A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study of LY2951742 in Patients With Episodic Migraine - the EVOLVE-2 Study
Phase: PHASE3
Conditions: Migraine
Sponsor: Eli Lilly and Company

 
I5Q-MC-CGAH (a) Clinical Protocol 
 
 
A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study of LY2951742 in Patients with 
Episodic Migraine – the EVOLVE-2 Study 
 
 
NCT02614196 
 
Approval Date: 22-Jan-2016 
 
 

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Protocol I5Q-MC-CGAH(a)
A Phase 3, Randomized, Double-Blind, Placebo-Controlled 
Study of LY2951742 in Patients with Episodic Migraine
– the EVOLVE-2 Study
Confidential Information
The information contained in this document is confidential and is intended for the use of 
clinical investigators.  It is the property of Eli Lilly and Company or its subsidiaries and 
should not be copied by or distributed to persons not involved in the clinical investigation of 
LY2951742, unless such persons are bound by a confidentiality agreement with Eli Lilly 
and Company or its subsidiaries.
Note to Regulatory Authorities:  this document may contain protected personal data 
and/or commercially confidential information exempt from public disclosure.  Eli Lilly and 
Company requests consultation regarding release/redaction prior to any public release.  In 
the United States, this document is subject to Freedom of Information Act (FOIA) 
Exemption 4 and may not be reproduced or otherwise disseminated without the written 
approval of Eli Lilly and Company or its subsidiaries.
LY2951742
Study CGAH is a Phase 3, multisite, randomized, double-blind, placebo-controlled, 6-month 
study to compare the efficacy and safety of two doses of LY2951742 with placebo in 
preventing migraine headaches in patients with episodic migraine (with or without aura).
Eli Lilly and Company
Indianapolis, Indiana USA 46285
Protocol Electronically Signed and Approved by Lilly:  23 September 2015
Protocol Amendment (a) Electronically Signed and Approved by Lilly on approval date 
provided below.
Approval Date: 22-Jan-2016 GMT

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Table of Contents
Section
Page
1.
Protocol Synopsis................................................................................................................8
2.
Introduction ......................................................................................................................11
2.1.
Background..................................................................................................................11
2.2.
Study Rationale............................................................................................................11
3.
Objectives and Endpoints..................................................................................................13
4.
Study Design.....................................................................................................................19
4.1.
Overview of Study Design ...........................................................................................19
4.2.
End of Trial Definition.................................................................................................21
4.3.
Scientific Rationale for Study Design...........................................................................21
4.4.
Justification for Dose ...................................................................................................21
4.5.
Benefit/Risk Assessment..............................................................................................21
5.
Study Population...............................................................................................................22
5.1.
Inclusion Criteria..........................................................................................................22
5.2.
Exclusion Criteria ........................................................................................................23
5.3.
Screen Failures.............................................................................................................26
5.4.
Lifestyle and/or Dietary Requirements .........................................................................26
6.
Treatment..........................................................................................................................27
6.1.
Treatments Administered .............................................................................................27
6.1.1.
Medical Devices...................................................................................................27
6.2.
Method of Treatment Assignment ................................................................................27
6.2.1.
Selection and Timing of Doses.............................................................................27
6.3.
Blinding .......................................................................................................................27
6.4.
Packaging and Labelling ..............................................................................................28
6.5.
Preparation/Handling/Storage.......................................................................................28
6.6.
Dose Modification........................................................................................................28
6.6.1.
Special Treatment Considerations ........................................................................28
6.7.
Treatment Compliance .................................................................................................28
6.8.
Concomitant Therapy...................................................................................................29
6.9.
Treatment after Study Completion................................................................................30
6.9.1.
Study Extensions..................................................................................................30
6.9.2.
Continued Access.................................................................................................30
7.
Discontinuation Criteria ....................................................................................................31
7.1.
Discontinuation from Study Treatment.........................................................................31
7.1.1.
Permanent Discontinuation from Study Treatment ...............................................31

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7.1.2.
Temporary Discontinuation from Study Treatment...............................................31
7.1.3.
Discontinuation of Inadvertently Enrolled Patients...............................................31
7.1.4.
Permanent Discontinuation from the Study ..........................................................32
7.1.5.
Patients Lost to Follow-Up...................................................................................32
8.
Study Assessments and Procedures ...................................................................................33
8.1.
Efficacy Assessments...................................................................................................33
8.1.1.
Primary Efficacy Assessments .............................................................................33
8.1.2.
Secondary Efficacy Assessments..........................................................................33
8.1.2.1.
Patient Global Impression of Severity.............................................................33
8.1.2.2.
Patient Global Impression of Improvement.....................................................33
8.1.3.
Appropriateness of Assessments ..........................................................................33
8.2.
Adverse Events ............................................................................................................34
8.2.1.
Serious Adverse Events........................................................................................34
8.2.1.1.
Suspected Unexpected Serious Adverse Reactions..........................................35
8.2.1.2.
Adverse Event Monitoring with a Systematic 
Questionnaire .................................................................................................35
8.2.2.
Complaint Handling.............................................................................................36
8.3.
Treatment of Overdose.................................................................................................36
8.4.
Safety Assessments ......................................................................................................36
8.4.1.
Electrocardiograms ..............................................................................................36
8.4.2.
Vital Signs ...........................................................................................................36
8.4.3.
Laboratory Tests ..................................................................................................36
8.4.4.
Other Tests...........................................................................................................37
8.4.5.
Safety Monitoring ................................................................................................37
8.5.
Pharmacokinetics .........................................................................................................37
8.6.
Pharmacodynamics ......................................................................................................38
8.8.
Biomarkers...................................................................................................................39
8.8.1.
Samples for Immunogenicity Research.................................................................39
8.9.
Health Economics ........................................................................................................39
9.
Statistical Considerations and Data Analysis.....................................................................41
9.1.
Determination of Sample Size ......................................................................................41
9.2.
General Statistical Considerations ................................................................................41
9.3.
Treatment Group Comparability...................................................................................42
9.3.1.
Patient Disposition...............................................................................................42
9.3.2.
Patient Characteristics..........................................................................................42
9.3.3.
Concomitant Therapy...........................................................................................42
9.3.4.
Treatment Compliance .........................................................................................42
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9.3.5.
Electronic Patient-reported Outcome Diary Compliance.......................................43
9.4.
Primary and Secondary Analyses .................................................................................43
9.4.1.
Primary Analyses.................................................................................................43
9.4.2.
Key Secondary Analyses......................................................................................44
9.4.3.
Other Secondary and Tertiary Efficacy Analyses..................................................45
9.5.
Safety Analyses............................................................................................................46
9.5.1.
Categorical Safety Variables ................................................................................46
9.5.2.
Adverse Events ....................................................................................................46
9.5.3.
Suicide-Related Thoughts and Behaviors .............................................................47
9.5.4.
Vital Signs and Weight ........................................................................................47
9.5.5.
Electrocardiogram Intervals and Heart Rate .........................................................47
9.5.6.
Laboratory Tests ..................................................................................................48
9.7.
Other Analyses.............................................................................................................48
9.7.1.
Health Economics ................................................................................................48
9.7.2.
Subgroup Analyses ..............................................................................................48
9.8.
Interim Analyses ..........................................................................................................49
10.
Study Governance Considerations.....................................................................................51
10.1. Regulatory and Ethical Considerations, Including the Informed 
Consent Process ...........................................................................................................51
10.1.1.
Informed Consent.................................................................................................51
10.1.2.
Ethical Review.....................................................................................................51
10.1.3.
Regulatory Considerations ...................................................................................51
10.1.4.
Investigator Information.......................................................................................52
10.1.5.
Protocol Signatures ..............................................................................................52
10.1.6.
Final Report Signature .........................................................................................52
10.2. Data Quality Assurance................................................................................................52
10.2.1.
Data Capture System............................................................................................53
10.3. Study and Site Closure .................................................................................................54
10.3.1.
Discontinuation of Study Sites .............................................................................54
10.3.2.
Discontinuation of the Study................................................................................54
11.
References ........................................................................................................................55
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List of Tables
Table
Page
Table CGAH.1. Objectives and Endpoints...............................................................................13
Table CGAH.2. Migraine and Headache Endpoint Definitions................................................18
Table CGAH.3. Treatments Allowed and Treatments Not Allowed as Concomitant 
Therapy .........................................................................................................29
Table CGAH.4. Definition of Subgroup Variables ..................................................................49

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List of Figures
Figure
Page
Figure CGAH.1. Illustration of study design for Clinical Protocol I5Q-MC-CGAH..................19
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List of Appendices
Appendix
Page
Appendix 1.
Abbreviations and Definitions........................................................................57
Appendix 2.
Schedule of Activities....................................................................................58
Appendix 3.
Clinical Laboratory Tests...............................................................................63
Appendix 4.
Hepatic Monitoring Tests for Treatment-Emergent Abnormality....................65
Appendix 5.
Protocol Amendment I5Q-MC-CGAH(a) Summary:  A Phase 3, 
Randomized, Double-Blind, Placebo-Controlled Study of LY2951742 
in Patients with Episodic Migraine – the EVOLVE-2 Study...........................66

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1.
Protocol Synopsis
Title of Study:
A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study of LY2951742 in Patients with Episodic Migraine
– the EVOLVE-2 Study.
Rationale:
Study I5Q-MC-CGAH (CGAH; EVOLVE-2) is intended to assess the efficacy and safety of two doses of
LY2951742 in the prevention of migraine headache compared with placebo in patients suffering from episodic 
migraine.  Episodic migraine is defined as 4 to 14 migraine headache days (with or without aura) per month.
Objective(s)/Endpoints:
Objectives
Endpoints
Primary
To test the hypothesis that at least 1 dose of LY2951742 
(120 or 240 mg/month) is superior to placebo in the 
prevention of migraine headache in patients with 
episodic migraine.
The overall mean change from baseline in the number 
of monthly migraine headache days during the 6-
month double-blind treatment phase
Key Secondary Objectives
If LY2951742 (120 or 240 mg/month) is statistically 
significantly superior to placebo on the primary 
objective, the following key secondary objectives will be 
tested with adjustment for multiplicity (only the key 
secondary objectives are listed below):
The specific methodology (including testing order, 
relationship and type I error allocation and 
propagation) for the tests of the following key 
secondary endpoints will be specified in the statistical 
analysis plan:

To compare LY2951742 with placebo with respect 
to 50% response rate

The proportion of patients with reduction from 
baseline ≥50% in monthly migraine headache 
days during the 6-month double-blind treatment 
phase

To compare LY2951742 with placebo with respect 
to 75% response rate

The proportion of patients with reduction from 
baseline ≥75% in monthly migraine headache 
days during the 6-month double-blind treatment 
phase

To compare LY2951742 with placebo with respect 
to 100% response rate

The proportion of patients with a 100% reduction 
from baseline in monthly migraine headache 
days during the 6-month double-blind treatment 
phase 

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Objectives
Endpoints

To compare LY2951742 with placebo with respect 
to change in functioning

The mean change from baseline in the Role 
Function-Restrictive domain score of the 
Migraine-Specific Quality of Life Questionnaire 
version 2.1 (MSQ v2.1) (average of Months 4, 5,
and 6)

To compare LY2951742 with placebo with respect 
to change in use of acute (abortive) migraine 
treatment

The overall mean change from baseline in the 
number of monthly migraine headache days 
requiring medication for the acute treatment of 
migraine or headache during the 6-month double-
blind treatment phase

To compare LY2951742 with placebo with respect 
to change in global severity of the migraine 
condition

The mean change from baseline in the Patient 
Global Impression of Severity (PGI-S) score 
(average of Months 4, 5, and 6)
Summary of Study Design:
A multisite, randomized, double-blind, parallel, placebo-controlled trial with 4 study periods in patients who meet 
International Classification of Headache Disorders (ICHD) criteria for a diagnosis of migraine as confirmed during a 
prospective baseline period that demonstrates episodic frequency (4 to 14 migraine headache days per month).
Treatment Arms and Duration:
Three treatment arms:  LY2951742 (120 mg/month with a 240 mg loading dose at the first injection [administered 
as 2 injections of 120 mg at Visit 3]), LY2951742 (240 mg/month, administered as 2 injections of 120 mg), and 
placebo.  Following a prospective baseline (30-40 days) period, eligible patients will be randomized in a 2:1:1 ratio 
to receive placebo, 120 mg/month of LY2951742, or 240 mg/month of LY2951742, respectively, and will begin a 6-
month treatment phase.  This phase will be followed by a 4-month, post-treatment phase during which patients will 
no longer receive any study medication.
Number of Patients:
The study will screen an estimated 1557 potential study participants to ensure randomization of approximately 825 
patients with episodic migraine.
Statistical Analysis:
Unless otherwise specified, analyses will be conducted on an intent-to-treat (ITT) population, which include all 
patients who are randomized and receive at least one dose of investigational product. Patients in the ITT population 
will be analyzed according to the treatment group to which they are randomized.  When mean change from baseline 
is assessed, the patient will be included in the analysis only if the patient has a baseline and postbaseline 
measurement.
The primary analysis will evaluate the efficacy of two doses of LY2951742 compared with placebo on the overall 
mean change from baseline in the number of monthly migraine headache days during the 6-month double-blind 
treatment phase. Migraine headache day will be defined to include both migraine and probable migraine days.  The 

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primary analysis will be performed using a restricted maximum likelihood based mixed models repeated measures 
(MMRM) technique.  The analysis will include the fixed categorical effects of treatment, region, month, and 
treatment-by-month interaction, as well as the continuous fixed covariates of baseline number of migraine headache 
days and baseline number of migraine headache days-by-visit interaction.

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2. Introduction
2.1.
Background
Migraine is a chronic, debilitating condition found to be one of the top 10 causes of disability 
expressed as years lived with disability globally (Vos et al. 2012).  However, one study estimates 
that only a small fraction of patients receive preventive treatment, although more than 25% of 
migraineurs are in need of preventive therapy (Rizzoli 2014).  Despite the availability of 
preventive medications for migraine, significant needs remain for new treatment options with 
improved efficacy and tolerability.
Calcitonin gene-related peptide (CGRP), a 37-amino acid neuropeptide, is widely expressed 
throughout the central and peripheral nervous system and acts as a local facilitator of 
inflammatory processes.  CGRP is implicated in the pathophysiology of migraine and is 
hypothesized to be involved in the release of inflammatory mediators and the transmission of
nociceptive (pain) information from intracranial blood vessels to the nervous system (Villalón
and Olesen 2009). In migraineurs, serum concentrations of CGRP are significantly elevated 
during migraine attacks (Goadsby et al. 1990; Goadsby and Edvinsson 1993), and infusion of 
CGRP to individuals with a history of migraine can trigger migraine attacks (Lassen et al. 1998;
Lassen et al. 2002). The neutralization of CGRP with antibodies has been shown to modulate 
neurogenic inflammation; thus, these antibodies may represent a promising pharmacologic
approach for the prevention of migraine (Investigator’s Brochure [IB], Section 3.1).
LY2951742 is a humanized monoclonal antibody that potently and selectively binds to CGRP, 
preventing CGRP-mediated biological effects (IB, Section 3.1).  To date, more than 450 clinical 
trial participants have been exposed to LY2951742 at single doses ranging from 1 to 600 mg and 
multiple doses up to 300 mg in 5 clinical trials of LY2951742.  In studies of patients with 
migraine (Studies I5Q-MC-ART1 [ART-01] and I5Q-MC-CGAB [CGAB]), efficacy data have 
demonstrated that LY2951742 had significantly greater mean reductions than placebo in 
migraine headache days and other efficacy parameters.  Across clinical studies of LY2951742, 
assessment of adverse events (AEs) indicates that LY2951742 has been well tolerated in both 
healthy subjects and in patients with episodic migraine.  The AEs generally have been mild to
moderate in severity. In two studies of patients with migraine, the most frequently reported 
adverse events (AEs) included injection-site pain, upper respiratory tract infection, abdominal 
pain, dizziness, injection-site erythema, rash, hypertension, and nasopharyngitis.  Analyses of 
laboratory values and cardiovascular monitoring of the clinical studies have shown no other 
clinically important changes in tested parameters.
2.2.
Study Rationale
Study I5Q-MC-CGAH (EVOLVE-2) will enable a more comprehensive clinical assessment of 
LY2951742 in a patient population for which the drug already has shown preliminary evidence 
of efficacy and safety.  This study, along with a study of identical design in patients with 
episodic migraine, is intended to provide pivotal efficacy data to support a registration program 
in patients with migraines.  EVOLVE-2 will include 6 months on LY2951742 or placebo

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followed by 4 months of post-treatment observation to deepen understanding of the effects of a 
CGRP antibody in preventing migraines.

