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Study of BOTOX Injections in Prevention of Migraine in Adult Participants With Episodic Migraine

Phase 3 Multicenter, Randomized, Double-blind, Placebo-controlled Study of BOTOX (Botulinum Toxin Type A) for the Prevention of Migraine in Subjects With Episodic Migraine

Status
Terminated
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05028569
Enrollment
775
Registered
2021-08-31
Start date
2021-11-05
Completion date
2024-11-06
Last updated
2025-12-09

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

Conditions

Episodic Migraine

Keywords

Migraine, Episodic Migraine, BOTOX, Botulinum Toxin Type A

Brief summary

Migraine is a neurological disease characterized by moderate or severe headache, associated with nausea, vomiting, and/or sensitivity to light and sound (International Classification of Headache Disorders, 2018). Migraine can be further categorized according to the frequency of attacks as episodic migraine (EM) or chronic migraine (CM). This study will assess the effects of BOTOX in preventing migraine in adult participants with EM. BOTOX is being developed for the prevention of migraine in adults with episodic migraine (EM). Participants will be enrolled in 3 different treatment groups. There is 1 in 3 chance that participants will be assigned to receive placebo. Approximately 777 adult participants with EM will be enrolled in approximately 125 sites across the world. Participants will receive intramuscular injections (injected into the muscle) of BOTOX or Placebo on Day 1 and Week 12. Eligible participants will receive BOTOX on Week 24 and Week 36. There may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.

Interventions

DRUGBOTOX

Intramuscular Injection

DRUGPlacebo

Intramuscular Injection

Sponsors

AbbVie
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

* History of migraine headache disorder meeting International Classification of Headache Disorders (ICHD)-3 diagnostic criteria for migraine with aura or migraine without aura for \>= 12 months. * Onset of migraine before 50 years of age. * History of 6 to 14 migraine days/month in each of the 3 months prior to Visit 1. * Six to 14 migraine/probable migraine days during the 4-week screening/baseline phase. * Less than 15 headache days/month in each of the 3 months prior to Visit 1 and during the 4-week screening/baseline phase.

Exclusion criteria

* Current diagnosis of chronic migraine according to ICHD-3. * History or current diagnosis of migraine with brainstem aura, retinal migraine, complications of migraine, chronic tension-type headache, trigeminal autonomic cephalalgias, hypnic headache, hemicrania continua, or new daily persistent headache. * History of headache attributed to another disorder (e.g., cervical dystonia, craniotomy, head/neck trauma) with exception that medication overuse headache per ICHD-3 criteria is allowed. * History of inadequate response to \> 4 prophylactic treatment for migraine, 2 of which have different mechanisms of action. * Female who is pregnant, breastfeeding, or considering becoming pregnant during the study or within 90 days after the last dose of study drug.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 6Baseline, Months 5-6The frequency of monthly migraine days across Months 5 and 6 is calculated by taking the 2-month average of monthly migraine days over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. Negative changes from Baseline indicate improvement.
Number of Participants With Treatment-Emergent Adverse Events (AEs)Double-Blind Phase (Week 0-24); Open-Label Phase (Week 24-48)An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study drug. A serious adverse event (SAE) is an event that results in death, is life-threatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event that, based on medical judgment, may jeopardize the participant and may require medical or surgical intervention to prevent any of the outcomes listed above. Treatment-emergent adverse events/treatment-emergent serious adverse events (TEAEs/TESAEs) are defined as any event that began or worsened in severity on or after the first dose of study drug.

