AzTrials
AzTrials

MigraineNCT06085144

Emgality for Migraine in Breastmilk

An observational study of Migraine, run by University of California, San Francisco at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this project is to evaluate galcanezumab transfer into maternal breastmilk, and to evaluate infant (growth, development, constipation, colic, infections) and maternal (headache) outcomes for dyads in which the mother was treated with galcanezumab and to compare outcomes for infants who were or were not… Read more about this study

Who is it for?
Ages 18 to 45 years, women only
Conditions the study is for
Migraine
What is being tested?
Galcanezumab
Type of treatment
Injection or infusion
How many people
30 participants
Where
1 siteUnited States
Study dates
26 Feb 2024to Apr 2028
How long will I take part?
1 Year
Phase
Observational
Are there results?
Not yet: the study is under way

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 18 to 45 years
  • Women only
  • No healthy volunteers
  • Adult

Study population: Mothers must carry a diagnosis of migraine, be aged 18-45 years, and be between 14 days and 9 months postpartum, and still nursing, at the time of enrollment.

Who may be able to join

  • Female
  • Childbearing age (18-45)
  • Established diagnosis of migraine
  • Status post uncomplicated delivery (no long-term maternal complications)
  • No prolonged (>3 night) NICU stay for infant
  • Between 14 days and 9 months postpartum, and still nursing, at the time of enrollment
  • Planning to receive galcanezumab postpartum
  • Suitable candidate to receive galcanezumab postpartum, at discretion of prescribing clinician

Who cannot join

  • Contraindications to breastfeeding, such as prior surgery or infant contraindications
  • Contraindications to galcanezumab or insurance coverage
  • Use of gepants
  • Moderately Severe or Severe Depression as established by the PHQ9 screen (i.e. score 15 or above)
  • Pregnant or planning pregnancy in the coming 6M
  • Patients with severe mastitis will not be enrolled; should mastitis occur during the study, this will be included as a covariate and results analyzed accordingly
  • Patients of infants with severe medical issues identified in the health record (developmental issues, delivery issues, concomitant medications)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Ayushi D Balan, BA, BS contact

415-514-8330

ayushi.balan@ucsf.edu

Stephanie Hsu, BA contact

415-502-7209

stephanie.hsu@ucsf.edu

United States1 site, 1 recruiting
  • University of California, San Francisco

    San Francisco, California, 94158

    Ayushi D Balan, BA, BS, 415-514-8330, ayushi.balan@ucsf.edu

    Stephanie Hsu, BA, 415-502-7209, stephanie.hsu@ucsf.edu

    Recruiting

Other trials in United States

About this study

Official title: Prospective Evaluation of Emgality (Galcanezumab) in Breastmilk in Adult Women With Migraine

The goal of this project is to evaluate galcanezumab transfer into maternal breastmilk, and to evaluate infant (growth, development, constipation, colic, infections) and maternal (headache) outcomes for dyads in which the mother was treated with galcanezumab and to compare outcomes for infants who were or were not breastfed after maternal treatment.

In this prospective observational study, the study team proposes to prospectively collect serial milk samples from 30 adult women who are treated with galcanezumab for migraine. Mothers who are interested in participating will be connected with us, the main clinical site, by neurologists across the USA. Mothers must carry a diagnosis of migraine, be aged 18-45 years, and be between 14 days and 9 months postpartum, and still nursing, at the time of enrollment.

This study will fill a significant unmet need as women of childbearing potential are over-represented in the migraine population, and yet they are excluded from clinical trials of migraine treatments during pregnancy and lactation.

Read the detailed description

Galcanezumab will be prescribed clinically by the treating clinician, i.e., no drug will be provided by the study. This treatment may be prescribed in several clinical scenarios:

  • Patient with established migraine history, treated with galcanezumab prior to pregnancy, who plans to resume the medication post partum
  • Patient with established migraine history, who experiences migraines postpartum and who has previously been "failed by", or intolerant to, other first-line prophylactic medications
  • Patient with established migraine history, who warrants said treatment trial otherwise, at the discretion of the prescribing clinician

Interested participants will be contacted by our UCSF coordinator, sign an informed consent form, and receive instructions for milk collection. A pamphlet on effective birth control will be provided to all enrollees (https://owh-wh-d9-dev.s3.amazonaws.com/s3fs-public/documents/fact-sheet-birth-control-methods.pdf), as well as OCT-available at-home pregnancy tests.

Mothers will complete questionnaires relating to their infants, at 6M and 12M postpartum (Ages and Stages, colic, etc.) and will sign a release form for us to obtain and review infant health records up to 12 months post-delivery to calculate: growth, infections, incidence of constipation or infant colic.

