the sum of the item responses and rescaled to a 0 to 100 scale, with higher scores representing greater burden. The recall period was the previous 7 days. A negative change from baseline indicates an improvement in burden. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.
Change From Baseline in Mean Monthly Emotional Functioning Domain Score as Measured by the MFIQ Over Months 1, 2, and 3Baseline, Month 1, Month 2, and Month 3The MFIQ is a self-administered 26-item instrument measuring the impact of migraine on broader functioning including Impact on Emotional Functioning (5 items). Participants responded to items using a 5-point scale assigned scores from 1 to 5, with 5 representing the greatest burden. Each domain score was calculated as the sum of the item responses and rescaled to a 0 to 100 scale, with higher scores representing greater burden. The recall period was the previous 7 days. A negative change from baseline indicates an improvement in burden. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.
Change From Baseline in Mean Monthly Social Functioning Domain Score as Measured by the MFIQ Over Months 1, 2, and 3Baseline, Month 1, Month 2, and Month 3The MFIQ is a self-administered 26-item instrument measuring the impact of migraine on broader functioning including Impact on Social Functioning (5 items). Participants responded to items using a 5-point scale assigned scores from 1 to 5, with 5 representing the greatest burden. Each domain score was calculated as the sum of the item responses and rescaled to a 0 to 100 scale, with higher scores representing greater burden. The recall period was the previous 7 days. A negative change from baseline indicates an improvement in burden. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.
Change From Baseline in Mean Monthly Average Duration of at Least Moderate Headache Pain Intensity in Migraine Attacks Occurring Over Months 1, 2, and 3Baseline, Month 1, Month 2, and Month 3At least moderate headache pain intensity was defined as headache pain intensity reported as 'Moderate' or 'Severe' based on the 3-level headache pain intensity scale. Worst or peak pain intensity during a headache was collected using the e-diary in 3-levels (mild, moderate or severe). The duration of headaches with at least moderate pain intensity during a migraine attack was collected. A negative change from baseline indicates a reduction in mean monthly average duration of at least moderate headache pain intensity during a migraine attack. Change from baseline in mean monthly measurement is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.
Change From Baseline in Mean Monthly Average Peak Migraine Pain Intensity as Assessed by the 11-point Numeric Rating Scale (NRS) Over Months 1, 2, and 3Baseline, Month 1, Month 2, and Month 3The NRS assesses headache pain intensity ranging from 0 to 10 with a higher score indicating more severe pain. Participants recorded the pain intensity using the e-diary at the headache end-time or in an evening diary entry on a daily basis for an ongoing headache. A negative change from baseline indicates an improvement in pain intensity. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Countries

Bulgaria, Czechia, Hungary, Italy, Poland, Portugal, Romania, Spain, United States

Contacts

STUDY_DIRECTORMD

Amgen

Participant flow

Recruitment details

This study was conducted at 61 study centers in North America and Europe from September 2020 to October 2023.

Pre-assignment details

Eligible adult participants with high frequency episodic migraine (EP) who met specific eligibility criteria during a 2-week run-in period and 4-week baseline period entered the double-blind treatment period (DBTP). The DBTP included a 12-week main-DBTP (M-DBTP) and a 4-week exploratory DBTP (E-DBTP)

Participants by arm

ArmCount
Placebo
Participants were randomized to receive matching placebo SC QW4 for up to 16 weeks in the DBTP.
256
Erenumab 140 mg SC Q4W
Participants were randomized to receive 140 mg erenumab SC Q4W for up to 16 weeks in the DBTP.
256
Total512

Baseline characteristics

CharacteristicPlaceboErenumab 140 mg SC Q4WTotal
Age, Continuous42.5 years
STANDARD_DEVIATION 10.2
41.9 years
STANDARD_DEVIATION 10.9
42.2 years
STANDARD_DEVIATION 10.5
Ethnicity (NIH/OMB)
Hispanic or Latino
7 Participants7 Participants14 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
248 Participants249 Participants497 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants0 Participants1 Participants
Monthly Hours of at Least Moderate Headache Pain Intensity47.382 hours/month
STANDARD_DEVIATION 29.302
48.843 hours/month
STANDARD_DEVIATION 29.502
48.114 hours/month
STANDARD_DEVIATION 29.383
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
1 Participants2 Participants3 Participants
Race (NIH/OMB)
Black or African American
2 Participants2 Participants4 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
253 Participants252 Participants505 Participants
Sex: Female, Male
Female
222 Participants220 Participants442 Participants
Sex: Female, Male
Male
34 Participants36 Participants70 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 2560 / 256
other
Total, other adverse events
0 / 2560 / 254
serious
Total, serious adverse events
2 / 2560 / 254

Outcome results

Primary

Change From Baseline in Mean Monthly Hours of at Least Moderate Headache Pain Intensity Over Months 1, 2, and 3