Secondary

MeasureTime frameDescription
Percentage of Participants With ≥ 50% Reduction From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 6Baseline, Months 5-6The frequency of monthly migraine days across Months 5 and 6 is calculated by taking the 2-month average of monthly migraine days over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. The responder status of 50% reduction from Baseline is defined as a participant with at least a 50% reduction from Baseline in the 2-month average of monthly migraine days over Months 5 and 6.
Change From Baseline in the Frequency of Monthly Acute Headache Medication Days Across Months 5 and 6Baseline, Months 5-6Monthly acute headache medication days across Months 5 and 6 is calculated by taking the 2-month average of monthly acute headache medication days over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. Negative changes from Baseline indicate improvement.
Change From Baseline in Migraine-Specific Quality of Life Questionnaire Version 2.1 (MSQ v2.1) Role Function - Restrictive (RFR) Domain Score At Month 6Baseline, Month 6The MSQ v2.1 is a 14-item questionnaire designed to measure health-related quality of life impairments attributed to migraine over the past 4 weeks. It is divided into 3 domains, and the Role Function Restrictive (RFR) assesses how migraines limit one's daily social and work-related activities using a 6-point scale ranging from none of the time to all of the time. Raw dimension scores are computed as a sum of item responses and rescaled to a 0 to 100 scale, where higher scores indicate better quality of life. Positive changes from Baseline indicate improvement.
Change From Baseline in the Activity Impairment in Migraine - Diary (AIM-D) Physical Impairment Domain Score Across Months 5 and 6Baseline, Months 5-6AIM-D Physical Impairment Domain score is calculated based on the summation of AIM-D items 6-9. Participants answer each question based on the level of difficulty experienced in the 24 hours prior, with during your headache indicated for when they reported a headache, using a 6-point rating scale ranging from not difficult at all to extremely difficult. The raw daily score is transformed to a 0-100 scale, and the monthly score is calculated using the average daily scores, where a higher score indicates worse physical impairment. AIM-D Physical Impairment domain score across Months 5 and 6 is calculated by taking the 2-month average of AIM-D Physical Impairment domain scores over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. Negative changes from Baseline indicate improvement.
Change From Baseline in the Total 6-item Headache Impact Test (HIT-6) Score Across Months 5 and 6Baseline, Months 5-6The HIT-6 is a 6-item assessment used to measure the impact headaches have on a participant's ability to function on the job, at school, at home and in social situations. It assesses the effect that headaches have on normal daily life and the subject's ability to function. Responses are based on frequency using a 5-point scale ranging from never to always. The HIT-6 total score, which ranges from 36 to 78, is the sum of the responses, each of which is assigned a score ranging from 6 points (never) to 13 points (always). The Total 6-item Headache Impact Test (HIT-6) score across Months 5 and 6 is calculated by taking the 2-month average of total 6-item Headache Impact Test (HIT-6) scores over Months 5 and 6. Negative changes from Baseline in the HIT-6 score indicate improvement.
Change From Baseline in the Frequency of Monthly Headache Days Across Months 5 and 6Baseline, Months 5-6The frequency of monthly headache days across Months 5 and 6 is calculated by taking the 2-month average of monthly headache days over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. Negative changes from Baseline indicate improvement.

Countries

Canada, Czechia, Germany, Israel, Poland, Spain, Sweden, United Kingdom, United States

Participant flow

Recruitment details

This study was conducted at 118 sites in 9 countries and was initiated in November 2021. Adults with episodic migraine (EM) were eligible.

Pre-assignment details

Participants were randomized in a 1:1:1 ratio to receive 2 treatment cycles of BOTOX 195 U, BOTOX 155 U, or placebo. BOTOX (155 U or 195 U) or matching placebo was administered by a trained injector at Day 1 and Week 12 of the Double-Blind Phase. Those who continued to the Open-label Phase received BOTOX 195 U at 12-week intervals for up to 2 treatment cycles.

Participants by arm

ArmCount
Double-Blind Phase: Placebo
Participants received placebo intramuscular injections in the head/neck muscles for BOTOX on Day 1 and Week 12.
257
Double-Blind Phase: BOTOX 155 U
Participants received intramuscular injections in the head/neck muscles of BOTOX 155 U on Day 1 and Week 12.
257
Double-Blind Phase: BOTOX 195 U
Participants received intramuscular injections in the head/neck muscles of BOTOX 195 U on Day 1 and Week 12.
261
Total775

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005FG006
Double-Blind PhaseDeath0001000
Double-Blind PhaseLost to Follow-up0639000
Double-Blind PhaseOther, not specified0546000
Double-Blind PhaseProtocol Deviation0200000
Double-Blind PhaseWithdrawal by Subject0272022000
Open-Label PhaseCompleted Double-Blind Phase and then withdrew due to pregnancy0000001
Open-Label PhaseCompleted Double-Blind Phase and then withdrew from study0000020
Open-Label PhaseDeath0000001
Open-Label PhaseLost to Follow-up0000554
Open-Label PhaseOther, not specified0000657
Open-Label PhasePregnancy0000010
Open-Label PhaseProtocol Deviation0000100
Open-Label PhaseStudy Terminated by Sponsor00004105
Open-Label PhaseWithdrawal by Subject000015813

