Chronic Migraine
Conditions
Keywords
Migraine, Atorvastatin, Randomized controlled trial
Brief summary
The main objective of this study is to see whether the favorable preventative effect of Atorvastatin 40mg per day in episodic migraine, that was found previously in three smaller randomized controlled cross-over studies, can be confirmed in a larger, multicenter, randomized controlled parallel group study. In addition it will be investigated whether 1) the favorable side effect profile, seen in previous studies, can be confirmed, and whether it is even better with the smaller dose, and 2) estimating the cost of Atorvastatin treatment, considering cost of medicine, cost of acute attack medicine, and cost of lost worktime.
Interventions
Each tablet will be taken once daily for 84 days.
DRUGPlacebo
Each tablet will be taken once daily for 84 days.
Sponsors
Haukeland University Hospital
Oslo University Hospital
University Hospital of North Norway
University Hospital, Akershus
Ullevaal University Hospital
St. Olavs Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
Triple blind (blinded to patients, study personnel, and statistician)
Intervention model description
Parallel group study with two arms, comparing Atorvastatin 40mg against placebo. Each participant will receive 84 encapsulated tablets. The participants will take one capsule orally each day, preferably at the same time of the day.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
1. Age 18 to 64 years 2. Signed informed consent 3. Chronic migraine according to ICHD-3 criteria (32) 4. At inclusion, patients should retrospectively have at least 15 headache days per month wheof at least 8 migraine days during the last 3 months. This frequency must be confirmed in the headache diary before randomisation to treatment (See below). 5. Debut of migraine at least one year prior to inclusion based on information in the patient record or by careful examination of previous headache history 6. Start of migraine before age 50 years. 7. No use of other migraine prophylactics during the study 8. For women of child-bearing potential (WOCBP, see below) there must be no pregnancy or planned pregnancy during the study period, and use of highly effective contraception (See below). After the baseline period, just before randomisation to the study drug, inclusion criteria will be evaluated once more, and the headache diary will be evaluated. If there are, according to the headache diary, fewer migraine days than 8 per month, the baseline period can be extended to 8 weeks.
Exclusion criteria
1. Medication overuse headache requiring detoxification from acute medication (triptans, opioids). Exception could be made for those fulfilling A and B: A. Have tried a withdrawal period of at least 2 months without impact on headache frequency B: Use of opioids (of any type) ≤ 8 days /months. 2. Pregnancy, planning to get pregnant, inability to use contraceptives (See inclusion criteria, point 8), and lactating 3. Clinical information on or signs of cholestasis or decreased hepatic or renal function. 4. High degree of comorbidity and/or frailty associated with reduced life expectancy or high likelihood of hospitalization, at the discretion of the investigator 5. Hypersensitivity to statins or previous use of statins 6. History of angioneurotic oedema 7. Use of medicines for migraine prophylaxis less than 4 weeks, or of botulinum toxin less than 16 weeks, prior to start of study 8. Current use of antiviral treatment agaist hepatitis C 9. Significant psychiatric illness 10. Alcohol or illicit drug dependence. 11. Inability to understand study procedures and to comply with them for the entire length of the study 12. Treatment for hypothyroidism 13. Lactose intolerance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of migraine days | 4 weeks | Change in number of migraine days/4 weeks from the baseline period to the intervention period. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of responders | 12 weeks | Number of responders (≥ 50 % improvement from baseline) |
| Rate of adverse events | 12 weeks | Number of patients with adverse events |
| Number of doses with acute medication | 12 weeks | Doses of triptans or analgesics per 4 weeks |
| Number of days with sick leave | 12 weeks | Days with sick leave per 4 weeks |
Countries
Norway
Contacts
Primary ContactLise R. Øie, Post.doc.
Backup ContactJoakim H. Østhus, Cand.med.
Outcome results
None listed