At least moderate headache pain intensity was defined as headache pain intensity reported as 'Moderate' or 'Severe' based on the 3-level headache pain intensity scale. Worst or peak pain intensity during a headache was collected using the e-diary in 3-levels (mild, moderate or severe). The duration of headaches with at least moderate pain intensity was collected. A negative change from baseline indicates a reduction in mean monthly hours of at least moderate headache pain intensity. Change from baseline in mean monthly measurement is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The least squares mean (LSM) estimates of change from baseline in reported headache pain intensity utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Time frame: Baseline, Month 1, Month 2, and Month 3

Population: The M-DBTP efficacy analysis set consisted of a subset the full analysis set (all participants randomized in the study) who received at least 1 dose of IP and had observed monthly hours of at least moderate headache pain intensity at baseline and at least 1 measurement during the M-DBTP.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Mean Monthly Hours of at Least Moderate Headache Pain Intensity Over Months 1, 2, and 3-23.38 hours/monthStandard Error 1.26
Erenumab 140 mg SC Q4WChange From Baseline in Mean Monthly Hours of at Least Moderate Headache Pain Intensity Over Months 1, 2, and 3-31.33 hours/monthStandard Error 1.25
p-value: <0.00195% CI: [-11.45, -4.46]Mixed Models Analysis
Secondary

Change From Baseline in Mean Monthly Average Duration of at Least Moderate Headache Pain Intensity in Migraine Attacks Occurring Over Months 1, 2, and 3

At least moderate headache pain intensity was defined as headache pain intensity reported as 'Moderate' or 'Severe' based on the 3-level headache pain intensity scale. Worst or peak pain intensity during a headache was collected using the e-diary in 3-levels (mild, moderate or severe). The duration of headaches with at least moderate pain intensity during a migraine attack was collected. A negative change from baseline indicates a reduction in mean monthly average duration of at least moderate headache pain intensity during a migraine attack. Change from baseline in mean monthly measurement is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Time frame: Baseline, Month 1, Month 2, and Month 3

Population: The M-DBTP efficacy analysis set consisted of a subset the full analysis set (all participants randomized in the study) who received at least 1 dose of IP and had observed monthly hours of at least moderate headache pain intensity at baseline and at least 1 measurement during the M-DBTP.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Mean Monthly Average Duration of at Least Moderate Headache Pain Intensity in Migraine Attacks Occurring Over Months 1, 2, and 3-2.78 hoursStandard Error 0.31
Erenumab 140 mg SC Q4WChange From Baseline in Mean Monthly Average Duration of at Least Moderate Headache Pain Intensity in Migraine Attacks Occurring Over Months 1, 2, and 3-3.86 hoursStandard Error 0.3
p-value: 0.01395% CI: [-1.92, -0.22]Mixed Models Analysis
Secondary

Change From Baseline in Mean Monthly Average Peak Migraine Pain Intensity as Assessed by the 11-point Numeric Rating Scale (NRS) Over Months 1, 2, and 3

The NRS assesses headache pain intensity ranging from 0 to 10 with a higher score indicating more severe pain. Participants recorded the pain intensity using the e-diary at the headache end-time or in an evening diary entry on a daily basis for an ongoing headache. A negative change from baseline indicates an improvement in pain intensity. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Time frame: Baseline, Month 1, Month 2, and Month 3

Population: The M-DBTP efficacy analysis set consisted of a subset the full analysis set (all participants randomized in the study) who received at least 1 dose of IP and had observed monthly hours of at least moderate headache pain intensity at baseline and at least 1 measurement during the M-DBTP.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Mean Monthly Average Peak Migraine Pain Intensity as Assessed by the 11-point Numeric Rating Scale (NRS) Over Months 1, 2, and 3-1.48 score on a scaleStandard Error 0.13
Erenumab 140 mg SC Q4WChange From Baseline in Mean Monthly Average Peak Migraine Pain Intensity as Assessed by the 11-point Numeric Rating Scale (NRS) Over Months 1, 2, and 3-1.96 score on a scaleStandard Error 0.13
p-value: 0.01195% CI: [-0.85, -0.11]Mixed Models Analysis
Secondary

Change From Baseline in Mean Monthly Emotional Functioning Domain Score as Measured by the MFIQ Over Months 1, 2, and 3

The MFIQ is a self-administered 26-item instrument measuring the impact of migraine on broader functioning including Impact on Emotional Functioning (5 items). Participants responded to items using a 5-point scale assigned scores from 1 to 5, with 5 representing the greatest burden. Each domain score was calculated as the sum of the item responses and rescaled to a 0 to 100 scale, with higher scores representing greater burden. The recall period was the previous 7 days. A negative change from baseline indicates an improvement in burden. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Time frame: Baseline, Month 1, Month 2, and Month 3

Population: The M-DBTP efficacy analysis set consisted of a subset the full analysis set (all participants randomized in the study) who received at least 1 dose of IP and had observed monthly hours of at least moderate headache pain intensity at baseline and at least 1 measurement during the M-DBTP. Data for participants included in the model for the MFIQ Emotional Functioning Domain are presented.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Mean Monthly Emotional Functioning Domain Score as Measured by the MFIQ Over Months 1, 2, and 3-22.77 score on a scaleStandard Error 1.34
Erenumab 140 mg SC Q4WChange From Baseline in Mean Monthly Emotional Functioning Domain Score as Measured by the MFIQ Over Months 1, 2, and 3-29.83 score on a scaleStandard Error 1.33
p-value: <0.00195% CI: [-10.76, -3.34]Mixed Models Analysis
Secondary

