Trial Outcomes & Findings for Dexamethasone for Migraine - Dose Comparison (NCT NCT04112823)

NCT ID: NCT04112823

Last Updated: 2024-03-20

Results Overview

The number of subjects achieving sustained headache relief for 48 hours and maintaining this level, without requiring additional rescue therapy for the entire 48 hour follow up period, will be determined. Headache relief will be defined as the number of subjects reporting a headache intensity of either "none" or "mild."

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

209 participants

Primary outcome timeframe

48 hours

Results posted on

2024-03-20

Participant Flow

Enrollment commenced in December 2019, was paused between March and June 2020 when all in-person clinical research halted at our institution due to COVID, and after completion of the interim analysis, enrollment was permanently halted in August 2022.

Altogether, 1823 patients were screened and 209 were randomized into the study.

Participant milestones

Participant milestones
Measure
Dexamethasone 4mg
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Overall Study
STARTED
104
105
Overall Study
COMPLETED
102
102
Overall Study
NOT COMPLETED
2
3

Reasons for withdrawal

Reasons for withdrawal
Measure
Dexamethasone 4mg
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Overall Study
Lost to Follow-up
2
3

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Dexamethasone 4mg
n=104 Participants
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=105 Participants
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Total
n=209 Participants
Total of all reporting groups
Age, Continuous
40 years
STANDARD_DEVIATION 11 • n=104 Participants
37 years
STANDARD_DEVIATION 11 • n=105 Participants
38.5 years
STANDARD_DEVIATION 11 • n=209 Participants
Sex: Female, Male
Female
96 Participants
n=104 Participants
83 Participants
n=105 Participants
179 Participants
n=209 Participants
Sex: Female, Male
Male
8 Participants
n=104 Participants
22 Participants
n=105 Participants
30 Participants
n=209 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United States
104 participants
n=104 Participants
105 participants
n=105 Participants
209 participants
n=209 Participants
Duration of Headache
48 hours
n=104 Participants
48 hours
n=105 Participants
48 hours
n=209 Participants
Aura Symptoms
No
62 Participants
n=104 Participants
64 Participants
n=105 Participants
126 Participants
n=209 Participants
Aura Symptoms
Yes
42 Participants
n=104 Participants
41 Participants
n=105 Participants
83 Participants
n=209 Participants
Treated Migraine Before Heading to the Emergency Department (ED)
No
35 Participants
n=104 Participants
42 Participants
n=105 Participants
77 Participants
n=209 Participants
Treated Migraine Before Heading to the Emergency Department (ED)
Yes
69 Participants
n=104 Participants
63 Participants
n=105 Participants
132 Participants
n=209 Participants
Headache Intensity
Moderate
27 Participants
n=104 Participants
31 Participants
n=105 Participants
58 Participants
n=209 Participants
Headache Intensity
Severe
77 Participants
n=104 Participants
74 Participants
n=105 Participants
151 Participants
n=209 Participants

PRIMARY outcome

Timeframe: 48 hours

Population: Two subjects in the Dexamethasone 4mg arm and 3 subjects in the Dexamethasone 16mg arm did not complete their 48 hour follow up. As such, 48 hour data was not collected from these subjects.

The number of subjects achieving sustained headache relief for 48 hours and maintaining this level, without requiring additional rescue therapy for the entire 48 hour follow up period, will be determined. Headache relief will be defined as the number of subjects reporting a headache intensity of either "none" or "mild."

Outcome measures

Outcome measures
Measure
Dexamethasone 4mg
n=102 Participants
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=102 Participants
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Number of Subjects With Headaches Who Have Sustained Headache Relief for 48 Hours
35 Participants
42 Participants

SECONDARY outcome

Timeframe: Two hours

The number of subjects who achieve a headache intensity level of either "none" or "mild" within two hours of medication administration, without requiring rescue medication, will be determined.

Outcome measures

Outcome measures
Measure
Dexamethasone 4mg
n=104 Participants
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=105 Participants
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Number of Subjects With Headache Who Have Relief Within Two Hours of Medication Administration
77 Participants
82 Participants

SECONDARY outcome

Timeframe: Up to 24 hours

The number of participants requiring the use of additional headache medication (rescue therapy) during their time in the ED will be determined.