Baseline characteristics

CharacteristicDouble-Blind Phase: PlaceboDouble-Blind Phase: BOTOX 155 UDouble-Blind Phase: BOTOX 195 UTotal
Age, Continuous40.3 years
STANDARD_DEVIATION 11.12
41.1 years
STANDARD_DEVIATION 10.37
41.1 years
STANDARD_DEVIATION 10.76
40.8 years
STANDARD_DEVIATION 10.75
Ethnicity (NIH/OMB)
Hispanic or Latino
24 Participants30 Participants37 Participants91 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
233 Participants227 Participants224 Participants684 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants1 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
3 Participants3 Participants7 Participants13 Participants
Race (NIH/OMB)
Black or African American
23 Participants12 Participants14 Participants49 Participants
Race (NIH/OMB)
More than one race
2 Participants0 Participants2 Participants4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants1 Participants0 Participants1 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants1 Participants1 Participants
Race (NIH/OMB)
White
229 Participants240 Participants237 Participants706 Participants
Sex: Female, Male
Female
231 Participants227 Participants224 Participants682 Participants
Sex: Female, Male
Male
26 Participants30 Participants37 Participants93 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
deaths
Total, all-cause mortality
0 / 7750 / 2570 / 2561 / 2620 / 2170 / 2271 / 223
other
Total, other adverse events
14 / 77521 / 25735 / 25622 / 26219 / 21718 / 22714 / 223
serious
Total, serious adverse events
2 / 7756 / 2573 / 2566 / 2622 / 2171 / 2271 / 223

Outcome results

Primary

Change From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 6

The frequency of monthly migraine days across Months 5 and 6 is calculated by taking the 2-month average of monthly migraine days over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. Negative changes from Baseline indicate improvement.

Time frame: Baseline, Months 5-6

Population: Intent-to-Treat Population (as Randomized); data used are observed data (without imputation for missing values)

ArmMeasureValue (LEAST_SQUARES_MEAN)
Double-Blind Phase: PlaceboChange From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 6-3.0 monthly migraine days
Double-Blind Phase: BOTOX 155 UChange From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 6-3.1 monthly migraine days
Double-Blind Phase: BOTOX 195 UChange From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 6-3.0 monthly migraine days
Comparison: BOTOX 195 U vs Placebop-value: =0.91495% CI: [-0.62, 0.69]Mixed Model for Repeated Measures (MMRM)
Comparison: BOTOX 155 U vs Placebop-value: =0.74595% CI: [-0.76, 0.55]Mixed Model for Repeated Measures (MMRM)
Primary

Number of Participants With Treatment-Emergent Adverse Events (AEs)

An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study drug. A serious adverse event (SAE) is an event that results in death, is life-threatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event that, based on medical judgment, may jeopardize the participant and may require medical or surgical intervention to prevent any of the outcomes listed above. Treatment-emergent adverse events/treatment-emergent serious adverse events (TEAEs/TESAEs) are defined as any event that began or worsened in severity on or after the first dose of study drug.

Time frame: Double-Blind Phase (Week 0-24); Open-Label Phase (Week 24-48)

Population: Safety Analysis Set: all participants who received any amount of study treatment; included in the analysis according to the study treatment that they actually received (as treated).

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Double-Blind Phase: PlaceboNumber of Participants With Treatment-Emergent Adverse Events (AEs)Any TEAE106 Participants
Double-Blind Phase: PlaceboNumber of Participants With Treatment-Emergent Adverse Events (AEs)TESAE6 Participants
Double-Blind Phase: BOTOX 155 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)Any TEAE117 Participants
Double-Blind Phase: BOTOX 155 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)TESAE3 Participants
Double-Blind Phase: BOTOX 195 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)Any TEAE120 Participants
Double-Blind Phase: BOTOX 195 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)TESAE6 Participants
Double-Blind Phase: Placebo/Open-Label Phase: BOTOX 195 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)Any TEAE76 Participants
Double-Blind Phase: Placebo/Open-Label Phase: BOTOX 195 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)TESAE2 Participants
Double-Blind Phase: BOTOX 155 U/Open-Label Phase: BOTOX 195 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)Any TEAE75 Participants
Double-Blind Phase: BOTOX 155 U/Open-Label Phase: BOTOX 195 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)TESAE1 Participants
Double-Blind Phase: BOTOX 195 U/Open-Label Phase: BOTOX 195 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)Any TEAE80 Participants
Double-Blind Phase: BOTOX 195 U/Open-Label Phase: BOTOX 195 UNumber of Participants With Treatment-Emergent Adverse Events (AEs)TESAE1 Participants
Secondary

Change From Baseline in Migraine-Specific Quality of Life Questionnaire Version 2.1 (MSQ v2.1) Role Function - Restrictive (RFR) Domain Score At Month 6

The MSQ v2.1 is a 14-item questionnaire designed to measure health-related quality of life impairments attributed to migraine over the past 4 weeks. It is divided into 3 domains, and the Role Function Restrictive (RFR) assesses how migraines limit one's daily social and work-related activities using a 6-point scale ranging from none of the time to all of the time. Raw dimension scores are computed as a sum of item responses and rescaled to a 0 to 100 scale, where higher scores indicate better quality of life. Positive changes from Baseline indicate improvement.

