AzTrials
AzTrials

MigrainePhase 3CHAMPNCT01581281

The Childhood and Adolescent Migraine Prevention Study

A Phase 3 study testing Amitriptyline and Topiramate in people with Migraine and Migraine Disorders, run by Children's Hospital Medical Center, Cincinnati at 35 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
Search all trials

Trial summary

The purpose of this research study is to test two medicines for migraine prevention in children and adolescents. Read more about this study

Who is it for?
Ages 8 to 17 years
Conditions the study is for
Migraine, Migraine Disorders, Headache
What is being tested?
Amitriptyline and Topiramate
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
488 participants
Where
35 sitesUnited States
Study dates
Jun 2012to Jan 2016
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 8 to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Migraine with or without aura (International Classification of Headache Disorders, 2nd Edition (ICHD-II) or chronic migraine (ICHD-II revised)
  • Migraine frequency based upon prospective headache diary of 28 days must be ≥ 4. Migraine frequency defined as any migraine during one day in the 28 day baseline period (1)
  • PedMIDAS Disability Score > 10, indicating at least mild disruption in daily activities and < 140, indicating extreme disability that may require more comprehensive, multi-component therapy
  • Females or males 8-17 years, inclusive
  • Migraine frequency is defined as the period from the onset to the stop time of painful migraine symptoms not to exceed 24 hours with the clock starting at midnight. If painful symptoms last longer than 24 hours, this is considered a new and distinct migraine headache. If painful symptoms recur within 24 hours of initial onset, this is considered part of the initial migraine episode and would be counted as one migraine.

Who cannot join

  • Continuous migraine defined as an unrelenting headache for a 28 day period
  • Weight less than 30 kg or greater than 120 kg
  • Unwilling to avoid taking non-specific acute medication such as NSAIDS (e.g., ibuprofen), more than 3 times per week, or migraine specific acute medications such as triptans more than 6 times per month
  • Currently taking other prophylactic anti-migraine medication within a period equivalent to 2 weeks of that medication before entering the screening phase, or the use of Botulinum toxin (Botox®) within 3 months of entering the screening phase
  • Subjects who have previously failed an adequate trial of AMI or TPM for prophylaxis of at least 3 months duration at doses recommended for migraine relief because of lack of efficacy or adverse events(2)
  • Current use of disallowed medications/products: opioids, antipsychotics, antimanics, barbiturates, benzodiazepines, muscle relaxants, sedatives, tramadol, nutraceuticals, SSRIs, or SSNRIs
Show all 17Show fewer
  • Known history of allergic reaction or anaphylaxis to AMI or TPM
  • Abnormal findings on ECG at baseline, particularly lengthening of the QT interval greater than or equal to 450 msec
  • Subject is pregnant or has a positive pregnancy test
  • Subject is sexually active and not using a medically acceptable form of contraception
  • Diagnosis of epilepsy or other neurological diseases
  • History of kidney stones
  • Inability to swallow pills after using behavioral techniques if indicated between screening visit and baseline visit (3)
  • Present psychiatric disease as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV) (e.g. psychosis, bipolar disorder, major depression, generalized anxiety disorder), alcohol or drug dependence, or documented developmental delays or impairments (e.g., autism, cerebral palsy, or mental retardation) that, in the opinion of the site investigator, would interfere with adherence to study requirements or safe participation in the trial
  • Any and all other diagnoses or conditions which in the opinion of the site investigator, that would prevent the patient from being a suitable candidate for the study or interfere with the medical care needs of the study subject
  • (2)"Previously failed an adequate trial of AMI or TPM" is defined as: dosage of 1mg/kg/day of AMI or 2 mg/kg/day of TPM; trial of at least 3 months duration; efficacy of having at least a 50% decrease in migraine frequency in response to drug therapy; or unable to tolerate taking the medication due to treatment-related side effects.
  • (3)Subjects who cannot swallow pills at the time of the screening visit will be given a training session using behavioral techniques. Upon return for baseline visit, if the subject continues to be unable to swallow pills, the subject will be excluded from the study.

Trial locations and contacts

35 sites in 1 country.