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3.
Objectives and Endpoints
Table CGAH.1 shows the key objectives and endpoints of the study.  Table CGAH.2 provides 
definitions for the terms referenced below.
Table CGAH.1.
Objectives and Endpoints
Objectives
Endpoints
Primary
To test the hypothesis that at least 1 dose of LY2951742 
(120 or 240 mg/month) is superior to placebo in the 
prevention of migraine headache in patients with 
episodic migraine.
The overall mean change from baseline in the number of 
monthly migraine headache days during the 6-month 
double-blind treatment phase
Key Secondary Objectives
If LY2951742 (120 or 240 mg/month) is statistically 
significantly superior to placebo on the primary 
objective, the following key secondary objectives will be 
tested with adjustment for multiplicity:
The specific methodology (including testing order, 
relationship and type I error allocation and propagation) 
for the tests of the following key secondary endpoints
will be specified in the statistical analysis plan:

To compare LY2951742 with placebo with respect 
to 50% response rate

The proportion of patients with reduction from 
baseline ≥50% in monthly migraine headache days 
during the 6-month double-blind treatment phase

To compare LY2951742 with placebo with respect 
to 75% response rate

The proportion of patients with reduction from 
baseline ≥75% in monthly migraine headache days 
during the 6-month double-blind treatment phase

To compare LY2951742 with placebo with respect 
to 100% response rate

The proportion of patients with a 100% reduction 
from baseline in monthly migraine headache days 
during the 6-month double-blind treatment phase

To compare LY2951742 with placebo with respect 
to change in functioning

The mean change from baseline in the Role
Function-Restrictive domain score of the Migraine-
Specific Quality of Life Questionnaire version 2.1 
(MSQ v2.1) (average of Months 4, 5, and 6)

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Table CGAH.1.
Objectives and Endpoints (continued)
Objectives (cont.)
Endpoints (cont.)
Key Secondary Objectives (cont.)

To compare LY2951742 with placebo with respect 
to change in use of acute (abortive) migraine 
treatment

The overall mean change from baseline in the 
number of monthly migraine headache days 
requiring medication for the acute treatment of 
migraine or headache during the 6-month double-
blind treatment phase

To compare LY2951742 with placebo with respect 
to change in global severity of migraine condition

The mean change from baseline in the Patient 
Global Impression of Severity (PGI-S) score 
(average of Months 4, 5, and 6)
Other Secondary Objectives

To compare LY2951742 with placebo with respect 
to change in headache days

The overall mean change from baseline in the 
number of monthly headache days during the 6-
month double-blind treatment phase

To compare LY2951742 with placebo with respect 
to change in moderate to severe headache days

The overall mean change from baseline in the 
number of monthly moderate to severe headache 
days during the 6-month double-blind treatment 
phase

To compare LY2951742 with placebo with respect 
to a 30% response rate

The proportion of patients with reduction from 
baseline ≥30% in monthly migraine headache days 
during the 6-month double-blind treatment phase

To compare LY2951742 with placebo with respect 
to distribution of response rates

Cumulative distribution of monthly migraine 
headache day response rates during the 6-month 
double-blind treatment phase

To compare LY2951742 with placebo with respect 
to time to 50% response

Time to first occurrence of a ≥50% reduction from 
baseline in the number of monthly migraine 
headache days (Kaplan-Meier analysis)

To compare LY2951742 with placebo with respect 
to onset of effect

The initial month at which statistical separation in 
mean change from baseline in the number of 
monthly migraine headache days is demonstrated
and maintained at all subsequent months through 
Month 6

To compare LY2951742 with placebo with respect 
to onset of 50% sustained response

The initial month at which statistical separation in 
the proportion of patients meeting at least a 50% 
reduction in monthly migraine headache days that is 
maintained at all subsequent months through Month 
6

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Table CGAH.1.
Objectives and Endpoints (continued)
Objectives (cont.)
Endpoints (cont.)
Other Secondary Objectives (cont.)

To compare LY2951742 with placebo with respect 
to maintenance of 50% response

The proportion of patients who maintain 50% 
response criteria for at least 3 consecutive months to 
the end of the double-blind treatment phase and the 
proportion of patients who maintain 50% response 
criteria for 6 consecutive months during double-
blind treatment

To compare LY2951742 with placebo with respect 
to changes in other efficacy parameters, 
specifically:
o
International Classification of Headache 
Disorders (ICHD) migraine headache days
o
migraine attacks
o
migraine headache hours
o
headache hours
o
severity of remaining migraines

Overall mean change from baseline (during the 6-
month double-blind treatment phase) on the 
following monthly measures:
o
International Classification of Headache 
Disorders (ICHD) migraine headache days
o
migraine attacks
o
migraine headache hours
o
headache hours
o
severity of remaining migraines

To compare LY2951742 with placebo with respect 
to global assessment of illness

Overall mean Patient Global Impression-
Improvement (PGI-I) rating during the 6-month 
double-blind treatment phase

To compare LY2951742 with placebo with respect 
to changes in disability and quality of life

Mean change from baseline on the following 
measures:
o
the Migraine Disability Assessment test 
(MIDAS) total score and individual items at 
Month 6
o
the Migraine-Specific Quality of Life 
Questionnaire, version 2.1 (MSQ v2.1) total 
score, and Role Function-Preventive and 
Emotional Function domain scores(average of 
Months 4, 5, and 6)

To compare LY2951742 with placebo with respect 
to safety and tolerability

Analysis of:
o
treatment-emergent adverse events (TEAEs)
o
discontinuation rates
o
vital signs and weight
o
electrocardiograms (ECGs)
o
laboratory measures
o
other safety parameters, including suicidality 
using the Columbia-Suicide Severity Rating 
Scale (C-SSRS)

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Table CGAH.1.
Objectives and Endpoints (continued)
Objectives (cont.)
Endpoints (cont.)
Other Secondary Objectives (cont.)

To evaluate LY2951742 with respect to 
immunogenicity

Throughout the study:
o
Development and consequences of anti-drug 
antibodies and neutralizing anti-drug antibodies
to LY2951742 

To evaluate LY2951742 with respect to 
pharmacokinetics

Serum concentrations of LY2951742

To evaluate LY2951742 with respect to 
pharmacodynamics (target engagement)

Plasma concentrations of CGRP

To assess changes in efficacy outcomes during 
Study Period IV as collected by electronic patient-
reported outcomes (ePRO) diary data

In Study Period IV:
o
Mean change from baseline in monthly 
migraine headache days
o
Time to first loss of response among patients 
who met the 50% response rate criteria at the 
end of the double-blind treatment phase
o
Time to initiation of  treatment with a migraine 
prevention medication
Tertiary Objectives

To explore the effect of LY2951742 on non-
migraine chronic pain

Mean change from baseline in average pain severity 
of other chronic pain conditions

To compare LY2951742 with placebo with respect 
to categorical changes in quality of life

Percentages of patients with:
o
≥50% improvement in MIDAS total score
o
change from baseline in MSQ Role Function-
Restrictive domain  ≥10.9
o
change from baseline in MSQ Role Function-
Preventive domain  ≥8.3
o
change from baseline in MSQ Emotional 
Function domain  ≥12.2
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Table CGAH.1.
Objectives and Endpoints (continued)
Objectives (cont.)
Endpoints (cont.)
Tertiary Objectives (cont.)

To compare LY2951742 with placebo with respect 
to the proportion of migraine headache days 
requiring medication for the acute treatment of 
migraine or headache

Change from baseline in the proportion of monthly 
migraine headache days requiring medication for 
the acute treatment of migraine or headache

To compare LY2951742 with placebo with respect 
to changes in symptomatology associated with 
migraine or probable migraine

Change from baseline in the number of monthly 
migraine headache days with:
o
nausea and/or vomiting
o
photophobia and phonophobia
o
aura
o
prodromal symptoms other than aura

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Table CGAH.2.
Migraine and Headache Endpoint Definitions
Diagnosis
Definition/Criteria
Migraine headache
A headache, with or without aura, of ≥30 minutes duration
with both of the following required features (A and B):
A.  At least 2 of the following headache characteristics:

Unilateral location

Pulsatile quality

Moderate or severe pain intensity

Aggravation by or causing avoidance of routine 
physical activity
AND
B.  During headache at least one of the following:

Nausea and/or vomiting

Photophobia and phonophobia
(Definition adapted from the Standard International 
Headache Society [IHS] International Classification of 
Headache Disorders (ICHD)-3 beta)
Probable migraine
A headache missing 1 of the migraine features in the IHS 
ICHD-3 beta definition such that one feature in criteria A is 
missing or one feature in criteria B is missing; that is, meet at 
least 2 A criteria and none of the B criteria or meet 1 of the A 
criteria and at least 1 of the B criteria.
Migraine headache day (primary objective)
A calendar day on which a migraine headache or probable 
migraine headache occurred.
Migraine headache attack
Beginning on any day a migraine headache or probable 
migraine headache is recorded and ends when a migraine-free
day occurs.
Non-migraine headache
All headaches of at least 30 minutes duration not fulfilling 
the definition of migraine or probable migraine are classified 
as non-migraine headaches.
Non-migraine headache day
A calendar day on which a non-migraine headache occurred.
Headache day
A calendar day on which any type of headache occurs 
(including migraine headache, probable migraine headache,
and non-migraine headache).

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4.
Study Design
4.1.
Overview of Study Design
Study CGAH (EVOLVE-2) is a Phase 3, multisite, double-blind, randomized, placebo-
controlled, study of LY2951742 in patients suffering from episodic migraine. The study has 4 
periods, including a prospective baseline phase to determine patient eligibility.
Figure CGAH.1 illustrates the study design.
Figure CGAH.1.
Illustration of study design for Clinical Protocol I5Q-MC-CGAH.
Study Period I: The study and potential risks will be explained to the patient at Visit 1.  The 
informed consent form (ICF) must be signed before any study procedures are performed.  
Patients are required to discontinue all excluded medications or migraine prevention treatments 
at least 30 days prior to Visit 2.  Botulinum toxin A or B in the head or neck area must be 
discontinued at least 4 months prior to Visit 2.
Month
0
2
3
Visit        
1
3a
4
6
7
Dosing
X
X
Randomization
LY2951742 (120 mg)a
Placebo
Daily diary reporting
SP I
Screening
5
10
5
1
X
4
8
X
X
X
6
12
8
13
10
14
2
--
3-45
days
Month 
4.5
9
11
SP II
Baseline
SP III
Double-Blind
Treatment
SP IV
Follow-up
30-40*
days
*Eligibility period determined between a minimum of 30 days and a maximum of 40 days.  Investigators may have 
up to 5 additional days (beyond the 40 days) if needed to schedule patients’ Visit 3 appointment.
aPatients randomized to the 120 mg dose will receive a loading dose of 240 mg at the first injection only (Visit 3).
Abbreviations:  SP = study period.
Month 0.5
LY2951742 (240 mg)
Month 
5.5

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The screening visit (Visit 1) will consist of a full clinical assessment, including a comprehensive 
medical evaluation documenting medical history, and a physical and neurological examination 
(Appendix 2).  Visit 1 will be complete when the last scheduled procedure of the screening 
assessment is completed.
Study Period II: Qualified patients will enter Study Period II (prospective baseline) to 
determine their eligibility for the study and to establish baseline data for comparison of endpoints 
during the treatment period.  Beginning at Visit 2, patients will log in daily to the electronic 
patient-reported outcomes (ePRO) system to answer questions about the occurrence of 
headaches, headache duration, headache features, severity of headache, and use of headache 
medication.  At the end of the prospective baseline period, sites will be notified whether their 
patients met criteria and are eligible to be randomized at Visit 3.
To avoid biased reporting, patients must not be told the number of migraine headache days 
on which study qualification is based.
Study Period III: At the start of the 6-month double-blind treatment phase (Visit 3), patients 
meeting all eligibility requirements will be randomized to 1 of 3 treatment groups in a 2:1:1 ratio 
to receive placebo, 120 mg/month LY2951742, or 240 mg/month LY2951742, respectively.
Patients randomized to the 120 mg dose of LY2951742 will receive an initial loading dose of 
240 mg (2 injections of 120 mg each at Visit 3 only). To preserve blinding throughout the study, 
patients in all treatment groups will receive 2 injections of investigational product at each dosing 
visit (two placebo injections, two 120-mg LY2951742 injections, or one placebo injection and 
one 120-mg injection).  At Visit 3, if available and where local regulations and Ethical Review 
Boards allow, patients will also watch a training video designed to address patient expectations 
with regard to participation in a placebo-controlled trial and the difference between medical 
treatment and research.
The patient will be considered enrolled in the study when randomization occurs.  During this 
phase, study procedures at dosing visits must always occur prior to the patient receiving their 
assigned treatment.
Patients will be given injections of investigational product during office visits (Figure CGAH.1).  
For all treatment groups, subcutaneous injections will be administered once monthly at the 
dosing visits.  At Visit 3 (first dose), patients will be required to remain in the office for 
observation for 30 minutes post injection.  Patients will continue to log in and complete the 
ePRO diary each day.  Patients may continue to take their allowed acute migraine headache 
medication (with some limitations; see Section 6.8) during the treatment phase.
Patients who complete this phase or discontinue for any reason during Study Period III will be 
expected to enter post-treatment follow-up (Study Period IV).
Study Period IV: During this 4-month phase, sites and patients will remain blinded to patients’ 
treatment assignments.  Patients will follow all study procedures during Study Period IV but will 
not receive LY2951742 or placebo. One month after Visit 12, if clinically warranted due to a 
worsening of symptoms, patients may start migraine prevention medications at the discretion of 

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the investigator.  The list of allowed preventive medications is provided in Section 6.8.  At Visit 
14 (Month 10), patients will return to the site for their last study visit and discharge from the 
study.
4.2.
End of Trial Definition
End of the trial is the date of the last visit or last scheduled procedure shown in the Schedule of 
Activities (Appendix 2) for the last patient.
4.3.
Scientific Rationale for Study Design
The length of the randomized treatment phase is considered sufficient to assess the safety and 
efficacy of a migraine prevention medication and is consistent with regulatory feedback. A 4-
month post-treatment follow-up phase is included to evaluate patient safety during wash-out of 
LY2951742. This allows for a total of 5 months of observation from the time of last injection of 
LY2951742.  A 5-month post-treatment observation period allows for a wash-out of 
approximately 5 elimination half-lives of LY2951742 and should decrease LY2951742 serum 
concentrations by approximately 97% during this time.
4.4.
Justification for Dose
Doses of 120 and 240 mg administered once monthly were selected primarily on the basis of 
clinical efficacy and pharmacokinetic/pharmacodynamic data from the Phase 2 dose-ranging 
study.  Results from the Phase 2 dose-ranging study indicate that 120 mg was statistically 
significantly superior to placebo at the last 28-day period of the 3-month treatment phase in 
mean change in migraine headache days, as well as in other measures of efficacy and quality of 
life.  The use of a loading dose for the 120 mg treatment arm, and the inclusion of a 240 mg 
treatment arm, is based on the finding that a dose higher than 120 mg achieved statistically 
significant separation from placebo as early as Month 1.  The planned doses of 120 mg and 240 
mg LY2951742 for Study CGAH also are being evaluated in two other pivotal efficacy studies 
of LY2951742; one of these studies is in patients with episodic migraine, and one is in patients 
with chronic migraine.
4.5.
Benefit/Risk Assessment
More information about the known and expected benefits, risks, serious adverse events (SAEs) 
and reasonably anticipated adverse events (AEs) of LY2951742 are to be found in the 
Investigator’s Brochure (IB).