Time frame: Baseline, Month 6

Population: Intent-to-Treat Population (as Randomized); data used are observed data (without imputation for missing values)

ArmMeasureValue (LEAST_SQUARES_MEAN)
Double-Blind Phase: PlaceboChange From Baseline in Migraine-Specific Quality of Life Questionnaire Version 2.1 (MSQ v2.1) Role Function - Restrictive (RFR) Domain Score At Month 618.6 units on a scale
Double-Blind Phase: BOTOX 155 UChange From Baseline in Migraine-Specific Quality of Life Questionnaire Version 2.1 (MSQ v2.1) Role Function - Restrictive (RFR) Domain Score At Month 619.4 units on a scale
Double-Blind Phase: BOTOX 195 UChange From Baseline in Migraine-Specific Quality of Life Questionnaire Version 2.1 (MSQ v2.1) Role Function - Restrictive (RFR) Domain Score At Month 619.0 units on a scale
Comparison: BOTOX 195 U vs Placebop-value: =0.83795% CI: [-3.18, 3.93]Mixed Model for Repeated Measures (MMRM)
Comparison: BOTOX 155 U vs Placebop-value: =0.66295% CI: [-2.74, 4.31]Mixed Model for Repeated Measures (MMRM)
Secondary

Change From Baseline in the Activity Impairment in Migraine - Diary (AIM-D) Physical Impairment Domain Score Across Months 5 and 6

AIM-D Physical Impairment Domain score is calculated based on the summation of AIM-D items 6-9. Participants answer each question based on the level of difficulty experienced in the 24 hours prior, with during your headache indicated for when they reported a headache, using a 6-point rating scale ranging from not difficult at all to extremely difficult. The raw daily score is transformed to a 0-100 scale, and the monthly score is calculated using the average daily scores, where a higher score indicates worse physical impairment. AIM-D Physical Impairment domain score across Months 5 and 6 is calculated by taking the 2-month average of AIM-D Physical Impairment domain scores over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. Negative changes from Baseline indicate improvement.

Time frame: Baseline, Months 5-6

Population: Intent-to-Treat Population (as Randomized); data used are observed data (without imputation for missing values)

ArmMeasureValue (LEAST_SQUARES_MEAN)
Double-Blind Phase: PlaceboChange From Baseline in the Activity Impairment in Migraine - Diary (AIM-D) Physical Impairment Domain Score Across Months 5 and 6-5.0 units on a scale
Double-Blind Phase: BOTOX 155 UChange From Baseline in the Activity Impairment in Migraine - Diary (AIM-D) Physical Impairment Domain Score Across Months 5 and 6-4.6 units on a scale
Double-Blind Phase: BOTOX 195 UChange From Baseline in the Activity Impairment in Migraine - Diary (AIM-D) Physical Impairment Domain Score Across Months 5 and 6-4.9 units on a scale
Comparison: BOTOX 195 U vs Placebop-value: =0.83495% CI: [-1.32, 1.63]Mixed Model for Repeated Measures (MMRM)
Comparison: BOTOX 155 U vs Placebop-value: =0.57895% CI: [-1.06, 1.9]Mixed Model for Repeated Measures (MMRM)
Secondary

Change From Baseline in the Frequency of Monthly Acute Headache Medication Days Across Months 5 and 6

Monthly acute headache medication days across Months 5 and 6 is calculated by taking the 2-month average of monthly acute headache medication days over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. Negative changes from Baseline indicate improvement.

Time frame: Baseline, Months 5-6

Population: Intent-to-Treat Population (as Randomized); data used are observed data (without imputation for missing values)

ArmMeasureValue (LEAST_SQUARES_MEAN)
Double-Blind Phase: PlaceboChange From Baseline in the Frequency of Monthly Acute Headache Medication Days Across Months 5 and 6-2.0 Monthly Acute Headache Medication Days
Double-Blind Phase: BOTOX 155 UChange From Baseline in the Frequency of Monthly Acute Headache Medication Days Across Months 5 and 6-1.9 Monthly Acute Headache Medication Days
Double-Blind Phase: BOTOX 195 UChange From Baseline in the Frequency of Monthly Acute Headache Medication Days Across Months 5 and 6-1.8 Monthly Acute Headache Medication Days
Comparison: BOTOX 195 U vs Placebop-value: =0.68695% CI: [-0.48, 0.74]Mixed Model for Repeated Measures (MMRM)
Comparison: BOTOX 155 U vs Placebop-value: =0.91395% CI: [-0.57, 0.64]Mixed Model for Repeated Measures (MMRM)
Secondary

Change From Baseline in the Frequency of Monthly Headache Days Across Months 5 and 6

The frequency of monthly headache days across Months 5 and 6 is calculated by taking the 2-month average of monthly headache days over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. Negative changes from Baseline indicate improvement.