Change From Baseline in Mean Monthly Physical Function Domain Score as Measured by the Migraine Functional Impact Questionnaire (MFIQ) Over Months 1, 2, and 3

The MFIQ is a self-administered 26-item instrument measuring the impact of migraine on broader functioning including on Physical Functioning (5 items). Participants responded to items using a 5-point scale assigned scores from 1 to 5, with 5 representing the greatest burden. Each domain score was calculated as the sum of the item responses and rescaled to a 0 to 100 scale, with higher scores representing greater burden. The recall period was the past 7 days. A negative change from baseline indicates an improvement in burden. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Time frame: Baseline, Month 1, Month 2, and Month 3

Population: The M-DBTP efficacy analysis set consisted of a subset the full analysis set (all participants randomized in the study) who received at least 1 dose of IP and had observed monthly hours of at least moderate headache pain intensity at baseline and at least 1 measurement during the M-DBTP. Data for participants included in the model for the MFIQ Physical Function Domain are presented.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Mean Monthly Physical Function Domain Score as Measured by the Migraine Functional Impact Questionnaire (MFIQ) Over Months 1, 2, and 3-22.92 score on a scaleStandard Error 1.25
Erenumab 140 mg SC Q4WChange From Baseline in Mean Monthly Physical Function Domain Score as Measured by the Migraine Functional Impact Questionnaire (MFIQ) Over Months 1, 2, and 3-30.28 score on a scaleStandard Error 1.23
p-value: <0.00195% CI: [-10.8, -3.92]Mixed Models Analysis
Secondary

Change From Baseline in Mean Monthly Social Functioning Domain Score as Measured by the MFIQ Over Months 1, 2, and 3

The MFIQ is a self-administered 26-item instrument measuring the impact of migraine on broader functioning including Impact on Social Functioning (5 items). Participants responded to items using a 5-point scale assigned scores from 1 to 5, with 5 representing the greatest burden. Each domain score was calculated as the sum of the item responses and rescaled to a 0 to 100 scale, with higher scores representing greater burden. The recall period was the previous 7 days. A negative change from baseline indicates an improvement in burden. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Time frame: Baseline, Month 1, Month 2, and Month 3

Population: The M-DBTP efficacy analysis set consisted of a subset the full analysis set (all participants randomized in the study) who received at least 1 dose of IP and had observed monthly hours of at least moderate headache pain intensity at baseline and at least 1 measurement during the M-DBTP. Data for participants included in the model for the MFIQ Social Functioning Domain are presented.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Mean Monthly Social Functioning Domain Score as Measured by the MFIQ Over Months 1, 2, and 3-25.05 score on a scaleStandard Error 1.28
Erenumab 140 mg SC Q4WChange From Baseline in Mean Monthly Social Functioning Domain Score as Measured by the MFIQ Over Months 1, 2, and 3-31.87 score on a scaleStandard Error 1.27
p-value: <0.00195% CI: [-10.37, -3.27]Mixed Models Analysis
Secondary

Change From Baseline in Mean Monthly Usual Activities Domain Score as Measured by the MFIQ Over Months 1, 2, and 3

The MFIQ is a self-administered 26-item instrument measuring the impact of migraine on broader functioning including Impact on Usual Activities (10 items). Participants responded to items using a 5-point scale assigned scores from 1 to 5, with 5 representing the greatest burden. Each domain score was calculated as the sum of the item responses and rescaled to a 0 to 100 scale, with higher scores representing greater burden. The recall period was the previous 7 days. A negative change from baseline indicates an improvement in burden. Change from baseline in mean monthly scores is the arithmetic mean of the monthly change from baseline values for the months considered with observed data, if there was at least one observed monthly value. The LSM estimates utilized a linear mixed model which included treatment, visit, treatment-by-visit interaction, and baseline value as covariates and assumed a first-order auto regression covariance structure.

Time frame: Baseline, Month 1, Month 2, and Month 3

Population: The M-DBTP efficacy analysis set consisted of a subset the full analysis set (all participants randomized in the study) who received at least 1 dose of IP and had observed monthly hours of at least moderate headache pain intensity at baseline and at least 1 measurement during the M-DBTP. Data for participants included in the model for the MFIQ Usual Activities Domain are presented.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Mean Monthly Usual Activities Domain Score as Measured by the MFIQ Over Months 1, 2, and 3-23.98 score on a scaleStandard Error 1.17
Erenumab 140 mg SC Q4WChange From Baseline in Mean Monthly Usual Activities Domain Score as Measured by the MFIQ Over Months 1, 2, and 3-31.08 score on a scaleStandard Error 1.16
p-value: <0.00195% CI: [-10.34, -3.87]Mixed Models Analysis

Source: ClinicalTrials.gov · Data processed: Apr 1, 2026