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5.
Study Population
All patients must meet the following selection criteria.  Eligibility of patients for study 
enrollment will be based on the results of a screening medical history, physical examination, 
neurological examination, clinical laboratory tests, electrocardiograms (ECGs), and migraine 
history during screening and a prospective baseline period, as described in the Inclusion and 
Exclusion Criteria sections.  The nature of any comorbid conditions present at the time of the 
physical examination and any pre-existing conditions must be documented.  Individuals who do 
not meet the criteria for participation in this study (screen failure) for specific reasons as outlined 
may be considered for rescreening once, with approval from Eli Lilly and Company (Lilly)
Medical (Section 5.3).
Study participants should be instructed not to donate blood or blood products during the study or 
for 5 months following last administration of investigational product.
Prospective approval of protocol deviations to recruitment and enrollment criteria, also known as 
protocol waivers or exemptions, are not permitted.
5.1.
Inclusion Criteria
Patients are eligible to be included in the study only if they meet all of the following criteria at
screening:
Patient and Disease Characteristics
[1]
Patients are 18 to 65 years of age (inclusive) at the time of screening.
[2]
Have a diagnosis of migraine as defined by International Headache Society 
(IHS) International Classification of Headache Disorders (ICHD)-3 beta 
guidelines (1.1 or 1.2) (ICHD-3 2013), with a history of migraine headaches
of at least 1 year prior to Visit 1, and migraine onset prior to age 50.
[3]
Prior to Visit 1, have a history of 4 to 14 migraine headache days and at least 
2 migraine attacks per month on average within the past 3 months.
[4]
From Visit 2 to Visit 3 (prospective baseline period), have a frequency of 4 to 
14 migraine headache days and at least 2 migraine attacks (see definitions, 
Table CGAH.1). To avoid biased reporting, patients must not be told the 
number of migraine headache days on which study qualification is based.
[5]
From Visit 2 to Visit 3 (prospective baseline period), must achieve sufficient 
compliance with ePRO daily headache entries as demonstrated by completion 
of at least 80% of daily diary entries.
Informed Consent and Patient Agreements
[6]
Are able and willing to give signed informed consent.
[7]
Are reliable and willing to follow study procedures, including all follow-up 
visits.

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[8]
Women of child-bearing potential must test negative for pregnancy at the time 
of enrollment based on a serum pregnancy test.
[9]
All patients, male and female, must agree to use a reliable method of birth 
control during the study as well as for 5 months after the last dose of 
investigational product. Acceptable methods of birth control for this study 
include:  oral contraceptives; implantable contraceptives; injectable 
contraceptives; a contraceptive patch; barrier methods such as diaphragms 
with contraceptive jelly, cervical caps with contraceptive jelly, condoms with 
contraceptive foam, or intrauterine devices; a partner with vasectomy.  Birth 
control is not required if the female is infertile due to surgical sterilization (at 
least 6 weeks after surgical bilateral oophorectomy, hysterectomy, or at least 6 
weeks after tubal ligation) confirmed by medical history or menopause.  
Menopause is defined as spontaneous amenorrhea for at least 12 months not 
induced by a medical condition, or spontaneous amenorrhea of 6-12 months 
and a follicle stimulating hormone level >40 mIU/mL.
[10] Agree not to post any personal medical data related to the study or 
information related to the study on any website or social media site (for 
example, Facebook, Twitter, LinkedIn, Google+, etc.) until the entire trial has 
completed.
5.2.
Exclusion Criteria
Patients will be excluded from study enrollment if they meet any of the following criteria at
screening:
Prior/Concurrent Clinical Trial Experience
[11] Are currently enrolled in any other clinical trial involving an investigational 
product or any other type of medical research judged not to be scientifically or 
medically compatible with this study.
[12] Have participated within the last 30 days or within 5 half-lives (whichever is 
longer) in a clinical trial involving an investigational product.  If the 
investigational product’s half-life is not known, 6 months should have passed 
prior to Visit 1.
[13] Current use or prior exposure to LY2951742 or another CGRP antibody, 
including those who have previously completed or withdrawn from this study 
or any other study investigating a CGRP antibody.
Prior/Concomitant Therapy
[14] Patients who are taking, or are expected to take, therapeutic antibodies during 
the course of the study (for example, adalimumab, infliximab, trastuzumab, 
bevacizumab, etc.).  Prior use of therapeutic antibodies, other than antibodies 
to CGRP or its receptor, is allowed if that use was more than 12 months prior 
to Visit 2.

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[15] Known hypersensitivity to multiple drugs, monoclonal antibodies or other 
therapeutic proteins, or to LY2951742.
[16] Are currently receiving medication or other treatments for the prevention of 
migraine headaches.  Patients must have discontinued such treatment at least 
30 days prior to Visit 2.  Botulinum toxin A and B that has been administered 
in the head or neck area must be discontinued at least 4 months prior to 
Visit 2.
[17] Failure to respond to 3 or more adequately dosed migraine preventive 
treatments from different classes (that is, maximum tolerated dose for at least 
2 months). Failure to respond due to tolerability issues is not considered a 
treatment failure.  Migraine preventive treatments are defined as Level A and 
Level B in Table 1 of the American Academy of Neurology’s Evidence-based 
Guidelines Update:  Pharmacologic Treatment for Episodic Migraine 
Prevention in Adults (Silberstein et al. 2012) as well as botulinum toxin A or 
B.
Diagnostics Assessments
[18] History of persistent daily headache, cluster headache or migraine subtypes 
including hemiplegic (sporadic or familial) migraine, ophthalmoplegic 
migraine, and  migraine with brainstem aura (basilar-type migraine) defined 
by IHS ICHD-3 beta.
[19] History of headache (for example, cluster headache, Medication Overuse 
Headache ) other than migraine or tension type headache as defined by IHS 
ICHD-3 beta within 3 months prior to randomization.
[20] Prior to Visit 1, a history of ≥15 headache days (migraine, probable migraine 
or any other headache) per month on average during the past 3 months or are 
suspected of suffering from chronic migraine as defined per ICHD-3 beta.
[21] History of head or neck injury within 6 months prior to Visit 1 .
[22] Patients with a history of traumatic head injury associated with significa nt 
change in the quality or frequency of their headaches should be excluded.
Medical Conditions
[23] Have ECGs showing abnormalities compatible with acute cardiovascular 
events and/or serious cardiovascular risk, including but not limited to a 
corrected QT (QTcB [Bazett's]) interval > 470 msec for women and >450 for 
men, or have had myocardial infarction, unstable angina, percutaneous 
coronary intervention, coronary artery bypass graft, or deep vein 
thrombosis/pulmonary embolism within 6 months of screening, or have 
planned cardiovascular surgery or percutaneous coronary angioplasty, or 
patients with a lifetime history of stroke.
[24] Patients with a body mass index ≥40 kg/m2.

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[25] Any liver tests outside the normal range at Visit 1 that are clinically 
significant.  Alanine aminotransferase (ALT) >2X upper limit of normal 
(ULN), or total bilirubin (TBL) >1.5X ULN, or alkaline phosphatase (ALP) 
>2X ULN must be discussed and judged not clinically significant by Lilly 
Medical prior to enrollment.
[26] Evidence of significant active or unstable psychiatric disease by medical 
history, such as bipolar disorder, schizophrenia, personality disorders, or other 
serious mood or anxiety disorders. Note: Patients with major depressive 
disorder or generalized anxiety disorder whose disease state is considered 
stable and expected to remain stable throughout the course of the study, in the 
opinion of the investigator, may be considered for inclusion if they are not on 
excluded medications.
[27] Patients who, in the clinician’s judgment, are actively suicidal and therefore 
deemed to be at significant risk for suicide, or those who have answered “yes”
to either Question 4 (Active Suicidal Ideation with Some Intent to Act, 
Without Specific Plan) or Question 5 (Active Suicidal Ideation with Specific 
Plan and Intent) on the “Suicidal Ideation” portion of the Columbia Suicide 
Severity Rating Scale (C–SSRS), or answer “yes” to any of the suicide-related 
behaviors (actual attempt, interrupted attempt, aborted attempt, preparatory 
act or behavior) on the “Suicidal Behavior” portion of the C–SSRS; and the 
ideation or behavior occurred within the past month.
[28] Women who are pregnant or nursing.
[29] Patients who have used opioids or barbiturate containing analgesic >2X per 
month for the treatment of pain in more than 2 of the past 6 months (opioid 
administration in an emergency setting may be an exception).
[30] History of drug or alcohol abuse/dependence within 1 year prior to Visit 1 
(excessive or compulsive use as judged by the Investigator), or currently using 
drugs of abuse (including opioids, barbiturates and marijuana), or any 
prescribed or over-the-counter medication in a manner that the Investigator 
considers indicative of abuse/dependence.
[31] Have a positive urine drug screen for any substances of abuse at Visit 1.  
Note:  A retest is allowed if the urine drug screen is positive for any 
prescribed substance or if, in the judgment of the investigator, there is an 
acceptable explanation for the positive result.  The results of the retest must be 
negative at or prior to Visit 2.
[32] Have a history or presence of any other medical illness including but not 
limited to any autoimmune disorder, cardiovascular, hepatic, respiratory, 
hematological, endocrine, psychiatric or neurological disease, or any clinically 
significant laboratory abnormality, that in the judgment of the investigator, 
indicates a medical problem that would preclude study participation.

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Other Exclusions
[33] In the opinion of the investigator have other issues which would interfere with 
compliance with the study requirements and completion of evaluations 
required for this study.
[34] Are investigator site personnel directly affiliated with this study and/or their 
immediate families.  Immediate family is defined as a spouse, parent, child, or 
sibling, whether biological or legally adopted.
[35] Are Lilly employees.
[36] Are unwilling or unable to comply with the use of a data collection device.
5.3.
Screen Failures
Individuals who do not meet the criteria for participation in this study (screen failure) may be
considered for rescreen once, with approval from Lilly Medical for only the criteria shown 
below.  The interval between screening and rescreening must be at least 45 days or longer if 
required for the specified timeframes in the inclusion/exclusion criteria or concomitant 
medications requirements.  If rescreening is performed, the individual must sign a new ICF and
will be assigned a new identification number.

Inclusion criterion 1.  If patients are less than age 18 at time of informed consent, 
they may be rescreened if they reach age 18 during the study enrollment period.

Inclusion criterion 8 

Exclusion criterion 12

Exclusion criterion 14

Exclusion criterion 16

Exclusion criterion 28
Patients using a concomitant medication that requires a stable dose for a specific duration prior 
to Visit 2 may be rescreened if additional time is needed to meet the duration requirement.
In addition, after consultation with and approval by a Lilly Medical representative, a patient may 
be rescreened if there is an unexpected technical difficulty with the electronic diary capture 
during the prospective baseline period.
5.4.
Lifestyle and/or Dietary Requirements
No changes in lifestyle or dietary requirements are required during the study.  However, patients 
must be in a fasting state for collection of laboratory samples at selected visits specified in 
Appendix 2.

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6.
Treatment
6.1.
Treatments Administered
This study involves a comparison of LY2951742 (120 and 240 mg) administered once monthly 
with placebo.  Sites will administer injections of investigational product (LY2951742 and/or 
placebo) at 6 office visits during the treatment phase (Appendix 2).
Possible injection sites include the abdomen, thigh, and upper arm.  Buttocks may also be used, 
if needed.
The investigator or his/her designee is responsible for the following:

maintaining accurate records of investigational product dispensing

at the end of the study returning all unused medication to Lilly, or its designee,
unless the sponsor and sites have agreed all unused medication is to be destroyed 
by the site, as allowed by local law.
6.1.1.
Medical Devices
The manufactured medical devices provided for use in the study are prefilled syringes.
6.2.
Method of Treatment Assignment
Patients who meet all criteria for enrollment will be randomized to double-blind treatment at
Visit 3.  Assignment to treatment groups will be determined by a computer-generated random 
sequence using an interactive web-response system (IWRS).  The IWRS will be used to assign
double-blind investigational product to each patient. Site personnel will confirm that they have 
located the correctly assigned package by entering the confirmation number found on the
package into the IWRS.
To achieve between-group comparability, the randomization will be stratified by country and 
baseline migraine frequency (<8 migraine headache days versus ≥8 migraine headache days).  To 
ensure an appropriate balance of low- and high-frequency migraine headache day patients, the
sponsor will stop enrollment of low-frequency patients if the number exceeds an estimated 578.
6.2.1. Selection and Timing of Doses
This is a fixed-dose study.  The actual time of all dose administrations will be recorded in the 
patient’s electronic case report form (eCRF).
6.3.
Blinding
This is a double-blind study.
To preserve the blinding of the study, a minimum number of Lilly personnel will see the 
randomization table and treatment assignments before the study is complete.

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Emergency unblinding for AEs may be performed through the IWRS.  This option may be used 
ONLY if the patient’s well-being requires knowledge of the patient’s treatment assignment.  All
unblinding events are recorded and reported by the IWRS.
If an investigator, site personnel performing assessments, or patient is unblinded, the patient 
must be discontinued from the study.  In cases where there are ethical reasons to have the patient 
remain in the study, the investigator must obtain specific approval from a Lilly clinical research 
physician (CRP) or clinical research scientist (CRS) for the patient to continue in the study.
In case of an emergency, the investigator has the sole responsibility for determining if unblinding 
of a patient’s treatment assignment is warranted. Patient safety must always be the first 
consideration in making such a determination. If an emergency unblinding occurs, Lilly must be 
notified as soon as possible.
6.4.
Packaging and Labelling
LY2951742 and matching placebo (excipients only) will be supplied as an injectable solution in 
1-mL, single-dose, prefilled, disposable manual syringes with study specific labels. Each syringe 
of LY2951742 is designed to deliver LY2951742 120 mg.  The syringes (and contents) 
containing either LY2951742 or placebo will be visibly indistinguishable from each 
other. Syringes will be supplied in cartons, with the appropriate quantity of syringes specific to 
the planned dispensing schedule of investigational product.
Clinical trial materials will be labeled according to the country’s regulatory requirements.
6.5.
Preparation/Handling/Storage
Investigational product will be shipped (as prefilled syringes) to sites using cold chain 
transportation.  Investigational product must be stable and stored in a refrigerator at 2ºC to 8ºC 
(35.6ºF to 46.4ºF).
Approximately 30 minutes prior to administration, the syringe should be removed from the 
storage area and allowed to equilibrate at ambient conditions.  The drug product should be kept 
away from direct exposure to bright light (such as sunlight) and hot surfaces until administration.
6.6.
Dose Modification
Dose modifications are not permitted in this study.
6.6.1.Special Treatment Considerations
During the post-treatment follow-up period, patients will not receive LY2951742 or placebo. 
One month after Visit 12, if clinically warranted due to a worsening of symptoms, patients may 
start migraine prevention medications at the discretion of the investigator.  The list of allowed 
preventive medications is provided separately.
6.7.
Treatment Compliance
Investigators will be required to document the administration of investigational product in the 
eCRF.