Time frame: Baseline, Months 5-6

Population: Intent-to-Treat Population (as Randomized); data used are observed data (without imputation for missing values)

ArmMeasureValue (LEAST_SQUARES_MEAN)
Double-Blind Phase: PlaceboChange From Baseline in the Frequency of Monthly Headache Days Across Months 5 and 6-3.2 monthly headache days
Double-Blind Phase: BOTOX 155 UChange From Baseline in the Frequency of Monthly Headache Days Across Months 5 and 6-3.1 monthly headache days
Double-Blind Phase: BOTOX 195 UChange From Baseline in the Frequency of Monthly Headache Days Across Months 5 and 6-2.9 monthly headache days
Comparison: BOTOX 195 U vs Placebop-value: =0.41495% CI: [-0.42, 1.01]Mixed Model for Repeated Measures (MMRM)
Comparison: BOTOX 155 U vs Placebop-value: =0.88995% CI: [-0.66, 0.76]Mixed Model for Repeated Measures (MMRM)
Secondary

Change From Baseline in the Total 6-item Headache Impact Test (HIT-6) Score Across Months 5 and 6

The HIT-6 is a 6-item assessment used to measure the impact headaches have on a participant's ability to function on the job, at school, at home and in social situations. It assesses the effect that headaches have on normal daily life and the subject's ability to function. Responses are based on frequency using a 5-point scale ranging from never to always. The HIT-6 total score, which ranges from 36 to 78, is the sum of the responses, each of which is assigned a score ranging from 6 points (never) to 13 points (always). The Total 6-item Headache Impact Test (HIT-6) score across Months 5 and 6 is calculated by taking the 2-month average of total 6-item Headache Impact Test (HIT-6) scores over Months 5 and 6. Negative changes from Baseline in the HIT-6 score indicate improvement.

Time frame: Baseline, Months 5-6

Population: Intent-to-Treat Population (as Randomized); data used are observed data (without imputation for missing values)

ArmMeasureValue (LEAST_SQUARES_MEAN)
Double-Blind Phase: PlaceboChange From Baseline in the Total 6-item Headache Impact Test (HIT-6) Score Across Months 5 and 6-6.2 units on a scale
Double-Blind Phase: BOTOX 155 UChange From Baseline in the Total 6-item Headache Impact Test (HIT-6) Score Across Months 5 and 6-6.9 units on a scale
Double-Blind Phase: BOTOX 195 UChange From Baseline in the Total 6-item Headache Impact Test (HIT-6) Score Across Months 5 and 6-6.5 units on a scale
Comparison: BOTOX 195 U vs Placebop-value: =0.58995% CI: [-1.69, 0.96]Mixed Model for Repeated Measures (MMRM)
Comparison: BOTOX 155 U vs Placebop-value: =0.3195% CI: [-2, 0.64]Mixed Model for Repeated Measures (MMRM)
Secondary

Percentage of Participants With ≥ 50% Reduction From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 6

The frequency of monthly migraine days across Months 5 and 6 is calculated by taking the 2-month average of monthly migraine days over Months 5 and 6. Month 5 and Month 6 are the 28-day daily diary periods ending with Days 56 and Days 84 after the second study treatment intervention day with BOTOX or placebo injections, respectively. The responder status of 50% reduction from Baseline is defined as a participant with at least a 50% reduction from Baseline in the 2-month average of monthly migraine days over Months 5 and 6.

Time frame: Baseline, Months 5-6

Population: Intent-to-Treat Population (as Randomized); data used are observed data (without imputation for missing values)

ArmMeasureValue (NUMBER)
Double-Blind Phase: PlaceboPercentage of Participants With ≥ 50% Reduction From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 644.9 percentage of participants
Double-Blind Phase: BOTOX 155 UPercentage of Participants With ≥ 50% Reduction From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 646.2 percentage of participants
Double-Blind Phase: BOTOX 195 UPercentage of Participants With ≥ 50% Reduction From Baseline in the Frequency of Monthly Migraine Days Across Months 5 and 647.1 percentage of participants
Comparison: BOTOX 195 U vs Placebop-value: =0.45195% CI: [-7.08, 11.46]Regression, Logistic
Comparison: BOTOX 155 U vs Placebop-value: =0.76295% CI: [-7.94, 10.4]Regression, Logistic

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026