Overview

Erenumab for Idiosyncratic Facial Pain

Status:
Recruiting
Trial end date:
2023-02-01
Target enrollment:
0
Participant gender:
All
Summary
This is a phase IV randomized, double-blinded, placebo-controlled study to evaluate the efficacy of Erenumab in subjects with midfacial pain or pressure, without clinical or radiographic evidence of sinusitis.
Phase:
Phase 4
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
David Jang, M.D.
Duke University
Collaborator:
Amgen
Treatments:
Antibodies, Monoclonal
Erenumab
Criteria
Inclusion Criteria:

1. Adults 18 years of age and older presenting to Duke Head & Neck Surgery and
Communications Sciences clinic for evaluation of rhinosinusitis and/or facial pain or
pressure.

2. Symptoms are present at least 10 days a month for the last 3 months as reported by
subject.

3. Symptoms must include midfacial pain or uncomfortable pressure (may be unilateral or
bilateral), which is defined as pain in the regions overlying the maxillary, ethmoid,
frontal sinuses either together or individually.

4. Nasal endoscopy in the last three months shows no signs of inflammation (i.e. thick
drainage, polyps, watery edema in the middle meatus or spheno-ethmoid recess (mild
edema permitted).

5. Sinus CT scan or MRI within 12 months of enrollment during a symptomatic period shows
no more than scattered minimal mucosal edema or mucous retention cyst with patent
infundibula bilaterally. For subjects with a CT scan more than 12 months old or just
an MRI, a CT will be repeated for study purposes. For patients with CT scans less than
12 months old, a CT will be repeated for study purposes if the subject has changes in
symptoms suggestive of sinusitis.

6. Ability to read/write English.

7. Has a smart phone, ipod or iPad touch for completion of the EMA on a daily basis.

Exclusion Criteria:

1. Hypersensitivity to erenumab or to any of the drug components (acetate, polysorbate,
and sucrose).

2. Previous exposure to erenumab or any other CGRP inhibitor in the six months prior to
treatment.

3. Allergy to latex.

4. Inability to differentiate facial pain from other headaches.

5. Non-English speaking or unable to provide written informed consent.

6. On a preventative migraine medication (see below) during the 30 day lead-in period:

- Category 1: Divalproex sodium, sodium valproate

- Category 2: Topiramate

- Category 3: Beta blockers (for example: atenolol, bisoprolol, metoprolol,
nadolol, ebivolol, pindolol, propranolol, timolol)

- Category 4: Tricyclic antidepressants (for example: amitriptyline, nortriptyline,
protriptyline)

- Category 5: Serotonin-norepinephrine reuptake inhibitors (for example:
venlafaxine, desvenlafaxine, duloxetine, milnacipran)

- Category 6: Flunarizine, verapamil

- Category 7: Lisinopril, candesartan

7. Received botulinum toxin (Botox) to the head and neck for migraines in the last four
months.

8. More than one major surgery of the nose or sinuses. Endoscopic sinus surgery,
septoplasty, rhinoplasty, and turbinate surgery are not considered major surgery.

9. History of uncontrolled or unstable blood pressure.

10. History of liver failure.

11. History of malignancy in the last five years except non-melanoma skin cancers,
cervical or breast ductal carcinoma in situ.

12. Active seizure disorder or other significant neurological conditions other than
migraine.

13. Myocardial infarction (MI), stroke, transient ischemic attack (TIA), unstable angina,
or coronary artery bypass surgery or other revascularization procedure within 12
months prior to screening.

14. History or evidence of any other unstable or clinically significant medical condition
that in the opinion of the sponsor-investigator/ Principal Investigator, would pose a
risk to subject safety or interfere with the study evaluation, procedures or
completion.

15. Evidence of drug or alcohol abuse or dependence within 12 months prior to screening,
based on medical records or patient self-report.

16. Pregnant or breastfeeding, or expecting to conceive during the study, including
through 16 weeks after the last dose of investigational product or placebo

17. Female subject of childbearing potential who is unwilling to use an acceptable method
of effective contraception during treatment with investigational product or placebo
through 16 weeks after the last dose of investigational product. Female subjects not
of childbearing potential are defined as any female who is post-menopausal by history,
defined as:

- Age ≥ 55 years with cessation of menses for 12 or more months, OR

- Age < 55 years but no spontaneous menses for at least 2 years, OR

- Underwent bilateral oophorectomy, bilateral salpingectomy, or hysterectomy

18. Unlikely to be able to complete all protocol required study visits or procedures.

19. Currently receiving treatment in another investigational device or drug study.