Milk collection:

Participants will pump and provide up to 8 samples (15mL volume each), at specific timepoints over up to 2 treatment cycles (before treatment 1; 24hours, 7d, 28d post treatment 1; 24hours, 7d, 28d post treatment 2 and 7d post treatment 3). Samples will be shipped in an insulated container with gel packs to maintain temperature via FedEx priority overnight shipping to our Laboratory at UCSF and stored in a -80 °C degrees freezer.

Sample assays:

Samples will be batch analyzed using enzyme immunoassay at (1) interim report after 15 sets received and (2) final report after all 30 sets received. The study team has worked with MarinBio who are experts in measuring biologics.

Conditions
Migraine
Being tested
Galcanezumab
Keywords
Emgality, Galcanezumab, Migraine, Breastmilk, Milk, Breastfeeding, Pregnancy, Postpartum, Monoclonal Antibodies
Medical subject headings
Migraine Disorders, Breast Feeding

What participants receive

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

  • GalcanezumabDrug

    Also called Emgality

    Receiving either 120mg or 300mg injections.

Study groups in NCT06085144
Study groupRoleWhat they receive
GalcanezumabPostpartum women both nursing and receiving treatment for migraine with galcanezumab.
Receives: Drug: Galcanezumab

What is being measured

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

  1. Determine emgality concentration in mature breastmilk

    Levels of galcanezumab (μg/mL) in the breastmilk of women at the selected timepoints before and after each treatment (24H pre, 24H post, 7D post, 28D post). For the third treatment, only 7D post will be collected. This outcome will be measured by breastmilk concentration (μg/mL).

    Measured: 12 months

  2. Determine average emgality concentration in mature breastmilk

    Levels of galcanezumab (μg/mL) in the breastmilk of women at the selected timepoints before and after each treatment (24H pre, 24H post, 7D post, 28D post). For the third treatment, only 7D post will be collected. This outcome will be measured by average breastmilk concentration (CAVE, determined using pharmacokinetic methods).

    Measured: 12 months

  3. Determine maximum emgality concentration in mature breastmilk

    Levels of galcanezumab (μg/mL) in the breastmilk of women at the selected timepoints before and after each treatment (24H pre, 24H post, 7D post, 28D post). For the third treatment, only 7D post will be collected. This outcome will be measured by maximum concentration of galcanezumab in breastmilk (CMAX).

    Measured: 12 months

  4. Determine average emgality dose to infants through mature breastmilk in a 24-hour period

    Levels of galcanezumab (μg/mL) in the breastmilk of women at the selected timepoints before and after each treatment (24H pre, 24H post, 7D post, 28D post). For the third treatment, only 7D post will be collected. This outcome will be measured by absolute average galcanezumab dose to the infant in a 24-hour period.

    Measured: 12 months

  5. Determine maximum emgality dose to infants through mature breastmilk in a 24-hour period

    Levels of galcanezumab (μg/mL) in the breastmilk of women at the selected timepoints before and after each treatment (24H pre, 24H post, 7D post, 28D post). For the third treatment, only 7D post will be collected. This outcome will be measured by maximum galcanezumab dose to the infant in a 24-hour period.

    Measured: 12 months

  6. Determine average relative infant dose of emgality in mature breastmilk

    Levels of galcanezumab (μg/mL) in the breastmilk of women at the selected timepoints before and after each treatment (24H pre, 24H post, 7D post, 28D post). For the third treatment, only 7D post will be collected. This outcome will be measured by average relative infant dose (RIDAVE).

    The investigators hypothesize that given that galcanezumab is an IgG mAb, it will similarly show very low concentrations, and acceptable relative infant dose (RID) (<1%).

    Measured: 12 months

  7. Determine maximum relative infant dose of emgality in mature breastmilk

    Levels of galcanezumab (μg/mL) in the breastmilk of women at the selected timepoints before and after each treatment (24H pre, 24H post, 7D post, 28D post). For the third treatment, only 7D post will be collected. This outcome will be measured by maximum relative infant dose (RIDMAX).

    The investigators hypothesize that given that galcanezumab is an IgG mAb, it will similarly show very low concentrations, and acceptable relative infant dose (RID) (<1%).

    Measured: 12 months

Secondary outcomes (11)
  1. Obtain information on newborn developmental milestones at 6 months of life

    The Ages and Stages Questionnaire, third edition, (ASQ-3) will be completed by participating mothers at the following timepoints postpartum, to determine the developmental age of infants at 6 months. The questionnaire scores 5 areas of development: Communication, Gross Motor, Fine Motor, Problem Solving and Personal-Social. Cumulative scores range from 0 to 60. Higher scores indicate more positive outcomes. Each version of the ASQ-3 has different cutoff scores that indicate whether the child's development appears to be on schedule, requires monitoring or requires further assessment. (Above and Monitoring Ranges indicate on schedule infant development for age).