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Investigational product must be administered as indicated in the Schedule of Activities
(Appendix 2).  If the investigator is unable to administer the investigational product in the 
allowed window, then the situation should be discussed with Lilly to determine if the patient may 
continue.
6.8.
Concomitant Therapy
Table CGAH.3 contains a list of medications that are, and are not, allowed in this study. Note 
that acute treatment of migraine headache is allowed throughout the study but with some 
limitations.  Treatments used for the prevention of migraine are not allowed at any time during 
Study Periods I through III.
Table CGAH.3.
Treatments Allowed and Treatments Not Allowed as Concomitant 
Therapy
Medications allowed for the ACUTE treatment of migraine headaches or other pain or 
injury:
Acetaminophen (paracetamol), NSAIDs; Triptans; Ergotamine and derivatives; Isometheptene mucate, 
dichloralphenazone and acetaminophen combination (Midrin); or combinations thereof.
The following medications are allowed with restrictions:
1.Opioid and barbiturates no more than 3 days/month (SP II, III and IV).
2.Single dose of injectable steroids allowed only once during the study, in an emergency setting (SP III and IV).
Medications, Procedures or Devices not allowed for any reason/indication:
Acetazolamide
Acupuncture
Anticonvulsants/Antiepileptics
Antipsychotics
Beta-blockers
Botulinum toxin applied to head/neck area
Cannabis / Cannabinoids
Chiropractic procedures, physiotherapy, TENS or other electric devices on head and neck
Corticosteroids for oral use
Flunarizine
Herbals with anti-inflammatory effect (feverfew, willow bark, petasites/butterbur), herbals with sympathomimetic 
effect (ma huang, ephedra, bitter orange, synephrine) and herbals with catecholamine transmitter reuptake 
inhibition (St John’s Wort)
Monoamine oxidase inhibitors (MAOIs)
Memantine
Serotonin 5HT2a/2c antagonists, e.g.:  trazodone, nefazodone
Stimulants (prescription strength), e.g.:  methylphenidate, dextroamphetamine, mixed amphetamine salts
Tizanidine
Therapeutic antibodies, e.g.:  adalimumab, infliximab, trastuzumab, bevacizumab, etanercept, etc.
Tricyclic antidepressants (TCAs)
Triptans for prophylaxis of menstrual related migraine
Venlafaxine
Verapamil

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Table CGAH.3.
Treatments Allowed and Treatments Not Allowed as Concomitant 
Therapy (continued)
Restricted medication during SP II-III:  Use of the following medications for indications 
other than migraine prevention is allowed providing the dose is stable 2 months prior to 
Visit 2 and is expected to remain stable during Visit 2 through 12.
ACE inhibitors
Angiotensin receptor blockers (ARBs)
Benzodiazepines
Bupropion 
Calcium-channel blockers (except verapamil and flunarizine)
Clonidine
Guanfacine
Mirtazapine
SSRIs/NRIs/SNRIs (other than venlafaxine)
Use of electric devices (i.e. TENS), physiotherapy, chiropractic procedures on low back and extremities
Restricted medication during SP II-III:  Use of the following medications for indications 
other than migraine prevention is allowed:
Beta-blockers, ophthalmic
Cyclandelate
Cyproheptadine
Melatonin
SP IV (After Visit 12)
One month after Visit 12, if clinically warranted due to a worsening of symptoms, patients may start migraine 
prevention medications at the discretion of the investigator with the exception of antipsychotics, cannabis and 
cannabinoids, MAOIs, memantine, serotonin 5HT2a/2c antagonists, and stimulants, which remain excluded.
6.9.
Treatment after Study Completion
6.9.1. Study Extensions
Not applicable.
6.9.2. Continued Access
Investigational product will not be made available to patients after conclusion of the study.

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7.
Discontinuation Criteria
Patients who discontinue the study or investigational product during the double-blind treatment 
phase (Study Period III) will proceed immediately to Study Period IV.
7.1.
Discontinuation from Study Treatment
7.1.1. Permanent Discontinuation from Study Treatment
Discontinuation of the investigational product is required in cases of pregnancy.
Discontinuation of the investigational product for abnormal liver tests is required when a patient 
meets one of the following conditions and the event is at least possibly related to study drug:

ALT or aspartate aminotransferase (AST) >8X ULN

ALT or AST >5X ULN for more than 2 weeks

ALT or AST >3X ULN and TBL >2X ULN or prothrombin time >1.5X ULN

ALT or AST >3X ULN with the appearance of fatigue, nausea, vomiting, right 
upper-quadrant pain or tenderness, fever, rash, and/or eosinophilia (>5%)

ALP >3X ULN

ALP >2.5X ULN and TBL >2X ULN

ALP >2.5X ULN with the appearance of fatigue, nausea, vomiting, right quadrant 
pain or tenderness, fever, rash, and/or eosinophilia (>5%)
Discontinuation of investigational product also is required in the following cases, if the event is 
at least possibly related to study drug:

Serious allergic reaction to study drug

Serious injection-site reaction

Serious event of suicidality or depression

Serious cerebrovascular event.
Patients who discontinue the investigational product early will have end -of-therapy (early 
termination) procedures performed as shown in the Schedule of Activities (Appendix 2) and are 
requested to proceed into the post-treatment phase.
7.1.2. Temporary Discontinuation from Study Treatment
Not applicable.
7.1.3. Discontinuation of Inadvertently Enrolled Patients
If the sponsor or investigator identifies a patient who did not meet enrollment criteria and was 
inadvertently enrolled, a discussion must occur between the sponsor CRP/CRS and the 
investigator to determine if the patient may continue in the study.  If both agree it is medically 
appropriate to continue, the investigator must obtain documented approval from the sponsor 

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CRP/CRS to allow the inadvertently enrolled patient to continue in the study with or without 
treatment with investigational product.
7.1.4. Permanent Discontinuation from the Study
Some possible reasons that may lead to permanent discontinuation include:

Enrollment in any other clinical trial involving an investigational product or enrollment in 
any other type of medical research judged not to be scientifically or medically compatible 
with this study

Participation in the study needs to be stopped for medical, safety, regulatory, or other 
reasons consistent with applicable laws, regulations, and good clinical practice (GCP)

Investigator Decision
o
the investigator decides that the patient should be discontinued from the study
o
if the patient, for any reason, requires treatment with another therapeutic agent that 
has been demonstrated to be effective for the study indication (prevention of 
migraine) during Study Period III, discontinuation from the study occurs prior to 
introduction of the new agent

Subject Decision
o
the patient asks to be withdrawn from the study
Patients who discontinue the study early will have end-of-study (early termination) procedures 
performed as shown in the Schedule of Activities (Appendix 2) and are requested to proceed into 
the post-treatment phase.
7.1.5. Patients Lost to Follow-Up
A patient will be considered lost to follow-up if he or she repeatedly fails to return for scheduled 
visits and is unable to be contacted by the study site.  Site personnel are expected to make 
diligent attempts to contact patients who fail to return for a scheduled visit or were otherwise 
unable to be followed up by the site.

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8.
Study Assessments and Procedures
Appendix 2 lists the Schedule of Activities, with the study procedures and their timing (including 
tolerance limits for timing).
Appendix 3 lists the laboratory tests that will be performed for this study.
Appendix 4 lists the tests that may be obtained in the event of a treatment-emergent hepatic 
abnormality.
Unless otherwise stated in the subsections below, all samples collected for specified laboratory 
tests will be destroyed within 60 days of receipt of confirmed test results.  Certain samples may 
be retained for a longer period, if necessary, to comply with applicable laws, regulations, or 
laboratory certification standards.
8.1.
Efficacy Assessments
8.1.1. Primary Efficacy Assessments 
ePRO Diary:  Patients will be asked to use an ePRO device (starting at Visit 2) to record 
headache symptoms, duration, and severity.  The device also will be used to collect the name and 
dose of concomitant medications used for the acute treatment of migraine, and the use of other 
pain medications.
8.1.2. Secondary Efficacy Assessments
8.1.2.1.
Patient Global Impression of Severity
The Patient Global Impression of Severity (PGI -S) scale (Guy 1976) is a patient-rated instrument 
that measures baseline illness severity.  The PGI-S includes a range of possible responses, from 1 
(“normal, not at all ill”) to 7 (“extremely ill”).
8.1.2.2.
Patient Global Impression of Improvement
The Patient Global Impression of Improvement (PGI-I) scale (Guy 1976) is a patient-rated
instrument that measures improvement of the patient’s symptoms.  It is a 7-point scale in which a 
score of 1 indicates the patient is “very much better,” a score of 4 indicates the patient has 
experienced “no change,” and a score of 7 indicates the patient is “very much worse.”
8.1.3. Appropriateness of Assessments
All efficacy and safety assessments have been well documented and are generally regarded as
reliable, accurate, and relevant in this patient population.  This includes health outcomes 
measures considered to be appropriate for evaluating changes in quality of life, global 
functioning, and disability (Section 8.9).

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8.2.
Adverse Events
Investigators are responsible for monitoring the safety of patients who have entered this study 
and for alerting Lilly or its designee to any event that seems unusual, even if this event may be 
considered an unanticipated benefit to the patient.
The investigator is responsible for the appropriate medical care of patients during the study.
Investigators must document their review of each laboratory safety report.
The investigator remains responsible for following, through an appropriate health care option, 
AEs that are serious or otherwise medically important, considered related to the investigational 
product or the study, or that caused the patient to discontinue the investigational product before 
completing the study.  The patient should be followed until the event resolves, stabilizes with 
appropriate diagnostic evaluation, or is reasonably explained.  The frequency of follow-up 
evaluations of the AE is left to the discretion of the investigator.
Lack of drug effect is not an AE in clinical studies, because the purpose of the clinical study is to 
establish treatment effect.
After the ICF is signed, study site personnel will record via eCRF the occurrence and nature of 
each patient’s pre-existing condition(s), including clinically significant signs and symptoms of 
the disease under treatment in the study.  In addition, site personnel will record via eCRF any 
change in the condition(s) and any new condition(s) as AEs. Investigators should record their 
assessment of the potential relatedness of each AE to protocol procedure or investigational 
product via eCRF.
The investigator will decide whether he or she interprets the observed AEs as reasonably 
possibly related to migraine headache, to the investigational product, study device, study 
procedure, or other concomitant treatment or pathologies.
The investigator will answer yes/no when making this assessment.
Planned surgeries and nonsurgical interventions should not be reported as AEs unless the 
underlying medical condition has worsened during the course of the study.
If a patient’s investigational product is discontinued as a result of an AE, study site personnel 
must report this to Lilly or its designee via eCRF, clarifying if possible, the circumstances 
leading to discontinuations of treatment.
8.2.1. Serious Adverse Events
An SAE is any AE from this study that results in one of the following outcomes:

death

initial or prolonged inpatient hospitalization

a life-threatening experience (that is, immediate risk of dying)

persistent or significant disability/incapacity

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
congenital anomaly/birth defect

considered significant by the investigator for any other reason:  important medical 
events that may not result in death, be life-threatening, or require hospitalization 
may be considered serious, based upon appropriate medical judgment

when a condition related to the investigational device (for example, prefilled 
syringe) necessitates medical or surgical intervention to preclude either permanent 
impairment of a body function or permanent damage to a body structure, the 
serious outcome of “required intervention” will be assigned
Although all AEs after signing the ICF are recorded in the eCRF, SAE reporting begins after the 
patient has signed the ICF and has received investigational product.  However, if an SAE occurs 
after signing the ICF, but prior to receiving investigational product, it needs to be reported 
ONLY if it is considered reasonably possibly related to study procedure.
Study site personnel must alert Lilly or its designee of any SAE within 24 hours of investigator 
awareness of the event via a sponsor-approved method.  If alerts are issued via telephone, they 
are to be immediately followed with official notification on study-specific SAE forms.  This 24-
hour notification requirement refers to the initial SAE information and all follow-up SAE 
information.
Pregnancy (during maternal or paternal exposure to investigational product) does not meet the 
definition of an AE.  However, to fulfill regulatory requirements, any pregnancy that occurs 
during the study, including those in which conception occurred within 5 months after last 
administration of investigational product, should be reported using the SAE process to collect 
data on the outcome for both mother and fetus.
Investigators are not obligated to actively seek AEs or SAEs in patients once they have 
discontinued and/or completed the study (the patient summary eCRF has been completed).  
However, if the investigator learns of any SAE, including a death, at any time after a patient has 
been discharged from the study, and he/she considers the event reasonably possibly related to the 
study treatment or study participation, the investigator must promptly notify Lilly.
8.2.1.1.
Suspected Unexpected Serious Adverse Reactions
Suspected unexpected serious adverse reactions (SUSARs) are serious events that are not listed 
in the IB and that the investigator identifies as related to investigational product or procedure.  
United States 21 CFR 312.32 and European Union Clinical Trial Directive 2001/20/EC and the 
associated detailed guidance or national regulatory requirements in participating countries 
require the reporting of SUSARs. Lilly has procedures that will be followed for the recording 
and expedited reporting of SUSARs that are consistent with global regulations and the associated 
detailed guidance.
8.2.1.2.
Adverse Event Monitoring with a Systematic Questionnaire
Suicidality will be assessed as required by the US Food and Drug Administration’s Division of 
Neurology for use in clinical trials involving all drugs for neurological indications. Before 
administering the C-SSRS) [Posner et al. 2011]), study site personnel will question the patient 

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about any change in the pre-existing condition(s) and the occurrence and nature of any AEs.  
Nonserious AEs obtained through the questionnaire are recorded and analyzed separately. Only 
serious AEs and AEs leading to discontinuation elicited through the C-SSRS are to be recorded 
as AEs via eCRF.  Serious adverse events must be reported to Lilly or its designee within 
24 hours as SAEs.  Any suicidal behavior, or suicidal ideation per items 4 or 5 (active suicidal 
ideation with some intent to act, either without specific plan or with specific plan and intent) 
would prompt referral of the patient to a mental health professional.
8.2.2. Complaint Handling
Lilly collects product complaints on investigational products and drug delivery systems used in 
clinical studies in order to ensure the safety of study participants, monitor quality, and to 
facilitate process and product improvements.
Patients will be instructed to contact the investigator as soon as possible if he or she has a
complaint or problem with the investigational product (or drug delivery system such as a 
prefilled syringe) so that the situation can be assessed.
8.3.
Treatment of Overdose
No data are available at this stage of development.
8.4.
Safety Assessments
8.4.1. Electrocardiograms
For each patient, a single, 12-lead digital ECG will be collected at the visits shown in the 
Schedule of Activities (Appendix 2). Electrocardiograms will have a central overread and 
should be recorded according to the study-specific recommendations included in the ECG
manual.
Any clinically significant findings from ECGs that result in a diagnosis should be reported to 
Lilly or its designee as an AE via eCRF.
8.4.2. Vital Signs
Vital signs will include body temperature, blood pressure, and pulse.  Blood pressure and pulse 
will be measured in triplicate in the sitting position prior to blood draws and study drug 
administration (see Study Schedule [Appendix 2]).
Any clinically significant findings from vital signs measurement that result in a diagnosis should 
be reported to Lilly or its designee as an AE via eCRF.
8.4.3. Laboratory Tests
For each patient, laboratory tests detailed in Appendix 3 should be conducted according to the 
Schedule of Activities (Appendix 2).
Any clinically significant findings from laboratory tests that result in a diagnosis should be 
reported to Lilly or its designee as an AE via eCRF.