35 sites in 1 country

United States35 sites
  • Akron Children's Hospital

    Akron, Ohio, 44308

  • Dent Neurological Institute

    Amherst, New York, 14226

  • Atlanta Headache Specialists

    Atlanta, Georgia, 30342

  • Children's Hospital Colorado

    Aurora, Colorado, 80045

  • University of Maryland School of Medicine

    Baltimore, Maryland, 21201

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • The Children's Hospital, Cleveland Clinic

    Cleveland, Ohio, 44195

  • Colorado Springs Neurological Associates

    Colorado Springs, Colorado, 80907

  • Nationwide Children's Hospital

    Columbus, Ohio, 43205

  • Dallas Pediatric Neurology Associates

    Dallas, Texas, 75230

  • Josephson Wallack Munshower Neurology Research

    Indianapolis, Indiana, 46237

  • Children's Mercy Hospital

    Kansas City, Kansas, 66160

  • University of Louisville Health Sciences Center

    Louisville, Kentucky, 40292

  • Marshfield Clinic

    Marshfield, Wisconsin, 54449

  • LeBonheur Children's Hospital

    Memphis, Tennessee, 38105

  • Winthrop University Hospital

    Mineola, New York, 11501

  • The Headache Institute at Roosevelt Hospital

    New York, New York, 10019

  • Eastern Virginia Medical School

    Norfolk, Virginia, 23510

  • Oklahoma Health Sciences

    Oklahoma City, Oklahoma, 73104

  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

  • Phoenix Children's Medical Group

    Phoenix, Arizona, 85016

  • Preferred Clinical Research

    Pittsburgh, Pennsylvania, 15236

  • University of Nevada

    Reno, Nevada, 89502

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • Primary Children's Medical Center

    Salt Lake City, Utah, 84108

  • University of California-San Francisco Headache Center

    San Francisco, California, 94115

  • Schenectady Neurological Constultants, PC

    Schenectady, New York, 12308

  • Seattle Children's Hospital

    Seattle, Washington, 98105

  • Saint Louis University

    St Louis, Missouri, 63104

  • Stanford Hospital and Clinics

    Stanford, California, 94305

  • Scott and White Healthcare

    Temple, Texas, 76508

  • Children's Hospital of Boston

    Waltham, Massachusetts, 02453

  • Children's National Medical Center

    Washington D.C., District of Columbia, 20010

  • Premiere Research Institute

    West Palm Beach, Florida, 33407

  • New England Regional Headache Center

    Worcester, Massachusetts, 01605

Other trials in United States

About this study

Official title: Amitriptyline and Topiramate in the Prevention of Childhood Migraine

The purpose of this research study is to test two medicines for migraine prevention in children and adolescents.

Read the detailed description

The purpose of this research study is to test two medicines for migraine prevention in children and adolescents. The investigators want to see if amitriptyline and/or topiramate are better than placebo (sugar pill) in reducing headache frequency in children and adolescents ages 8 to 17 with migraines. At this time, there are no FDA approved medicines approved in the US for the prevention treatment of migraine headaches in children and adolescents.

Being tested
Amitriptyline, Topiramate, Placebo
Keywords
Pediatric, Children, Adolescent, Headache, Migraine
Medical subject headings
Migraine Disorders, Headache

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AmitriptylineDrug

    Amitriptyline will be administered twice daily at home during the 8-week titration period followed by a 16 week maintenance phase of the highest tolerated dose. The morning dose is a placebo pill. Dosing of amitriptyline will be weight-based.

  • TopiramateDrug

    Topiramate will be administered twice daily at home during the 8-week titration period followed by a 16 week maintenance phase of the highest tolerated dose. Dosing of topiramate will be weight-based.

  • PlaceboDrug

    Placebo will be administered twice daily at home during the 8-week titration period followed by a 16 week maintenance period.

Study groups in NCT01581281
Study groupRoleWhat they receive
AmitriptylineActive comparatorDrug to be administered twice daily.
Receives: Drug: Amitriptyline
TopiramateActive comparatorDrug to be administered twice daily.
Receives: Drug: Topiramate
PlaceboPlacebo comparatorTo be administered twice daily.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number (Percentage) of Participants Reporting a ≥ 50% Reduction in Headache Days

    The primary endpoint was a ≥ 50% reduction in headache frequency from the 28 days (4 weeks) baseline period prior to randomization to the last 28 days (4 weeks) of the trial. Headache frequency was defined as the number of days with headache for a given four week 28 day (4 week) period. A headache day was defined as any day during which any headache occurs within a 24 hour period, starting and ending at midnight.

    For each participant, the primary endpoint involved a determination of whether a 50% or greater reduction in headache frequency was observed during the last 4 weeks of active treatment as compared with the headache frequency during the 4-week baseline period. Results were compared across the three treatment groups.

