Registry for Migraine - Structural and Functional MRI Before and After Erenumab Treatment

Study Overview
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Brief Summary
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This study aims to investigate structural and functional cerebral changes using magnetic resonance imaging before and after treatment with erenumab in patients with migraine.

Detailed Description
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Migraine is a prevalent neurological disorder and a leading cause of years lived with disability worldwide. As of recent, therapies targeting calcitonin gene-related peptide (e.g. erenumab) have been approved for the preventive treatment of migraine. This study aims to investigate structural and functional cerebral changes using magnetic resonance imaging before and after treatment with erenumab in patients with migraine.

Official Title
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Registry for Migraine - Structural and Functional Magnetic Resonance Imaging Before and After Erenumab Treatment

Conditions
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Migraine, Headache

Intervention / Treatment
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* Drug: Erenumab


Participation Criteria
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Eligibility Criteria
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Criteria: Inclusion Criteria: Subject has provided informed consent prior to initiation of any study-specific activities/procedures Age greater than or equal to 18 years upon entry into screening History of migraine (with or without aura) for greater than or equal to 12 months before screening according to the International Headache Society (IHS) Classification ICHD-3 (Headache Classification Committee of the International Headache Society, 2018) based on medical records and/or patient self report Greater than or equal to 4 headache days that meet criteria as migraine days per month on average across the 3 months before screening after baseline period Must have demonstrated greater than or equal to 75% compliance in headache diary usage during baseline period Exclusion Criteria: Subjects are excluded from the study if any of the following criteria apply: Disease Related Greater than 50 years of age at migraine onset History of cluster headache or hemiplegic migraine headache Inability to differentiate between migraine from other headaches The subject is at risk of self-harm or harm to others as evidenced by past suicidal behaviour History or evidence of any other clinically significant disorder, condition or disease (with the exception of those outlined above) that, in the opinion of the investigator would pose a risk to subject safety or interfere with the study evaluation, procedures or completion Prior/Concomitant Therapy Previously received erenumab (Aimovig®) Received an anti-CGRP monoclonal antibody within 3 months prior to the start of the baseline period Prior/Concurrent Clinical Study Experience Currently receiving treatment in another investigational device or drug study, or less than 30 days or 5 half-lives since ending treatment on another investigational device or drug study (ies). Other investigational procedures while participating in this study are excluded. Other Exclusions Female subjects of childbearing potential with a positive pregnancy test assessed at screening or day 1 by a urine pregnancy test. Female subject is pregnant or breastfeeding or planning to become pregnant or breastfeed during treatment and for an additional 16 weeks after the last dose of investigational product. Female subjects of childbearing potential unwilling to use 1 acceptable method of effective contraception during treatment and for an additional 16 weeks after the last dose of investigational product. Evidence of current pregnancy or breastfeeding per subject self-report or medical records Subject has known sensitivity to any of the products or components to be administered during dosing Subject likely to not be available to complete all protocol-required study visits or procedures, and/or to comply with all required study procedures to the best of the subject and investigator's knowledge Contraindications to MRI: Does not wish to be informed about unexpected MRI findings Severe claustrophobia Implanted magnetic material including pacemaker, prothesis, metal-clips, etc. Insulin pump which cannot be removed Magnetic foreign object in the body Surgical intervention within 6 weeks prior to MRI

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Single-Arm<br>Erenumab packed in a SureClick® Autoinjector Pen (AI). | Drug: Erenumab<br>* Erenumab 70 mg or 140 mg packed in a SureClick® Autoinjector Pen (AI)<br>* Other names: Aimovig;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Headache Diary | Headache diary with daily entries to record migraine-related data. | Baseline Phase (Day -42 to -28) to Month 6] | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 3T Brain Structural and Functional Magnetic Resonance Imaging (MRI) at Baseline | MP2RAGE GRAPPATINI Gradient-Recalled-Echo (GRE) Sequence w/wo Magnetization Transfer (MT) MPRAGE Diffusion Tensor Imaging (DTI) Resting State Functional MRI Task-Based Functional MRI (visual stimulation with checkerboard) 3D FLAIR | Baseline Phase (Day -42 to -28) | 
| 3T Brain Structural and Functional Magnetic Resonance Imaging (MRI) at Baseline at Month 6 | MP2RAGE GRAPPATINI Gradient-Recalled-Echo (GRE) Sequence w/wo Magnetization Transfer (MT) MPRAGE Diffusion Tensor Imaging (DTI) Resting State Functional MRI Task-Based Functional MRI (visual stimulation with checkerboard) 3D FLAIR | Week 24 ± 2 Weeks | 
| 3T Brain Structural and Functional Magnetic Resonance Imaging (MRI) at Baseline at Month 12 | MP2RAGE GRAPPATINI Gradient-Recalled-Echo (GRE) Sequence w/wo Magnetization Transfer (MT) MPRAGE Diffusion Tensor Imaging (DTI) Resting State Functional MRI Task-Based Functional MRI (visual stimulation with checkerboard) 3D FLAIR | Week 48 ± 4 Weeks | 
| Headache Diary | Headache diary with daily entries to record migraine-related data. | Baseline Phase (Day -42 to -28) to Month 12 | 
| Blood Specimen for Analysis of Biomarkers at Baseline | 31 mL Blood for Plasma 16 mL Blood for Serum 28 mL Blood for Heparinized Plasma | Baseline Phase (Day -42 to -28) | 
| Blood Specimen for Analysis of Biomarkers at Month 6 | 31 mL Blood for Plasma 16 mL Blood for Serum 28 mL Blood for Heparinized Plasma | Week 24 ± 2 Weeks | 
| Blood Specimen for Analysis of Biomarkers at Month 12 | 31 mL Blood for Plasma 16 mL Blood for Serum 28 mL Blood for Heparinized Plasma | Week 48 ± 4 Weeks | 
| Semi-Structured Interview | In-person semi-structured interview to record migraine-related data. | Baseline Phase (Day -42 to -28) |