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In addition, an immunogenicity plasma sample will be collected, when possible, for any patient 
who experiences a potential systemic allergic/hypersensitivity reaction during the study as 
judged by the investigator. This immunogenicity plasma sample should be collected 
immediately or as soon as possible, taking into consideration the availability and wellbeing of 
the patient. Exact date and time of the sample should be recorded on the laboratory requisition 
form.
8.4.4. Other Tests
Not applicable.
8.4.5. Safety Monitoring
Investigators are responsible for monitoring individual patient safety throughout the trial. If a 
study patient/subject experiences elevated ALT ≥3X ULN, ALP ≥2X ULN, or elevated 
TBL ≥2X ULN, clinical and laboratory monitoring should be initiated by the 
investigator. Details for hepatic monitoring depend upon the severity and persistence of 
observed laboratory test abnormalities. To ensure patient/subject safety and comply with 
regulatory guidance, the investigator is to consult with the Lilly CRP/CRS regarding collection 
of specific recommended clinical information and follow-up laboratory tests. See Appendix 4.
Neurological examinations will be conducted at screening, Month 3 and Month 6 of treatment, as 
well as at the final visit of the follow-up period or early termination visit in order to assess for 
any signs of pre-existing or treatment-emergent neurological abnormalities such as stroke or 
other cerebrovascular events.  If a study patient experiences signs of a cerebrovascular event, 
appropriate follow-up and clinical management should be conducted by the investigator, and the 
Lilly CRP/CRS should be consulted regarding collection of further clinical information and 
follow-up testing.
Lilly will periodically review evolving aggregate safety data within the study by appropriate 
blinded methods.  In addition, safety data for the trial will also be reviewed periodically by an 
independent Data Monitoring Committee (DMC; an advisory group for this study formed to 
protect the integrity of data; refer to Interim Analyses section [Section 9.8]).  In the event that 
safety monitoring uncovers an issue that needs to be addressed by unblinding at the group level, 
members of the DMC can request additional analyses of the safety data.
8.5.
Pharmacokinetics
At the visits and times specified in the Schedule of Activities (Appendix 2), venous blood
samples of approximately 2.5 mL each will be collected to determine the serum concentrations 
of LY2951742.  A maximum of 3 samples may be collected at additional time points during the 
study if warranted and agreed upon between both the investigator and sponsor.  Instructions for 
the collection and handling of blood samples will be provided by the sponsor.
When a blood sample is collected, the time and date of last dose administration prior to blood 
sampling should be recorded.  The actual date and time (24-hour clock time) of each sampling 
will be recorded.  LY2951742 concentration information that may/would unblind the study will 

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not be reported to investigative sites or blinded personnel until the study has been unblinded.  
Bioanalytical samples collected to measure investigational product concentration will be retained 
for a maximum of 1 year following last patient visit for the study.
A validated assay will be used to determine serum LY2951742 concentrations.  Samples will be 
analyzed at a laboratory approved by the sponsor.
It is intended that blood samples collected from patients who received placebo should not be 
analyzed for determination of serum concentrations of LY2951742.
8.6.
Pharmacodynamics
At the visits and times specified in the Schedule of Activities (Appendix 2), venous blood 
samples will be collected to determine the plasma concentrations of CGRP.  A maximum of 3 
samples may be collected at additional time points during the study if warranted and agreed upon 
between both the investigator and sponsor.  Instructions for the collection and handling of blood 
samples will be provided by the sponsor.  When a blood sample is collected, the time and date of 
last dose administration prior to blood sampling should be recorded.  The actual date and time 
(24-hour clock time) of each sampling will be recorded.
A validated LY2951742-tolerant assay will be used to determine plasma CGRP concentrations.  
Samples will be analyzed at a laboratory approved by the sponsor.
Plasma CGRP concentration information that may/would unblind the study will not be reported 
to investigative sites or blinded personnel until the study has been unblinded.
Bioanalytical samples collected to measure CGRP will be identified by the patient number 
(coded) and retained for a maximum of 1 year following last patient visit for the study at a 
facility selected by the sponsor.
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8.8.
Biomarkers
Blood samples for non-genetic biomarker research will be collected at the times specified in the 
Schedule of Activities (Appendix 2), where local regulations and ERBs allow.
Samples will be used for research on the drug target, disease process, pathways associated with 
migraine headache and/or other pain conditions, mechanism of action of LY2951742, and/or 
research method or in validating diagnostic tools or assay(s) related to migraine headache and/or 
other pain conditions.
All biomarker samples will be coded with the patient number.  These samples and any data 
generated can be linked back to the patient only by the investigator site personnel.  Samples will 
be destroyed according to a process consistent with local regulations.
Samples will be retained for a maximum 15 years after the last patient visit for the study, or for a 
shorter period if local regulations and ERBs impose shorter time limits, at a facility selected by 
the sponsor.  This retention period enables use of new technologies, response to regulatory 
questions, and investigation of variable response that may not be observed until later in drug 
development or when the drug is commercially available.
8.8.1. Samples for Immunogenicity Research
Where local regulations and ERBs allow, blood samples for immunogenicity testing will be 
collected to determine antibody production against LY2951742 as specified in the Schedule of 
Activities (Appendix 2). Immunogenicity will be assessed by a validated assay designed to 
detect anti-drug antibodies in the presence of the investigational product.  Antibodies may be 
further characterized and/or evaluated for their ability to neutralize the activity of LY2951742.
Samples will be retained for a maximum of 15 years after the last patient visit for the study, or 
for a shorter period if regulations and ERBs impose shorter time limits, at a facility selected by 
the sponsor.  The duration allows the sponsor to respond to future regulatory requests related to 
LY2951742.
8.9.
Health Economics
Health economic, disability and quality of life assessments of LY2951742 in patients with 
migraine will be based on the following scales:
Migraine Disability Assessment test (MIDAS): The MIDAS was designed to quantify 
headache-related disability over a 3-month period.  This instrument consists of five items that 
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reflect the number of days reported as missing, or with reduced productivity at work or home and 
social events; a higher value is indicative of more disability (Stewart 1999; Stewart 2001).  This 
instrument is considered highly reliable and valid; and is correlated with clinical judgment 
regarding the need for medical care (Stewart 1999; Stewart 2001).
Migraine Specific Quality of Life questionnaire (MSQ v2.1): The MSQ v2.1 is a self-
administered health status instrument, and was developed to address physical and emotional 
limitations of specific concern to individuals suffering from migraine headaches. The instrument 
consists of 14 items that address 3 domains:  (1) Role Function-Restrictive; (2) Role Function-
Preventive; and, (3) Emotional Function (Jhingran 1998).  The instrument was designed with a 4-
week recall period, and is considered reliable, valid and sensitive to change in migraine (Jhingran 
1998; Rendas-Baum 2013). Clinically meaningful differences for each domain have been 
established and are widely used in the literature.

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9.
Statistical Considerations and Data Analysis
9.1.
Determination of Sample Size
The study will enroll approximately 825 patients. Eligible patients will be randomized in 
blinded fashion in a 2:1:1 ratio to placebo (target of 413 patients), LY2951742 120 mg/month 
(target of 206 patients), or 240 mg/month (target of 206 patients).  With the assumption of a 26% 
discontinuation rate and an effect size of 0.33, it is estimated that this sample size will provide 
approximately 95% power that at least 1 dose of LY2951742 will separate from placebo at a 
two-sided significance level of 0.05 based on simulations using Dunnett (Dunnett 1955) test.
Assumptions in the simulations were based on data from two double-blind, placebo-controlled, 
Phase 2 studies, with adjustment to reflect the longer treatment duration and greater variability 
expected in a larger, multi-country Phase 3 study.
Approximately 100 sites in 11 countries are planned for inclusion in Study CGAH, with an 
average of approximately 8 patients to be randomized at each investigative site.  The final 
number of sites, countries, and patients per site may vary depending on sites’ enrollment rates.
Approximately 1557 patients may be screened to ensure randomization of 825 patients, with an 
estimated 611 patients completing the study.
9.2.
General Statistical Considerations
Statistical analysis of this study will be the responsibility of Lilly or its designee.  Details of 
statistical analysis methods will be described in the statistical analysis plan (SAP) document.
Unless otherwise specified, analyses will be conducted on an intent-to-treat (ITT) population, 
which will include all patients who are randomized and receive at least one dose of 
investigational product.  Patients in the ITT population will be analyzed according to the 
treatment group to which they are randomized. When change from baseline is assessed, the 
patient will be included in the analysis only if he/she has a baseline and a postbaseline 
measurement.
The primary analysis will be performed using a restricted maximum likelihood-based mixed 
models repeated measures (MMRM) technique with prespecified model terms (Section 9.4.1).
Visitwise binary efficacy variables will be analyzed using a generalized linear mixed model 
(GLIMMIX) as pseudo-likelihood-based mixed effects repeated measures analysis.
In addition to the MMRM approach, analysis of covariance (ANCOVA) model or analysis of 
variance (ANOVA) with the last observation carried forward (LOCF) will also be implemented. 
When an ANCOVA model is used to analyze a continuous variable, the model will contain the 
main effects of treatment and region, as well as the continuous fixed covariates of baseline.  The 
ANOVA model will use the same terms except the continuous fixed covariate of baseline.  
Type III sum-of-squares for the least-squares means will be used for the statistical comparisons.
Continuous efficacy and health outcome endpoints will be analyzed using MMRM methods, as 
well as an ANCOVA model with LOCF imputation if deemed appropriate.

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Categorical comparisons between treatment groups will be performed using Cochran-Mantel-
Haenszel (CMH) controlling for region or using the Fisher’s exact test, where appropriate.
Patients will be pooled within each region for statistical analysis purposes.  Region will be 
defined in the SAP.
All tests of treatment effects will be conducted at a 2-sided alpha level of 0.05, unless otherwise 
stated.
Any change to the data analysis methods described in the protocol will require an amendment 
ONLY if it changes a principal feature of the protocol.  Any other change to the data analysis 
methods described in the protocol, and the justification for making the change, will be described 
in the clinical study report or SAP.  Changes may only be made in the SAP prior to unblinding.  
Additional exploratory analyses of the data will be conducted as deemed appropriate.
9.3.
Treatment Group Comparability
9.3.1. Patient Disposition
The number and percentage of ITT patients who complete the study or discontinue early will be 
summarized for all treatment groups for Study Period III (double-blind treatment) and Study 
Period IV (post-treatment follow-up) both overall and by visit.
Patient allocation by investigator will be summarized for Study Period III for all ITT patients. 
Patient allocation by investigator will also be listed for all study periods.
9.3.2. Patient Characteristics
The following patient characteristics at baseline will be summarized by treatment group for all 
ITT patients:

Demographic (age, gender, ethnic origin, height, weight, body mass index)

Migraine headache, headache, variation of migraine/headache measures per 30-
day baseline period.

Alcohol, tobacco, caffeine and nicotine consumption

Medical history and pre-existing condition
Medical history and pre-existing conditions will be summarized by preferred term within system 
organ class (SOC).
9.3.3. Concomitant Therapy
The proportion of patients who received concomitant medication (as recorded via eCRF) as well 
as abortive medications (recorded through ePRO) will be summarized for all ITT patients for 
Study Period III and Study Period IV separately.
9.3.4. Treatment Compliance
Not applicable.

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9.3.5. Electronic Patient-reported OutcomeDiaryCompliance
ePRO diary com
pliance at each period (including baseline, Month 1, 2, 3, … till Month 10) will 
becalculated.  Diary com
pliance at each period is calculated as:
Actual number of diary days in the period
Expected number of diary days in the period∗100
Actual number of diary days is calculated as the total number of days with non-missing answers.
9.4. Primary and Secondary Analyses
9.4.1. Primary Analyses
The primary efficacy
 measure is the overall mean change from the baseline period in thenumber 
ofmonthly migraine headache dayduring the 6-monthdouble-blindtreatment phase, and the 
primary analysis will evaluate the efficacy of LY2951742(120 or 240 mg/month) compared with 
placebo.
The primary analysis will be performed using a restricted maximum likelihood-based MMRM 
technique.  The analysis will include the fixed categorical effects of treatment, region, m
onth, 
and treatment-by-month interaction, as well as the continuous fixed covariates of baseline 
number of migraine headache days and baseline number of migraine headache days-by-month
interaction.
An unstructured covariance structure will be used to model wi
thin-patient errors.  The Kenward-
Roger (Kenward and Roger 1997) approximation will be used to estimate denominator degrees 
of f
reedom. If the model does not converge with both the Hessian and the G matrix being 
positive definite under the default fitting algorithm used by PROC MIXED, the Fisher scoring 
algorithm will
 be implemented by specifying the SCORING option in SAS. If the model still 
fails to converge, the model will be fit using covariance matrices of the following order specified 
by a decreasing number of covariance parameters until convergence is met:
• Heterogeneous Toeplitz
• Heterogeneous First-order autoregressive
• Toeplitz
• First-order autoregressive
When the unstructured covariance matrix is not utilized, the sandwich estimator (Diggle and
Kenward 1994) will be used to estimate the standard errors of the fixed effects parameters.  The 
sandwich estimator is implemented by specifying the EMPIRICAL option in SAS
®.  When the 
sandwich estimator is utilized, the Kenward-Roger approximation for denominator degrees of 
freedom cannot be used.  Instead, the denominator degrees of freedom will be partitioned into 
between-subject and within-subject portions by the DDFM=BETWITHIN option in SAS
®.  
SAS®PROC MIXED will be used to perform the analysis.

