Prophylactic Treatment of Episodic Cluster Headache

The purpose of this study is to determine whether candesartan cilexetil are effective prophylactic treatment of episodic Cluster...

Date First Received: September 13, 2005

Last Updated: April 18, 2007

Verified by: Norwegian University of Science and Technology, April 2007

Clinical Trial Phase: Phase 2 | Start Date: March 2005

Overall Status: Recruiting

Estimated Enrollment: 64

Brief Summary

Official Title: “Prophylactic Treatment of Episodic Cluster Headache With an Angiotensin II Receptor Blocker (Candesartan Cilexetil); a Randomized, Placebo Controlled Parallel Study”

Condition Keyword(s):

The purpose of this study is to determine whether candesartan cilexetil are effective prophylactic treatment of episodic Cluster headache

Study Type: Interventional

Study Design: Treatment, Randomized, Double-Blind, Placebo Control, Parallel Assignment, Efficacy Study

Detailed Clinical Trial Description

Cluster headache is an unilateral headache with periodic attacks, that usually lasts for 6 to 12 weeks. The pain is usually unbearable. The attacks are treated with injections of sumatriptan (migraine medication)and inhalation of oxygen.

The most common prophylactics today has limited effect and a risk of side effects.

Candesartan has in one study shown a clinically significant effect in migraine prophylaxis.

The angiotensin II receptor blocker, candesartan is well tolerated with side-effects not significantly different from placebo and with few drug interactions. We therefore wish to investigate the prophylactic effect in treatment of cluster in headache patients.

This will be a multicenter, double-blind, randomized, parallel study where the prophylactic effect of candesartan is compared to placebo in a period of 3 weeks. First week 16 mg and the following 2 weeks 32 mg.

Outcome Measures for this Clinical Trial

Primary:

  • frequency of attacks per week

Secondary:

  • level of disability
  • duration of attacks
  • hours with cluster headache
  • days with cluster headache
  • hours with headache
  • days with headache
  • occurrence of autonomic symptoms
  • number of attacks treated with sumatriptan or oxygen
  • doses of sumatriptan
  • acceptability of treatment
  • comparison between the last two weeks on medication and yhe week with headache diary only
  • days with sick leave
  • headache severity index
  • doses of analgesics
  • candesartan-responders
  • placebo-responders

Criteria for Participation in this Clinical Trial

Inclusion Criteria:

  • The episodic cluster headache must be diagnosed according to the IHS classification.
  • Had at least one episode with cluster headache before inclusion. Previously had at least one cluster headache episode lasting one month or more. At the time of inclusion, the cluster headache period shall not have lasted more than 3 weeks

Exclusion Criteria:

  • Pregnancy, nursing, decreased hepatic og renal function, psychiatric illness, cardiac problems, hypersensitivity to candesartan, previous serious allergic reaction to medication, chronic cluster headache, drug/alcohol abuse, use of antipsychotic,antidepressants, lithium or other prophylactic treatment less than one month prior to inclusion, systolic blood pressure below 110 mmHg, use of other hypertensive medication, use og other specific attack medication than sumatriptan injection or oxygen 7-10l/min and inability to change medication, use of other triptans than sumatriptan during the study

Clinical Trials Locations, Contact Details, and Sponsors

Lead Sponsor: Norwegian University of Science and Technology

Norwegian National Headache Centre St.Olavs Hospital

Trondheim  7006 Norway

Overall Clinical Trial Officials and Contacts

Lars J Stovner, PhD Principal Investigator Norwegian National Headache Center St.Olavs Hospital  

Overall Contact: Erling A Tronvik, MD +47 73 86 84 20 erling.tronvik@ntnu.no

Related Publications

References

Tronvik E, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with an angiotensin II receptor blocker: a randomized controlled trial. JAMA. 2003 Jan 1;289(1):65-9.

Stoukides CA, McVoy HJ, Kaul AF. Candesartan cilexetil: an angiotensin II receptor blocker. Ann Pharmacother. 1999 Dec;33(12):1287-98. Review.

El Amrani M, Massiou H, Bousser MG. A negative trial of sodium valproate in cluster headache: methodological issues. Cephalalgia. 2002 Apr;22(3):205-8.

Yusuf S, Pfeffer MA, Swedberg K, Granger CB, Held P, McMurray JJ, Michelson EL, Olofsson B, Ostergren J; CHARM Investigators and Committees. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003 Sep 6;362(9386):777-81.

Chaturvedi N, Sjoelie AK, Svensson A; DIRECT Programme Study Group. The DIabetic Retinopathy Candesartan Trials (DIRECT) Programme, rationale and study design. J Renin Angiotensin Aldosterone Syst. 2002 Dec;3(4):255-61.

Olesen J, Goadsby PJ, Cluster Headache and Related Conditions.Oxford University Press 1999

Lipton RB, Micieli G, Russell D, Solomon S, Tfelt-Hansen P, Waldenlind E. Guidelines for controlled trials of drugs in cluster headache. Cephalalgia. 1995 Dec;15(6):452-62. No abstract available.

Altman DG, Practical statistics for medical research. Chapman & Hall (1988)

Additional Information

Information obtained from ClinicalTrials.gov on July 23, 2008

Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00184587

Study ID Number: D2452L0004

ClinicalTrials.gov Identifier: NCT00184587

Health Authority: Norway: Norwegian Social Science Data Services

Clinical Trials Authorship and Review

Clinical Trials content is provided directly by the U.S. National Institutes of Health via ClinicalTrials.gov and is not reviewed separately by ClinicalTrialsFeeds.org. Every page of specific clinical trials information contains a unique identifier which can be used to find further details directly from the National Institutes of Health.