    Measured: 4 week baseline period and last 4 weeks of the 24-week trial

Secondary outcomes (4)
  1. Change in Absolute Headache Disability Score on PedMIDAS

    The PedMIDAS scale which evaluated the impact of headaches in school, home, play, and social activities, is comprised of six items that pertain to days missed in various activities over the past 90 days. Questions were answered by the youth in consultation with their parents and reviewed by study staff. The PedMIDAS scale was administered at baseline (covering the three months prior to enrollment) and at the 24-week endpoint visit (the end of the maintenance period, covering three months of enrollment). A total PedMIDAS score (sum of items 1-6) was used in this trial. Scores range from 0-240; with a score of 0-10 indicating no disability, 11-30 mild disability, 31-50 moderate disability, and more than 50 severe disability in daily activities. The main outcome measure for this comparison will be the difference in the baseline and endpoint (24 week) PedMIDAS total scores for:

    1. Amitriptyline vs. Placebo
    2. Topiramate vs. Placebo
    3. Amitriptyline vs Topiramate

    Measured: baseline and 24 week endpoint

  2. Change in Number of Headache Days

    This outcomes measure examines whether the rate of absolute number of headache days, per 28 day period, differs between treatment groups over time. This was assessed longitudinally based on the actual number of headache days from the 28 days prior to randomization to the last 28 days of this 24 week trial. The change in absolute headache days was compared between:

    1. Amitriptyline vs. placebo
    2. Topiramate vs. placebo
    3. Amitriptyline vs. Topiramate

    Measured: 4 week baseline period and last 4 weeks of the 24-week trial

  3. Tolerability, as Indicated by the Number (Percentage) of Participants That Completed the 24-week Treatment Phase

    To assess tolerability, the percentage of subjects who complete the entire 24-week treatment period will be estimated in each of the three groups.

    Measured: 24 weeks

  4. Occurrence of Treatment Emergent Serious Adverse Events

    To determine if amitriptyline or topiramate differ from placebo on the occurrence of treatment emergent serious adverse events.

    Measured: 24 weeks of the trial

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Apr 2012 (estimated)
  2. Study startJun 2012
  3. Primary completionApr 2015
  4. Study completionJan 2016

Why it stopped: Interim assessment provided sufficient data to answer study questions

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
488 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01581281
Sponsor's protocol ID
CIN-001
Other IDs
1U01NS076788-01
Acronym
CHAMP
Status last verified
Jul 2017
First submitted
16 Dec 2011
Last updated
10 Aug 2017
Data monitoring committee
Yes
Individual data sharing
Yes: De-identified datasets and associated documentation will be submitted to NINDS for archiving and public access, consistent with current NINDS data sharing policy.

Publications

  • Reidy BL, Powers SW, Coffey CS, Chamberlin LA, Ecklund DJ, Klingner EA, Yankey JW, Korbee LL, Porter LL, Peugh J, Kabbouche MA, Kacperski J, Hershey AD; CHAMP Investigators. Multimodal Assessment of Medication Adherence Among Youth With Migraine: An Ancillary Study of the CHAMP Trial. J Pediatr Psychol. 2022 Apr 8;47(4):376-387. doi: 10.1093/jpepsy/jsab123.

    PubMed 34865085
  • Reidy BL, Peugh J, Hershey AD, Coffey CS, Chamberlin LA, Ecklund DJ, Klingner EA, Yankey JW, Korbee LL, Porter LL, Kabbouche MA, Kacperski J, Powers SW. Trajectory of treatment response in the child and adolescent migraine prevention (CHAMP) study: A randomized clinical trial. Cephalalgia. 2022 Jan;42(1):44-52. doi: 10.1177/03331024211033551. Epub 2021 Aug 17.

    PubMed 34404270
  • Powers SW, Coffey CS, Chamberlin LA, Ecklund DJ, Klingner EA, Yankey JW, Korbee LL, Porter LL, Hershey AD; CHAMP Investigators. Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine. N Engl J Med. 2017 Jan 12;376(2):115-124. doi: 10.1056/NEJMoa1610384. Epub 2016 Oct 27.

    PubMed 27788026
  • Hershey AD, Powers SW, Coffey CS, Eklund DD, Chamberlin LA, Korbee LL; CHAMP Study Group. Childhood and Adolescent Migraine Prevention (CHAMP) study: a double-blinded, placebo-controlled, comparative effectiveness study of amitriptyline, topiramate, and placebo in the prevention of childhood and adolescent migraine. Headache. 2013 May;53(5):799-816. doi: 10.1111/head.12105. Epub 2013 Apr 17.

    PubMed 23594025

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Amitriptyline and Topiramate in people with Migraine and Migraine Disorders, run by Children's Hospital Medical Center, Cincinnati at 35 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 10 Aug 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 35 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 Aug 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number (Percentage) of Participants Reporting a ≥ 50% Reduction in Headache Days (time frame: 4 week baseline period and last 4 weeks of the 24-week trial). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01581281, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Aug 2017.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in