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9.4.2. Key Secondary Analyses
The key secondary objectives (see Table CGAH.1) will be tested using an appropriate multiple 
testing approach providing strong control of the familywise error rate (for the primary and key 
secondary tests) at a one-sided 0.025 alpha level (or, equivalently, two-sided 0.05 alpha level).
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There will be no adjustments for multiplicity for analyses of other endpoints.  If the multiple 
testing approach for key secondary measures only need s to be changed, the updated approach 
will be provided in the SAP, and it should not lead to modification of this protocol.
The key secondary measures will be analyzed for the double-blind treatment (Study Period III).
For the continuous key secondary measures, the change from baseline during the 6-month 
double-blind treatment phase will be analyzed from repeated measures analyses as described in 
Section 9.4.1.  For the analysis of 50%, 75%, and 100% response, the percentage of patients 
meeting response criteria during the 6-month double-blind treatment phase will be estimated for 
each treatment from a categorical, pseudo-likelihood-based repeated measures analysis of 
longitudinal binary outcomes indicating whether patients meet response criteria.
This analysis will be implemented using the GLIMMIX procedure in SAS.
9.4.3. Other Secondary and Tertiary Efficacy Analyses
The other secondary and exploratory efficacy analyses will be conducted for the double-blind 
treatment phase, and for the double-blind treatment and post-treatment follow-up phases (Study 
Period III and Study Period IV) combined.  Further details regarding other secondary and tertiary 
efficacy analyses are summarized in the SAP.
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9.5.
Safety Analyses
The safety analyses will be conducted for the double-blind treatment and post-treatment follow-
up phases, as well as the two periods combined.  For the two phases combined, only repeated 
measures and time-to-event analyses will be conducted.
The safety and tolerability of treatment will be assessed by summarizing the following:

adverse events
o
treatment-emergent adverse events (TEAEs)

by preferred term

by SOC

by maximum severity

by outcome

considered to be related to investigational product by investigator
o
serious adverse event
o
adverse event leading to discontinuation

Suicidal ideation and behaviors assessed by solicited questioning using the C-
SSRS

Vital signs and weight

electrocardiograms

Laboratory measurements

Anti-LY2951742 antibody
9.5.1. Categorical Safety Variables
Unless specified otherwise, the categorical safety analyses will include both schedule and 
unscheduled visits.
Comparisons between treatment groups for all categorical safety measures will be made using 
the Fisher’s exact test for Study Period III (double-blind treatment) with the ITT population.  
Descriptive statistics only will be presented for the treatment groups in the post-treatment 
follow-up phase (Study Period IV) with the post-treatment population.
9.5.2. Adverse Events
Treatment-emergent adverse events are defined as the reported AEs that first occurred or 
worsened during the postbaseline phase compared with baseline phase.  For each TEAE, the 
severity level of the event (mild, moderate, or severe) will be determined by patient or physician 
opinion.  The Medical Dictionary for Regulatory Activities (MedDRA) Lowest Level Term will 
be used in the treatment-emergent computation.  For each Lowest Level Term, the maximum 
severity at baseline will be used as the baseline severity.  If the maximum severity during 

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postbaseline is greater than the maximum baseline severity, the event is considered to be 
treatment-emergent for the specific postbaseline period.  For each patient and TEAE, the 
maximum severity for the MedDRA level being displayed (PT, High Level Term, or SOC) is the 
maximum postbaseline severity observed from all associated Lowest Level Terms mapping to 
that MedDRA level.
For events that are gender-specific, the denominator and computation of the percentage will 
include only patients from the given gender.
9.5.3. Suicide-Related Thoughts and Behaviors
Suicidal ideation, suicidal behavior, and non-suicidal self-injurious behavior based on the 
C-SSRS will be summarized by treatment group.  For each of the following events, the number 
and percentage of patients with the event will be enumerated by treatment:  completed suicide, 
non-fatal suicide attempt, interrupted attempt, aborted attempt, preparatory acts or behavior, 
active suicidal ideation with specific plan and intent, active suicidal ideation with some intent to 
act without specific plan, active suicidal ideation with any methods (not plan) without intent to 
act, non-specific active suicidal thoughts, wish to be dead, and non-suicidal self-injurious 
behavior.  In addition, the number and percentage of patients who experienced at least one of the
composite measures during Study Period III and Study Period IV separately will be presented
and compared.  These include suicidal acts (completed suicide and nonfatal suicidal attempts), 
suicidal behavior (suicidal acts, interrupted attempts, aborted attempts, and preparatory acts or 
behavior), treatment-emergent suicidal ideation or treatment-emergent suicidal behavior.
The Fisher’s exact test will be used for treatment comparisons.
9.5.4. Vital Signs and Weight
Vital signs collected during the study include systolic and diastolic blood pressure, pulse, and 
temperature.  Blood pressure and pulse measurements will be taken when the patient is in a 
sitting position. Three measurements of sitting blood pressure and pulse will be collected at 
every visit; the 3 sitting blood pressure and pulse measurements will be averaged and used as the 
value for that visit for analysis.
The incidence rates of patients with treatment-emergent vital sign and weight changes based at 
any time postbaseline and at LOCF endpoint will be assessed using the Fisher’s exact test.  
Specific criteria for treatment emergent definition will be documented in the SAP.
9.5.5. Electrocardiogram Intervals and Heart Rate
Analyses of corrected QT interval will be calculated using two correction formulas.  The QTcF 
(measured in milliseconds [msec]) will be calculated with Fridericia’s formula as QT/RR⅓.  The 
Large Clinical Trial Population Based QT Correction (QTcLCTPB) (msec) will be calculated 
with the formula as QT/RR0.413.  The number and percent of patients meeting criteria for 
treatment-emergent abnormalities in ECG intervals (pulse rate [PR], QRS, QTcF, and 
QTcLCTPB) and heart rate at any time during study will be summarized.  Treatment group 
comparisons will be performed using the Fisher’s exact test.

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9.5.6. Laboratory Tests
The incidence rates of patients with treatment-emergent abnormal, high, or low laboratory values 
at any time postbaseline and at LOCF endpoint will be assessed using the Fisher’s exact test for 
each laboratory test.
Patients will be defined as having a treatment-emergent low value if they have all normal or high 
values at baseline, followed by a value below the lower reference limit at any postbaseline visit.  
Patients with all normal or high values at baseline (no low values) will be included in the 
analysis of treatment-emergent low laboratory values.  Patients will be defined as having a 
treatment-emergent high value if they have all normal or low values at baseline, followed by a 
value above the upper reference limit at any postbaseline visit.  Patients with all normal or low 
values at baseline (no high values) will be included in the analysis of treatment-emergent high 
laboratory values.
For analytes simply classified as normal or abnormal, patients will be defined as having a 
treatment-emergent abnormal value if they have all normal values at baseline, followed by an 
abnormal value at any postbaseline visit.  Patients with all normal values at baseline will be 
included in the analysis of treatment-emergent abnormal laboratory values.
9.7.
Other Analyses
9.7.1. Health Economics
The change from baseline to each postbaseline visit for the double-blind treatment phase and for 
the double-blind treatment and post-treatment follow-up phases combined for MSQ v2.1 (Role 
Function-Restrictive, Role Function-Preventive, Emotional Function, and total score) and
MIDAS (item scores and total score) will be analyzed.  In addition, categorical analysis for the 
frequency measure will be performed.
9.7.2. Subgroup Analyses
Subgroup analyses will be performed for the primary efficacy measure (change from baseline in 
the number of migraine headache days) separately for each of the subgroup populations listed in 
Table CGAH.4.  Subgroup analyses will be conducted only for the ITT patients in Study Period 
III.
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Each of the subgroup analyses for the primary measure of change from baseline in the number of 
migraine headache days will be conducted using MMRM. The same MMRM model described 
in Section 9.4.1 will be used, with terms of subgroup, subgroup-by-treatment, subgroup-by-
month, and subgroup-by-treatment-by-month interactions added as additional co variates.
Table CGAH.4.
Definition of Subgroup Variables
Subgroup Variable
Categories

Sex
Male, female

Racial Origin (combine those with 
less than 10%)
American Indian / Alaskan Native
Asian
Black / African American
Native Hawaiian / Pacific Islander
White
Multiple

Ethnicity
Hispanic or Latino
Not Hispanic or Latino

Region
Defined in the statistical analysis plan (SAP)

Baseline number of migraine 
headache days
2 levels of baseline migraine frequency :

<8 migraine headache days

≥8 migraine headache days

Treatment-resistant status
Treatment-resistant status about whether a patient has failed 2 or 
more prophylactic treatments (Yes or No)

Having aura or not (during baseline 
period)
Yes or No

Baseline anti-drug antibody status
Any confirmed positive anti-drug antibody at baseline (Yes 
versus No)

Neutralizing anti-drug antibody
status
Any positive neutralizing anti-drug antibody time point (Yes 
versus No) – note that neutralizing ADA assays are performed 
only on confirmed-positive anti-drug antibodies .

Treatment-emergent anti-drug 
antibody status
Any treatment-emergent anti-drug antibody (Yes versus No)
9.8.
Interim Analyses
Two interim analyses are anticipated for this study.  The first possible interim analysis will occur 
during Study Period III (double-blind treatment) and could result in stopping the trial for safety 
or futility.  This analysis is planned to occur when approximately 330 (40% of the total sample 
size) randomized patients have had the chance to complete at least 3 months of the treatment 
period.  The interim analysis will be conducted by an independent data monitoring committee 
(DMC) with members external to Lilly.  The data from the interim analysis will be used to 
evaluate whether to stop or modify the study for futility and/or safety issues.  Stopping rules for 
futility at this interim analysis will be based on the conditional power of comparing LY2951742 
to placebo.  Specifically, conditional power represents the probability that the ongoing trial will 

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result in a statistically significant difference between LY2951742 and placebo at end of the trial, 
based on the data available at the time of the interim analysis.  Rules for stopping the study are 
detailed in the Statistical Analysis Center SAP and the DMC Charter.  Only the DMC is 
authorized to evaluate unblinded interim efficacy and safety analyses.  Study sites will receive 
information about interim results ONLY if they need to know for the safety of their patients.  
There is no inflation of type 1 error due to the conduct of a futility analysis (Snapinn et al. 2006), 
so no adjustment to the nominal significance level will be made for the primary analysis as a 
result of a futility assessment.
The second interim analysis will be conducted after all patients have had the opportunity to 
complete Study Period III, and thus, will be the final analysis of the primary efficacy endpoint.
Unblinding details are specified in the unblinding plan section of the SAP or a separate 
unblinding plan document.
Additional interim analyses may be conducted in support of regulatory submissions if necessary.

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10. Study Governance Considerations
10.1. Regulatory and Ethical Considerations, Including the Informed 
Consent Process
10.1.1. Informed Consent
The investigator is responsible for ensuring:

that the patient understands the potential risks and benefits of participating in the 
study

that informed consent is given by each patient.  This includes obtaining the
appropriate signatures and dates on the ICF prior to the performance of any 
protocol procedures and prior to the administration of investigational product.

answering any questions the patient may have throughout the study and sharing in 
a timely manner any new information that may be relevant to the patient’s
willingness to continue his or her participation in the trial.
10.1.2. Ethical Review
The investigator must give assurance that the ERB was properly constituted and convened as 
required by International Conference on Harmonisation (ICH) guidelines and other applicable 
laws and regulations.
Documentation of ERB approval of the protocol and the ICF must be provided to Lilly before the 
study may begin at the investigative site(s).  Lilly or its representatives must approve the ICF, 
including any changes made by the ERBs, before it is used at the investigative site(s).  All ICFs
must be compliant with the ICH guideline on GCP.
The study site’s ERB(s) should be provided with the following:

the current IB and updates during the course of the study

informed consent document

relevant curricula vitae
10.1.3. Regulatory Considerations
This study will be conducted in accordance with:

consensus ethics principles derived from international ethics guidelines, including 
the Declaration of Helsinki and Council for International Organizations of
Medical Sciences (CIOMS) International Ethical Guidelines

applicable ICH GCP guidelines

applicable laws and regulations
Some of the obligations of the sponsor will be assigned to a third-party organization (TPO).

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10.1.4. Investigator Information
Investigators in this clinical trial should be neurologists, headache specialists, or other specialists 
with experience in headache clinical trials and treating migraine headache patients.
10.1.5. Protocol Signatures
The sponsor’s responsible medical officer will approve the protocol, confirming that, to the best 
of his or her knowledge, the protocol accurately describes the planned design and conduct of the 
study.
After reading the protocol, each principal investigator will sign the protocol signature page and 
send a copy of the signed page to a Lilly representative.
10.1.6. Final Report Signature
The clinical study report (CSR) coordinating investigator will sign the final CSR for this study, 
indicating agreement that, to the best of his or her knowledge, the report accurately describes the 
conduct and results of the study.
An investigator selected by the study team will serve as the CSR coordinating investigator.  If 
this investigator is unable to fulfill this function, another investigator will be chosen by Lilly to 
serve as the CSR coordinating investigator.
The sponsor’s responsible medical officer and statistician will approve the final CSR for this 
study, confirming that, to the best of his or her knowledge, the report accurately describes the 
conduct and results of the study.
10.2. Data Quality Assurance
To ensure accurate, complete, and reliable data, Lilly or its representatives will do the following:

provide instructional material to the study sites, as appropriate

sponsor start-up training to instruct the investigators and study coordinators.  This 
training will give instruction on the protocol, the completion of the eCRFs, and 
study procedures.

make periodic visits to the study site

be available for consultation and stay in contact with the study site personnel by 
mail/e-mail, telephone, and/or fax

review and evaluate eCRF data and use standard computer edits to detect errors in 
data collection

conduct a quality review of the database
In addition, Lilly or its representatives will periodically check a sample of the patient data
recorded against source documents at the study site.  The study may be audited by Lilly or its 
representatives, and/or by regulatory agencies at any time.  Investigators will be given notice 
before an audit occurs.

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To ensure the safety of participants in the study, and to ensure accurate, complete, and reliable
data, the investigator will keep records of ECGs, laboratory tests, clinical notes, and patient
medical records in the patient files as original source documents for the study according to 
retention requirements as outlined by the ICH guidelines.  If requested, the investigator will 
provide the sponsor, applicable regulatory agencies, and applicable ERBs with direct access to 
original source documents.
10.2.1. Data Capture System
An electronic data capture system will be used in this study.  The site maintains a separate source 
for the data entered by the site into the sponsor-provided electronic data capture system.
Some or all of a patient’s data will be directly entered into the eCRF at the time the information 
is obtained. In instances where direct data entry is not used, the site will maintain source 
documentation in the trial files, and the patient’s data will be transcribed into the eCRF.  Any 
data for which the eCRF will serve as the source document, or any other data not entered directly 
into the eCRF, will be identified and documented by the site in the site’s trial file. For data 
handled by a data management TPO, eCRF data and some or all data that are related will be 
managed and stored electronically in the TPO system.  Subsequent to the final database lock, 
validated data will be transferred to the sponsor. For data handled internally, eCRF data and 
some or all data that are related will be managed by the sponsor and stored electronically in the 
sponsor’s system.
In this study, patient migraine headache data will be collected directly via an ePRO diary as part 
of an ePRO/Clinical Outcome Assessment (COA) system. Patient-rated scales/questionnaires 
will be collected directly via an ePRO tablet device at each visit.  Data entered into the 
ePRO/COA system will serve as the source data.
If ePRO/COA records are stored at a third-party site, investigator sites will have continuous 
access to the source documents during the study and will receive an archival copy at the end of 
the study for retention.
Any data for which the ePRO/COA instrument record will serve to collect source data will be 
identified and documented by each site in that site’s study file.
Case report form data will be encoded and stored in a clinical trial database.  Data managed by a 
central vendor, such as laboratory test data or ECG data, will be stored electronically in the 
central vendor’s database system.  Data will subsequently be transferred from the central vendor 
to the Lilly data warehouse. Data from complaint forms submitted to Lilly will be encoded and 
stored in the global product complaint management system.

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10.3. Study and Site Closure
10.3.1. Discontinuation of Study Sites
Study site participation may be discontinued if Lilly or its designee, the investigator, or the ERB 
of the study site judges it necessary for medical, safety, regulatory, or other reasons consistent 
with applicable laws, regulations, and GCP.
10.3.2. Discontinuation of the Study
The study will be discontinued if Lilly or its designee judges it necessary for medical, safety, 
regulatory, or other reasons consistent with applicable laws, regulations, and GCP.