Outcome measures

Outcome measures
Measure
Dexamethasone 4mg
n=104 Participants
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=105 Participants
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Additional Headache Medication in the ED
No
83 Participants
87 Participants
Additional Headache Medication in the ED
Yes
21 Participants
18 Participants

SECONDARY outcome

Timeframe: 48 hours

Population: Two subjects in the Dexamethasone 4mg arm and 3 subjects in the Dexamethasone 16mg arm did not complete their 48 hour follow up. As such, 48 hour data was not collected from these subjects.

During the 48 hour follow up patients were queried as to whether they would want the same headache treatment regimen during the onset of a subsequent headache. The number of responses were tabulated and reported.

Outcome measures

Outcome measures
Measure
Dexamethasone 4mg
n=102 Participants
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=102 Participants
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Patient Preference for Receiving the Same Medication for a Subsequent Headache
No
12 Participants
7 Participants
Patient Preference for Receiving the Same Medication for a Subsequent Headache
Yes
80 Participants
83 Participants
Patient Preference for Receiving the Same Medication for a Subsequent Headache
Not sure
10 Participants
12 Participants

SECONDARY outcome

Timeframe: One week

Population: Two subjects in the Dexamethasone 4mg arm and 3 subjects in the Dexamethasone 16mg arm were lost to follow up. Data was not collected from these subjects.

The median number of headache days during the week after ED discharge will be determined.

Outcome measures

Outcome measures
Measure
Dexamethasone 4mg
n=102 Participants
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=102 Participants
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Number of Days With Headache
2 days
Interval 1.0 to 5.0
2 days
Interval 0.0 to 4.0

SECONDARY outcome

Timeframe: Up to 24 hours

Population: Data related to additional headache medication is missing for 4 participants in each treatment arm.

The number of participants requiring the use of additional headache medication following ED discharge will be summarized.

Outcome measures

Outcome measures
Measure
Dexamethasone 4mg
n=100 Participants
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=101 Participants
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Use of Additional Headache Medication After ED Discharge
No
55 Participants
60 Participants
Use of Additional Headache Medication After ED Discharge
Yes
45 Participants
41 Participants

Adverse Events

Dexamethasone 4mg

Serious events: 2 serious events
Other events: 22 other events
Deaths: 0 deaths

Dexamethasone 16mg

Serious events: 0 serious events
Other events: 24 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Dexamethasone 4mg
n=104 participants at risk
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=105 participants at risk
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Nervous system disorders
Cerebellar Stroke
0.96%
1/104 • Number of events 1 • Up to 48 hours
0.00%
0/105 • Up to 48 hours
Metabolism and nutrition disorders
Hyperglycemia
0.96%
1/104 • Number of events 1 • Up to 48 hours
0.00%
0/105 • Up to 48 hours

Other adverse events

Other adverse events
Measure
Dexamethasone 4mg
n=104 participants at risk
Dexamethasone 4mg, administered intravenously Dexamethasone 4mg: Dexamethasone 4mg + metoclopramide 10mg, intravenously
Dexamethasone 16mg
n=105 participants at risk
Dexamethasone 16mg, administered intravenously Dexamethasone 16mg: Dexamethasone 16mg + metoclopramide 10mg, intravenously
Nervous system disorders
Somnolence
3.8%
4/104 • Up to 48 hours
8.6%
9/105 • Up to 48 hours
Nervous system disorders
Dizziness
4.8%
5/104 • Up to 48 hours
3.8%
4/105 • Up to 48 hours
Nervous system disorders
Akathisia
7.7%
8/104 • Up to 48 hours
6.7%
7/105 • Up to 48 hours
General disorders
Fatigue
2.9%
3/104 • Up to 48 hours
1.9%
2/105 • Up to 48 hours
Gastrointestinal disorders
Stomach Pain
1.9%
2/104 • Up to 48 hours
0.95%
1/105 • Up to 48 hours
Cardiac disorders
Palpitations
1.9%
2/104 • Up to 48 hours
0.95%
1/105 • Up to 48 hours

Additional Information

Dr. Benjamin Friedman

Montefiore Medical Center

Phone: 718-920-6626

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place