    Measured: 6 months

  2. Obtain information on newborn developmental milestones at 12 months of life

    The Ages and Stages Questionnaire, third edition, (ASQ-3) will be completed by participating mothers at the following timepoints postpartum, to determine the developmental age of infants at 12 months. The questionnaire scores 5 areas of development: Communication, Gross Motor, Fine Motor, Problem Solving and Personal-Social. Cumulative scores range from 0 to 60. Higher scores indicate more positive outcomes. Each version of the ASQ-3 has different cutoff scores that indicate whether the child's development appears to be on schedule, requires monitoring or requires further assessment. (Above and Monitoring Ranges indicate on schedule infant development for age).

    Measured: 12 months

  3. Obtain information on newborn adjusted length until 12 months of life

    Newborn adjusted length (in cm) will be collected by manual review of infant medical records at all visits occurring in the first 12 months of life.

    Measured: 12 months

  4. Obtain information on newborn weight until 12 months of life

    Newborn weight (in kg) will be collected by manual review of infant medical records at all visits occurring in the first 12 months of life.

    Measured: 12 months

  5. Obtain information on newborn head circumference until 12 months of life

    Newborn head circumference (in cm) will be collected by manual review of infant medical records at all visits occurring in the first 12 months of life.

    Measured: 12 months

  6. Obtain information on the number of newborn infections until 12 months of life

    The number of and nature of each newborn infections will be collected by manual review of infant medical records at all visits occurring in the first 12 months of life.

    Measured: 12 months

  7. Obtain information on number of instances of newborn constipation including medications or interventions until 12 months of life

    The number of instances of newborn constipation along with any relevant evidence will be collected by manual review of infant medical records at all visits occurring in the first 12 months of life.

    Measured: 12 months

  8. Determine time to peak levels of galcanezumab in breastmilk

    Levels of galcanezumab (μg/mL) in the breastmilk of women at the selected timepoints before and after each treatment (24H pre, 24H post, 7D post, 28D post). For the third treatment, only 7D post will be collected. The average peak level of galcanezumab concentration will be determined from this.

    Measured: 12 months

  9. Determine headache severity surrounding the participants' galcanezumab treatments

    The maternal migraine diary will be completed by participating mothers in the months surrounding their galcanezumab treatments. It tracks headache severity by asking participants to self-report their percieved headache severity on a scale of 0-10 daily.

    Measured: 12 months

  10. Determine the number of days with headaches surrounding the participants' galcanezumab treatments

    The maternal migraine diary will be completed by participating mothers in the months surrounding their galcanezumab treatments. It tracks headache dats by asking participants to self-report whether or not they experienced at least one migraine daily.

    Measured: 12 months

  11. Determine what acute migraine medications were used by participants surrounding their galcanezumab treatments

    The maternal migraine diary will be completed by participating mothers in the months surrounding their galcanezumab treatments. It tracks acute medication use by asking participants to self-report what acute medications they use to manage their migraines and when.

    Measured: 12 months

Timeline

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

  1. First posted16 Oct 2023
  2. Study start26 Feb 2024
  3. Primary completionApr 2028 (estimated)
  4. Study completionApr 2028 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
30 participants (estimated)
Target duration
1 Year
IDs, dates and publications
ClinicalTrials.gov ID
NCT06085144
Sponsor's protocol ID
Emgality in breast milk
Status last verified
Aug 2026
First submitted
4 Oct 2023
Last updated
11 Aug 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • LaHue SC, Gelfand AA, Bove RM. Navigating monoclonal antibody use in breastfeeding women: Do no harm or do little good? Neurology. 2019 Oct 8;93(15):668-672. doi: 10.1212/WNL.0000000000008213. Epub 2019 Sep 6.

    PubMed 31492717
  • Krysko KM, LaHue SC, Anderson A, Rutatangwa A, Rowles W, Schubert RD, Marcus J, Riley CS, Bevan C, Hale TW, Bove R. Minimal breast milk transfer of rituximab, a monoclonal antibody used in neurological conditions. Neurol Neuroimmunol Neuroinflamm. 2019 Nov 12;7(1):e637. doi: 10.1212/NXI.0000000000000637. Print 2020 Jan.

    PubMed 31719115
  • Proschmann U, Haase R, Inojosa H, Akgun K, Ziemssen T. Drug and Neurofilament Levels in Serum and Breastmilk of Women With Multiple Sclerosis Exposed to Natalizumab During Pregnancy and Lactation. Front Immunol. 2021 Aug 26;12:715195. doi: 10.3389/fimmu.2021.715195. eCollection 2021.

    PubMed 34512637

Questions about this trial

What is this clinical trial studying?

An observational study of Migraine, run by University of California, San Francisco at 1 site 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 8 inclusion and 7 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: looking for participants now, as of the sponsor's last update on 11 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Ayushi D Balan, BA, BS (415-514-8330, ayushi.balan@ucsf.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Determine emgality concentration in mature breastmilk (time frame: 12 months). The study lists 7 primary outcomes in all. 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 NCT06085144, which also lists 3 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 11 Aug 2026.

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