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11. References
Diggle P, Kenward MG. Informative drop-out in longitudinal data analysis. J Royal Statist Soc 
Series C: Appl Statist. 1994;43(1):49-93.
Goadsby PJ, Edvinsson L. The trigeminovascular system and migraine: Studies characterizing 
cerebrovascular and neuropeptide changes seen in humans and cats. Ann Neurol. 
1993;33(1):48-56.
Goadsby PJ, Edvinsson L, Ekman R. Vasoactive peptide release in the extracerebral circulation 
of humans during migraine headache. Ann Neurol. 1990;28(2):183-187.
Guy W. ECDEU assessment manual for psychopharmacology, revised 1976. Rockville, MD: 
National Institute of Mental Health, Psychopharmacology Research Branch. p 217-222. 
Available at: https://archive.org/details/ecdeuassessmentm1933guyw. Accessed January 11,
2016.
[ICHD-3] Headache Classification Committee of the International Headache Society (IHS). The 
International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 
2013;33(9):629-808.
Jhingran P, Osterhaus JT, Miller DW, Lee JT, Kirchdoetfer L. Development and validation of 
the migraine-specific quality-of-life questionnaire. Headache. 1998;38(4):295-302.
Kenward MG, Roger JH. Small sample inference for fixed effects from restricted maximum 
likelihood. Biometrics. 1997;53(3):983-997.
Lassen LH, Haderslev PA, Jacobsen VB, Iversen HK, Sperling B, Olesen J. CGRP may play a 
causative role in migraine. Cephalalgia. 2002;22(1):54-61.
Lassen LH, Jacobsen VB, Pedersen PA, Sperling B, Iversen H, Olesen J. Human calcitonin gene-
related peptide (hCGRP)-induced headache in migraineurs. Eur J Neurol. 
1998;5(suppl 3):S63.
Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Currier GW, Melvin 
GA, Greenhill L, Shen S, Mann JJ. The Columbia-Suicide Severity Rating Scale: initial 
CCI
CCI
CCI
CCI
CCI

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validity and internal consistency findings from three multisite studies with adolescents and 
adults.Am J Psychiatry. 2011;168(12):1266-1277.
Rendas-BaumR, Bloudek LM, Maglinte GA, Varon SF. The psychometric properties of the 
Migraine-Specific Qualityof Life Questionnaire version 2.1 (MSQ) in chronic migraine
patients. Qual Life Res.2013;22(5):1123–1133.
Rizzoli P. Preventive pharmacotherapy in migraine. Headache. 2014;54(2):364-369.
Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based 
guideline update: Pharmacologic treatment for episodic migraine prevention in adults: Report 
of the Quality Standards Subcommittee of the American Academy of Neurology and the 
American Headache Society. Neurology. 2012;78(17):1337-1345.
Snapinn S, Chen MG, Jiang Q, Koutsoukos T. Assessment of futility in clinical trials. Pharm 
Stat.2006;5(4):273–281.
Stewart WF, Lipton RB, Dowson AJ, Sawyer J. Development and testing of theMigraine 
Disability Assessment (MIDAS) Questionnaire to assess headache-related disability (abstract). 
Neurology. 2001;56 (6 Suppl 1):S20–S28.
Stewart WF, Lipton RB, Kolodner K, Liberman J, Sawyer J. Reliability of the migraine 
disability assessment score in a population-based sample of headache sufferers. Cephalalgia
1999;19(2):107-114.
Villalón CM, Olesen J. The role of CGRP in the pathophysiology of
 migraine and efficacy
 of
 
CGRP receptor antagonists as acute antimigraine drugs. Pharmacol Ther. 
2009;124(3):309-323.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with 
disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic 
analysis for the Global Burden of Disease Study 2010. Lancet.2012;380(9859): 2163-2196.

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Appendix 1.
Abbreviations and Definitions
Term
Definition
AE
adverse event:  Any untoward medical occurrence in a patient or clinical investigation 
subject administered a pharmaceutical product that does not necessarily have a causal 
relationship with this treatment.  An adverse event can therefore be any unfavorable and 
unintended sign (including an abnormal laboratory finding), symptom, or disease 
temporally associated with the use of a medicinal (investigational) product, whether or
not related to the medicinal (investigational) product.
complaint
A complaint is any written, electronic, or oral communication that alleges deficiencies 
related to the identity, quality, purity, durability, reliability, safety or effectiveness, or 
performance of a drug or drug delivery system.
CRP/CRS
Lilly Clinical Research Physician/Clinical Research Scientist
enroll
The act of assigning a patient to a treatment.  Patients who are enrolled in the trial are 
those who have been assigned to a treatment.
enter
Patients entered into a trial are those who sign the informed consent form directly or 
through their legally acceptable representatives.
ePRO
electronic patient-reported outcomes
interim analysis
An interim analysis is an analysis of clinical study data, separated into treatment groups, 
that is conducted before the final reporting database is created/locked.
investigational 
product
A pharmaceutical form of an active ingredient or placebo being tested or used as a 
reference in a clinical trial, including products already on the market when used or 
assembled (formulated or packaged) in a way different from the authorized form, or 
marketed products used for an unauthorized indication, or marketed products used to 
gain further information about the authorized form.
ITT
intent to treat: The principle that asserts that the effect of a treatment policy can be best 
assessed by evaluating on the basis of the intention to treat a patient (that is, the planned 
treatment regimen) rather than the actual treatment given.  It has the consequence that 
patients allocated to a treatment group should be followed up, assessed, and analyzed as 
members of that group irrespective of their compliance to the planned course of 
treatment.
IWRS
interactive web-response system
SAE
serious adverse event
TEAE
treatment-emergent adverse event: Any untoward medical occurrence that either occurs 
or worsens at any time after treatment baseline and that does not necessarily have to 
have a causal relationship with this treatment.

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Appendix 2.
Schedule of Activities

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Schedule of Activities, Protocol I5Q-MC-CGAH
Study Period (SP)
SP I-
Screening
SP II-
Prospective 
Baseline
SP III - Treatment
SP IV – Follow-up
(Target) Interval (days) 
since previous visit
30-45
14
16
30
30
30
15
15
15
15
60
60
ET
Allowable range (days) 
between visits
3-45 
30-40a
Interval allowance (days)
+/- 1
+/- 3
+/- 2
+/- 2
+/- 2
+/- 2
+/- 2
+/- 2
+/- 2
+/- 5
+/- 5
Visit
1
2
3
4b
5
6
7
8
9c
10
11c
12
13
14
Month
0
0.5
1
2
3
4
4.5
5
5.5
6
8
10
Assessments and Procedures
Informed consent
X
Inclusion/exclusion
X
X
X
Demographics
X
Physical examination
X
Neurological 
examinationd
X
X
X
X
X
Height
X
Weight
X
X
X
X
Waist and hip 
circumference
X
Medical history 
X
Pre-specified 
migraine history
X

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Visit
1
2
3
4
b
5
6
7
8
9c
10
11c
12
13
14
ET
Month
0
0.5
1
2
3
4
4.5
5
5.5
6
8
10
Substance use 
X
ECGe
X
X
X
X
X
Vital signsf
X
X
X
X
X
X
X
X
X
X
X
Adverse events
X
X
X
X
X
X
X
X
X
X
X
X
X
Concomitant medications
X
X
X
X
X
X
X
X
X
X
X
X
ePRO training
X
ePRO daily patient entries
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Patient training video
X
Clinical Laboratory Tests and Sampling Schedules
Hematology
X
X
X
X
X
X
Clinical chemistry
X
Xg
Xg
Xg
Xg
Xg
HDL
X
Xg
Xg
Xg
Xg
Xg
HbA1c
X
X
X
X
Fasting insulin/
fasting C-peptide
Xg
Xg
Xg
Urinalysish
X
X
X
X
X
Serum Pregnancy (for 
women of childbearing 
potential) or FSH at Visit 
1 (all other female 
patients)i
X
X
X
X
Urine pregnancyi
X
X
X
X
X
X
Urine drug screen
X

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Visit
1
2
3
4
b
5
6
7
8
9c
10
11c
12
13
14
ET
Month
0
0.5
1
2
3
4
4.5
5
5.5
6
8
10
Immunogenicity
j
X
X
X
X
X
X
X
X
Biomarker storage sample
j
X
X
X
X
X
X
X
X
PK blood sample
j
X
X
X
X
X
X
X
X
X
X
X
X
RNA
X
X
X
Study drug administeredk
X
X
X
X
X
X
Scales, Questionnaires, and Outcome Measures
MIDAS
X
X
X
X
X
MSQ v2.1
X
X
X
X
X
X
X
X
X
Non-migraine chronic 
pain assessmentl
X
X
X
X
PGI-S
X
X
X
X
X
X
X
X
X
PGI-I
X
X
X
X
X
X
X
C-SSRS/SHSF, SHFUm
X
X
X
X
X
X
X
X
X
X
X
X
Abbreviations:  AE = adverse event; CGRP = Calcitonin-gene related peptide; C-SSRS = Columbia-Suicide Severity Rating Scale; ECG = electrocardiogram; 
ePRO = electronic patient reported outcomes; ET = early termination; FSH = follicle stimulating hormone; HDL = High-density lipoprotein; MIDAS = 
Migraine Disability Assessment test; MSQ (v2.1) = Migraine Specific Quality of Life Questionnaire; PGI-I = Patient Global Impression of Improvement; 
PGI-S = Patient Global Impression of Severity; PK = pharmacokinetics; RNA = ribonucleic acid; SHSF = Self-harm supplement form; SHFU = Self-harm 
follow-up form.
Note:  Selected tests may be obtained in the event of a treatment-emergent hepatic abnormality and may be required in follow-up with patients in consultation 
with the Lilly, or its designee, clinical research physician. See Appendix 4 for more details regarding specific hepatic monitoring tests.  If the patient has 
discontinued the trial and returns for hepatic follow-up, the site should use the 800 series as the visit designation.
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Schedule of Activities, Protocol I5Q-MC-CGAH (footnotes)
a
The eligibility period of the prospective baseline assessment will last from 30 to 40 days.  Investigators and patients may have up to an additional 5 days to 
schedule their Visit 3 appointment (beyond the 40 days); however, eligibility will be based on the 30-40 day period.
b
Visit is to include a review of any spontaneously reported adverse events and collection of blood samples for immunogenicity, PK, and CGRP plasma.
c
Visit 9 and Visit 11 are laboratory visits (for PK and CGRP plasma) only. Adverse events are not intended to be collected at these visits because patients may 
be going to a different location for laboratory assessments.  However, any spontaneously reported AEs at these lab visits should be reported on the AE page.
d
A neurological exam will be conducted at screening, Month 3 and Month 6 of treatment, as well as at the final visit of the follow-up period or early 
termination visit in order to assess for any signs of pre-existing or treatment-emergent neurological abnormalities such as stroke or other cerebrovascular 
events.
e
Electrocardiograms (ECGs) will be performed at Visit 1, Visit 3, Visit 12, and Visit 14 or early termination.  Note:  The Visit 3 ECG should be collected prior 
to blood draws and dosing.  Patients must be supine for approximately 5 to 10 minutes before ECG collection and remain supine but awake during ECG 
collection.
f
Vital signs will include body temperature, blood pressure and pulse.  Blood pressure and pulse will be measured in triplicate in the sitting position and should 
be measured prior to blood draws.  Blood pressure will be assessed by utilizing a calibrated machine.
g
Chemistry samples collected at Visit 3, Visit 7, Visit 12, and Visit 14 or early termination must be fasting. Fasting is defined as no food or drink, except 
water, for at least 8 hours prior to testing.
h In the event of a positive urine leukocyte esterase result, a repeat urine sample will be collected and shipped to the central laboratory.
i
A positive urine test must be followed by a serum pregnancy test for confirmation.
j
Immunogenicity,
 and PK sampling to be performed at the indicated visits and prior to dose administration if the visit is a dosing visit.  
Samples will be taken in the event of early termination.  Immunogenicity samples also may be collected in the event of a systemic allergic/hypersensitivity 
reaction (see Section 8.4.3).  The timing of samples will be recorded.
k
Patients will receive injections of placebo or LY2951742 after all other visit procedures are completed.  Following the first dose at Visit 3, patients will be 
observed for at least 30 minutes in the office.
l
Questionnaire administered by clinician to assess other chronic pain conditions.
m The C-SSRS and SHSF (and SHFU when applicable) will be completed at scheduled and unscheduled office visits.
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Appendix 3.
Clinical Laboratory Tests
Hematology:
Clinical Chemistryb:
Hemoglobin
Serum Concentrations of:
Hematocrit
Sodium
Erythrocyte count (RBC)
Potassium
Mean cell volume 
Total bilirubin
Mean cell hemoglobin concentration 
Direct bilirubin
Leukocytes (WBC)
Alkaline phosphatase
Neutrophils, segmented
Alanine aminotransferase (ALT)
Lymphocytes
Aspartate aminotransferase (AST)
Monocytes
Blood urea nitrogen (BUN)
Eosinophils
Creatinine
Basophils
Uric acid
Platelets
HbA1c
Calcium
Glucose (fasting)b
Albumin
Creatine kinase (CK)
Triglycerides
Total cholesterolb
HDLb
Urinalysis:
Specific gravity
pH
Insulin (fasting)b
C-peptide (fasting)b
Protein
Glucose
Ketones
Blood
Urine leukocyte esterasea
Microscopic analysisa
Urine culturea
Other
PK Sample (LY2951742 serum concentration 
determination)
Immunogenicity
Urine Drug Screenc
Pregnancy Test (females only)
c 
Serum pregnancy or FSH
Urine pregnancy test (local)
Stored Samples
Biomarker storage
RNA
Abbreviations:  FSH = follicle-stimulating hormone; HDL = high density lipoprotein;
PK = pharmacokinetic; RBC = red blood cells; RNA = ribonucleic acid; WBC = white blood cells.
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Clinical Laboratory Tests (footnotes)
a
A positive urine leukocyte esterase result will require a follow-up sample with microscopic analysis and possibly 
a urine culture.
b
Fasting laboratory samples will be collected as shown in the Schedule of Activities (Appendix 2).  Fasting is 
defined as no food or drink, except water, for at least 8 hours prior to testing.  All other samples may be collected 
on a nonfasting basis.
c
May be repeated during the study at the discretion of the investigator.

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Appendix 4.
Hepatic Monitoring Tests for Treatment-
Emergent Abnormality
Selected tests may be obtained in the event of a treatment-emergent hepatic abnormality and may 
be required in follow-up with patients in consultation with the Lilly, or its designee, clinical 
research physician.
Hepatic Monitoring Tests
Hepatic Hematologya
Haptoglobina
Hemoglobin
Hematocrit
Hepatic Coagulationa
RBC
Prothrombin Time
WBC
Prothrombin Time, INR
Neutrophils, segmented
Lymphocytes
Hepatic Serologiesa,b
Monocytes
Hepatitis A antibody, total
Eosinophils
Hepatitis A antibody, IgM
Basophils
Hepatitis B surface antigen
Platelets
Hepatitis B surface antibody
Hepatitis B Core antibody
Hepatic Chemistrya
Hepatitis C antibody
Total bilirubin
Hepatitis E antibody, IgG
Direct bilirubin
Hepatitis E antibody, IgM
Alkaline phosphatase
ALT
Anti-nuclear antibodya
AST
GGT
CPK
Alkaline phosphatase isoenzymesa
Anti-Actin antibodya
Anti-smooth muscle antibodya
Abbreviations:  ALT = alanine aminotransferase; AST = aspirate aminotransferase; CPK = creatinine 
phosphokinase; GGT = gamma-glutamyl transferase; Ig = immunoglobulin; INR = international normalized 
ratio; RBC = red blood cells; WBC = white blood cells.
a
Assayed by Lilly-designated or local laboratory.
b
Reflex/confirmation dependent on regulatory requirements and/or testing availability.

