BACKGROUND: Migraine is one of the most common health problems for children and adolescents. If not successfully treated, it can impact patients and families with significant disability due to loss of school, work, and social function. When headaches become frequent, it is essential to try to prevent the headaches. For children and adolescents, this is guided by extrapolation from adult studies, a limited number of small studies in children and adolescents and practitioner preference. The aim of the Childhood and Adolescent Migraine Prevention (CHAMP) study is to determine the most effective preventive agent to use in children and adolescents. METHODS:CHAMP is a double-blinded, placebo-controlled, multicenter, comparative effectiveness study of amitriptyline and topiramate for the prevention of episodic and chronic migraine, designed to mirror real-world practice, sponsored by the US National Institute of Neurological Disorders and Stroke/National Institutes of Health (U01NS076788). The study will recruit 675 subjects between the ages of 8 and 17 years old, inclusive, who have migraine with or without aura or chronic migraine as defined by the International Classification of Headache Disorders, 2nd Edition, with at least 4 headaches in the 28 days prior to randomization. The subjects will be randomized in a 2:2:1 (amitriptyline: topiramate: placebo) ratio. Doses are weight based and will be slowly titrated over an 8-week period to a target dose of 1 mg/kg of amitriptyline and 2 mg/kg of topiramate. The primary outcome will be a 50% reduction in headache frequency between the 28-day baseline and the final 28 days of treatment (weeks 20-24). CONCLUSIONS: The goal of the CHAMP study is to obtain level 1 evidence for the effectiveness of amitriptyline and topiramate in the prevention of migraine in children and adolescents. If this study proves to be positive, it will provide information to the practicing physician as how to best prevent migraine in children and adolescents and subsequently improve the disability and outcomes.
RCT Entities:
BACKGROUND:Migraine is one of the most common health problems for children and adolescents. If not successfully treated, it can impact patients and families with significant disability due to loss of school, work, and social function. When headaches become frequent, it is essential to try to prevent the headaches. For children and adolescents, this is guided by extrapolation from adult studies, a limited number of small studies in children and adolescents and practitioner preference. The aim of the Childhood and Adolescent Migraine Prevention (CHAMP) study is to determine the most effective preventive agent to use in children and adolescents. METHODS: CHAMP is a double-blinded, placebo-controlled, multicenter, comparative effectiveness study of amitriptyline and topiramate for the prevention of episodic and chronic migraine, designed to mirror real-world practice, sponsored by the US National Institute of Neurological Disorders and Stroke/National Institutes of Health (U01NS076788). The study will recruit 675 subjects between the ages of 8 and 17 years old, inclusive, who have migraine with or without aura or chronic migraine as defined by the International Classification of Headache Disorders, 2nd Edition, with at least 4 headaches in the 28 days prior to randomization. The subjects will be randomized in a 2:2:1 (amitriptyline: topiramate: placebo) ratio. Doses are weight based and will be slowly titrated over an 8-week period to a target dose of 1 mg/kg of amitriptyline and 2 mg/kg of topiramate. The primary outcome will be a 50% reduction in headache frequency between the 28-day baseline and the final 28 days of treatment (weeks 20-24). CONCLUSIONS: The goal of the CHAMP study is to obtain level 1 evidence for the effectiveness of amitriptyline and topiramate in the prevention of migraine in children and adolescents. If this study proves to be positive, it will provide information to the practicing physician as how to best prevent migraine in children and adolescents and subsequently improve the disability and outcomes.
Authors: Paul Winner; Eric M Pearlman; Stephen L Linder; Donna M Jordan; Alan C Fisher; Joseph Hulihan Journal: Headache Date: 2005 Nov-Dec Impact factor: 5.887
Authors: Seymour Diamond; Marcelo E Bigal; Stephen Silberstein; Elizabeth Loder; Michael Reed; Richard B Lipton Journal: Headache Date: 2007-03 Impact factor: 5.887
Authors: Donald Lewis; Paul Winner; Joel Saper; Seth Ness; Elena Polverejan; Steven Wang; Caryn L Kurland; Jeff Nye; Eric Yuen; Marielle Eerdekens; Lisa Ford Journal: Pediatrics Date: 2009-03 Impact factor: 7.124
Authors: Scott W Powers; Susmita M Kashikar-Zuck; Janelle R Allen; Susan L LeCates; Shalonda K Slater; Marium Zafar; Marielle A Kabbouche; Hope L O'Brien; Chad E Shenk; Joseph R Rausch; Andrew D Hershey Journal: JAMA Date: 2013-12-25 Impact factor: 56.272
Authors: Scott W Powers; Andrew D Hershey; Christopher S Coffey; Leigh A Chamberlin; Dixie J D Ecklund; Stephanie M Sullivan; Elizabeth A Klingner; Jon W Yankey; Susmita Kashikar-Zuck; Leslie L Korbee; Michele L Costigan; Holly H Riss; Linda L Porter Journal: Headache Date: 2016-04-04 Impact factor: 5.887