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Appendix 5.
Protocol Amendment I5Q-MC-CGAH(a) 
Summary:  A Phase 3, Randomized, Double-Blind, 
Placebo-Controlled Study of LY2951742 in Patients with 
Episodic Migraine – the EVOLVE-2 Study 
Overview
Protocol I5Q-MC-CGAH (CGAH) [A Phase 3, Randomized, Double-Blind, Placebo-Controlled 
Study of LY2951742 in Patients with Episodic Migraine – the EVOLVE-2 Study] has been 
amended.  The new protocol is indicated by amendment (a) and will be used to conduct the study 
in place of any preceding version of the protocol.
The changes were required by 4 European Union Member States participating in the Voluntary 
Harmonisation Procedure.  The key changes are as follows:

Added the protocol amendment approval date (with updated trial alias) on every 
page of the protocol.

Added language regarding the contents of each injection for the different 
treatment assignments in order to clarify how treatment is blinded (Section 4.1).

Excluded patients with a prior lifetime history of stroke (Section 5.2, Exclusion 
[23]) to provide additional safeguards for patients who may be at risk for stroke.

Added text to indicate that neurological examinations will be conducted to assess 
for possible cerebrovascular events, along with instructions for appropriate 
follow-up (Section 8.4.5, Safety Monitoring).

Revised wording regarding procedures associated with emergency unblinding
(Section 6.3) such that investigators no longer need to contact Lilly prior to 
emergency unblinding of a patient’s treatment assignment.

Added the list of allowed and disallowed concomitant treatments directly into 
Section 6.8 rather than referencing a separate document.

Modified treatment discontinuation criteria (Section 7.1.1) to require (rather than
recommend) discontinuation of treatment in the event of specific liver function 
test abnormalities, and added language to indicate the additional events requiring 
discontinuation from LY2951742 or placebo.

Added information regarding the approximate number of countries, investigative 
sites, and patients planned for inclusion in Study CGAH (Section 9.1).

Added clarification on the statistical model to be used for subgroup analyses 
(Section 9.7.2).

Provided language clarifying the timing, and intent, of planned interim analyses 
(Section 9.8).

Updated the Schedule of Activities and footnotes to reflect added neurological 
examinations.
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Revised Protocol Sections
Header
I5Q-MC-CGAH(a) Clinical Protocol
Footer
Approved: XX January 2016
Title
Protocol I5Q-MC-CGAH(a)
4.
Study Design
4.1
Overview of Study Design
Patients randomized to the 120 mg dose of LY2951742 will receive an initial loading dose of 
240 mg (2 injections of 120 mg each at Visit 3 only).  To preserve blinding throughout the study, 
patients in all treatment groups will receive 2 injections of investigational product at each dosing 
visit (two placebo injections, two 120-mg LY2951742 injections, or one placebo injection and 
one 120-mg injection).  At Visit 3, if available and where local regulations and Ethical Review 
Boards allow, patients will also watch a training video designed to address patient expectations 
with regard to participation in a placebo-controlled trial and the difference between medical 
treatment and research.
Patients will be given injections of investigational product during office visits (Figure CGAH.1).  
For all treatment groups, subcutaneous injections will be administered once monthly at the 
dosing visits.  At Visit 3 (first dose), patients will be required to remain in the office for 
observation for 30 minutes post injection.  Patients will continue to log in and complete the 
ePRO diary each day.  Patients may continue to take their allowed acute migraine headache 
medication (with some limitations; see Section 6.8 concomitant medication study tool) during 
the treatment phase.
Study Period IV:  During this 4-month phase, sites and patients will remain blinded to patients’ 
treatment assignments.  Patients will follow all study procedures during Study Period IV but will 
not receive LY2951742 or placebo. One month after Visit 12, if clinically warranted due to a 
worsening of symptoms, patients may start migraine prevention medications at the discretion of 
the investigator.  The list of allowed preventive medications is provided in Section 6.8 the 
concomitant medications study tool.  At Visit 14 (Month 10), patients will return to the site for 
their last study visit and discharge from the study.

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5.2
Exclusion Criteria
Medical Conditions
[23] Have ECGs showing abnormalities compatible with acute cardiovascular 
events and/or serious cardiovascular risk, including but not limited to a 
corrected QT (QTcB [Bazett's]) interval > 470 msec for women and >450 for 
men, or have had myocardial infarction, unstable angina, percutaneous 
coronary intervention, coronary artery bypass graft, stroke, or deep vein 
thrombosis/pulmonary embolism within 6 months of screening, or have 
planned cardiovascular surgery or percutaneous coronary angioplasty, or 
patients with a lifetime history of stroke.
5.3
Screen Failures
Individuals who do not meet the criteria for participation in this study (screen failure) may be
considered for rescreen once, with approval from Lilly Medical for only the criteria shown 
below.  The interval between screening and rescreening must be at least 45 days or longer if 
required for the specified timeframes in the inclusion/exclusion criteria or concomitant 
medications requirements study tool.  If rescreening is performed, the individual must sign a new 
ICF and will be assigned a new identification number.
6.3
Blinding
In case of an emergency, the investigator has the sole responsibility for determining if unblinding 
of a patient’s treatment assignment is warranted. Patient safety must always be the first 
consideration in making such a determination. If the investigator decides that unblinding is 
warranted, the investigator should make every effort to contact the Lilly CRP/CRS prior to 
unblinding a patient’s treatment assignment. If an emergency unblinding occurs,a patient’s 
treatment assignment is unblinded, Lilly must be notified as soon as possibleimmediately.

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6.8
Concomitant Therapy
Table CGAH.3 contains a list of medications that are, and are not, allowed in this study.  Note 
that acute treatment of migraine headache is allowed throughout the study but with some 
limitations.  Treatments used for the prevention of migraine are not allowed at any time during 
Study Periods I through III.
Table CGAH.3.
Treatments Allowed and Treatments Not Allowed as Concomitant 
Therapy
Medications allowed for the ACUTE treatment of migraine headaches or other pain or 
injury:
Acetaminophen (paracetamol), NSAIDs; Triptans; Ergotamine and derivatives; Isometheptene mucate, 
dichloralphenazone and acetaminophen combination (Midrin); or combinations thereof.
The following medications are allowed with restrictions:
3.Opioid and barbiturates no more than 3 days/month (SP II, III and IV).
4.Single dose of injectable steroids allowed only once during the study, in an emergency setting (SP III and IV).
Medications, Procedures or Devices not allowed for any reason/indication:
Acetazolamide
Acupuncture
Anticonvulsants/Antiepileptics
Antipsychotics
Beta-blockers
Botulinum toxin applied to head/neck area
Cannabis / Cannabinoids
Chiropractic procedures, physiotherapy, TENS or other electric devices on head and neck
Corticosteroids for oral use
Flunarizine
Herbals with anti-inflammatory effect (feverfew, willow bark, petasites/butterbur), herbals with sympathomimetic 
effect (ma huang, ephedra, bitter orange, synephrine) and herbals with catecholamine transmitter reuptake 
inhibition (St John’s Wort)
Monoamine oxidase inhibitors (MAOIs)
Memantine
Serotonin 5HT2a/2c antagonists, ege.g.:  trazodone, nefazodone
Stimulants (prescription strength), ege.g.:  methylphenidate, dextroamphetamine, mixed amphetamine salts
Tizanidine
Therapeutic antibodies, ege.g.:  adalimumab, infliximab, trastuzumab, bevacizumab, etanercept, etc.
Tricyclic antidepressants (TCAs)
Triptans for prophylaxis of menstrual related migraine
Venlafaxine
Verapamil
Restricted medication during SP II-III:  Use of the following medications for indications 
other than migraine prevention is allowed providing the dose is stable 2 months prior to 
Visit 2 and is expected to remain stable during Visit 2 through-V12.
ACE inhibitors
Angiotensin receptor blockers (ARBs)
Benzodiazepines

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Bupropion 
Calcium-channel blockers (except verapamil and flunarizine)
Clonidine
Guanfacine
Mirtazapine
SSRIs/NRIs/SNRIs (other than venlafaxine)
Use of electric devices (i.e. TENS), physiotherapy, chiropractic procedures on low back and extremities
Restricted medication during SP II-III:  Use of the following medications for indications 
other than migraine prevention is allowed:
Beta-blockers, ophthalmic
Cyclandelate
Cyproheptadine
Melatonin
SP IV (After Visit 12)
One month after Visit 12, if clinically warranted due to a worsening of symptoms, patients may start migraine 
prevention medications at the discretion of the investigator with the exception of antipsychotics, cannabis and 
cannabinoids, MAOIs, memantine, serotonin 5HT2a/2c antagonists, and stimulants, which remain excluded.
The list of medications allowed or not allowed for the acute treatment of migraine, as well as 
those prohibited for the prevention of migraine, is provided in the concomitant medication list in 
the concomitant medications study tool, along with all concomitant therapies allowed or not 
allowed during the study.  Note that there are some limitations regarding concomitant 
medications for the acute treatment of migraines during the study.  Any changes in the list of 
allowed/not allowed medications will be communicated to investigators and will not constitute a 
protocol amendment. 
7.
Discontinuation Criteria
7.1
Discontinuation from Study Treatment
7.1.1. Permanent Discontinuation from Study Treatment
Discontinuation of the investigational product is required in cases of pregnancy.
Discontinuation of the investigational product for abnormal liver tests is requiredshould be 
considered by the investigator when a patient meets one of the following conditions and the 
event is at least possibly related to study drugafter consultation with the Lilly designated medical 
monitor:

ALT or aspartate aminotransferase (AST) >8X ULN

ALT or AST >5X ULN for more than 2 weeks

ALT or AST >3X ULN and TBL >2X ULN or prothrombin time >1.5X ULN

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
ALT or AST >3X ULN with the appearance of fatigue, nausea, vomiting, right 
upper-quadrant pain or tenderness, fever, rash, and/or eosinophilia (>5%)

ALP >3X ULN

ALP >2.5X ULN and TBL >2X ULN

ALP >2.5X ULN with the appearance of fatigue, nausea, vomiting, right quadrant 
pain or tenderness, fever, rash, and/or eosinophilia (>5%)
Discontinuation of investigational product also is required in the following cases, if the event is 
at least possibly related to study drug:

Serious allergic reaction to study drug

Serious injection-site reaction

Serious event of suicidality or depression

Serious cerebrovascular event.
8.
Study Assessments and Procedures
8.4
Safety Assessments
8.4.5 Safety Monitoring
Neurological examinations will be conducted at screening, Month 3 and Month 6 of treatment, as 
well as at the final visit of the follow-up period or early termination visit in order to assess for 
any signs of pre-existing or treatment-emergent neurological abnormalities such as stroke or 
other cerebrovascular events.  If a study patient experiences signs of a cerebrovascular event, 
appropriate follow-up and clinical management should be conducted by the investigator, and the 
Lilly CRP/CRS should be consulted regarding collection of further clinical information and 
follow-up testing.
9.
Statistical Considerations and Data Analysis
9.1
Determination of Sample Size
Approximately 100 sites in 11 countries are planned for inclusion in Study CGAH, with an 
average of approximately 8 patients to be randomized at each investigative site.  The final 
number of sites, countries, and patients per site may vary depending on sites’ enrollment rates.
9.2
General Statistical Considerations
The primary analysis will be performed using a restricted maximum likelihood-based mixed 
models repeated measures (MMRM) technique with prespecified model terms (Section 9.4.1).

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Any change to the data analysis methods described in the protocol will require an amendment 
ONLY if it changes a principal feature of the protocol.  Any other change to the data analysis 
methods described in the protocol, and the justification for making the change, will be described 
in the clinical study report or SAP.  Changes may only be made in the SAP prior to unblinding.  
Additional exploratory analyses of the data will be conducted as deemed appropriate.
9.4
Primary and Secondary Analyses
9.4.2. Key Secondary Analyses
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There will be no adjustments for multiplicity for analyses of other endpoints.  If the multiple 
testing approach for key secondary measures only needs to be changed, the updated approach 
will be provided in the SAP, and it should not lead to modification of this protocol.
9.7.2
Subgroup Analyses
Subgroup analyses will be performed for the primary efficacy measure (change from baseline in 
the number of migraine headache days) separately for each of the subgroup populations listed in
Table CGAH.4.  Subgroup analyses will be conducted only for the ITT patients in Study Period 
III.
Each of tThe subgroup analyses for the primary measure of change from baseline in the number 
of migraine headache days will be conducted using MMRM.  The same MMRM model 
described in Section 9.4.1 will be used, with terms of subgroup, subgroup-by-treatment, 
subgroup-by-month, and subgroup-by-treatment-by-month interactions added as additional 
covariates.
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Table CGAH.34.
Definition of Subgroup Variables
9.8
Interim Analyses
Two interim analyses are anticipated for this study.  The first possible interim analysis will occur 
during Study Period III (double-blind treatment) and could result in stopping the trial for safety 
or futility.  Details will be documented in the Statistical Analysis Center SAP and the DMC 
Charter.  A DMC will be convened to assess safety and futility analyses.  This analysis is 
planned to occur when approximately 330 (40% of the total sample size) randomized patients 
have had the chance to complete at least 3 months of the treatment period.  The interim analysis 
will be conducted by an independent data monitoring committee (DMC) with members external 
to Lilly.  The data from the interim analysis will be used to evaluate whether to stop or modify 
the study for futility and/or safety issues.  Stopping rules for futility at this interim analysis will 
be based on the conditional power of comparing LY2951742 to placebo.  Specifically, 
conditional power represents the probability that the ongoing trial will result in a statistically 
significant difference between LY2951742 and placebo at end of the trial, based on the data 
available at the time of the interim analysis.  Rules for stopping the study are detailed in the 
Statistical Analysis Center SAP and the DMC Charter.  Only the DMC is authorized to evaluate 
unblinded interim efficacy and safety analyses.  Study sites will receive information about 
interim results ONLY if they need to know for the safety of their patients.  There is no inflation 
of type 1 error due to the conduct of a futility analysis (Snapinn et al. 2006), so no adjustment to 
the nominal significance level will be made for the primary analysis as a result of a futility 
assessment.
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Appendix 2
Schedule of Activities
Schedule of Activities, Protocol I5Q-MC-CGAH
Study Period (SP)
SP I-
Screening
SP II-
Prospective 
Baseline
SP III - Treatment
SP IV – Follow-up
(Target) Interval (days) 
since previous visit
30-45
14
16
30
30
30
15
15
15
15
60
60
ET
Allowable range (days) 
between visits
3-45 
30-40a
Interval allowance (days)
+/- 1
+/- 3
+/- 2
+/- 2
+/- 2
+/- 2
+/- 2
+/- 2
+/- 2
+/- 5
+/- 5
Visit
1
2
3
4b
5
6
7
8
9c
10
11c
12
13
14
Month
0
0.5
1
2
3
4
4.5
5
5.5
6
8
10
Assessments and Procedures
Physical examinationd
X
Neurological 
examinationd
X
X
X
X
X
Schedule of Activities, Protocol I5Q-MC-CGAH (footnotes)
d
Physical examinations at screening must include a neurological exam.A neurological exam will be conducted at screening, Month 3 and Month 6 of treatment, 
as well as at the final visit of the follow-up period or early termination visit in order to assess for any signs of pre-existing or treatment-emergent neurological 
abnormalities such as stroke or other cerebrovascular events.

Leo Document ID = 0141c58f-0217-46f5-9eb1-151a7b7010e3
Approver: 
Approval Date & Time: 22-Jan-2016 16:59:38 GMT
Signature meaning: Approved
Approver: 
Approval Date & Time: 22-Jan-2016 20:45:52 GMT
Signature meaning: Approved
PPD
PPD