Effect of Ivabradine on Levcromakalim-Induced Symptoms in Individuals With Migraine Without Aura (ILIM)

Last updated: March 22, 2024
Sponsor: Danish Headache Center
Overall Status: Active - Recruiting

Phase

N/A

Condition

Chronic Pain

Oral Facial Pain

Migraine (Pediatric)

Treatment

Levcromakalim

Ivabradine

Placebo

Clinical Study ID

NCT04853797
Ivabradine H-20061329
  • Ages 18-60
  • All Genders

Study Summary

This study aims to explore the effect of Ivabradine on Levcromakalim-induced migraine in individuals with migraine without aura.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Be able to give voluntary written informed consent to participate.
  • Have a diagnosis of episodic migraine without aura according to The InternationalClassification of Headache Disorders 3rd Edition.
  • Be in good general health and without any cardio- or cerebrovascular diseases,psychiatric disorders or other severe comorbidities.
  • Be 18-60 years of age.
  • Have a weight between 50-100 kg.
  • Have a normal standard resting 12-lead ECG at the screening visit with heart rate (HR) ≥ 60 bpm (the inclusion criterium of HR ≥ 60 bpm at screening has previously been usedin studies with dosages of ivabradine up to 20 mg as single and multiple doses with nosignificant adverse events).
  • Be without any chronic use of medicine.
  • Have a negative urine-human chorionic gonadotropin (hCG) test at the screening visitif they are female of childbearing potential.

Exclusion

Exclusion Criteria:

  • Suffer from tension type headache, as defined by the The International Classificationof Headache Disorders 3rd Edition, more than five days a month on average in the lastyear.
  • Are diagnosed with any primary headache disorder apart from migraine without aura asde-fined in The International Classification of Headache Disorders 3rd Edition (relating to tension type headache, see above).
  • Suffer from any headache 48 hours prior to the start of the experiment or any migraine 72 hours prior to the start of the experiment.
  • Are allergic to ivabradine or levcromakalim.
  • Are lactose intolerant (due to Ivabradine tablets containing lactose).
  • Have a daily intake of any medicine other than oral contraception or use of drugs orother ed-ibles/beverages with potential serious interactions with ivabradine
  • Have a history of personal/familial or clinical signs of: cardiovascular andcerebrovascular disease (Long QT Syndrome, Cardiac dysrhythmia, Bradycardia, i.e. aresting heart rate of < 60 bpm at screening, Amnestic information or clinical signs ofhyper- or hypotension (Hypertension (systolic blood pressure > 150 mmHg and / ordiastolic blood pressure > 100 mmHg)/Hypotension (systolic blood pressure < 90 mm Hgand / or diastolic blood pressure < 50 mmHg)), Heart failure (NYHA II or higher));Psychiatric conditions; Drug abuse of any kind; Smoking; Other comorbidities orclinical signs of diseases of any kind considered by the investigating physician tomake the participant ineligible because of safety concerns).
  • Are pregnant, breastfeeding or not using appropriate contraception.
  • Do not want any information on significant pathological findings in the study.

Study Design

Total Participants: 30
Treatment Group(s): 3
Primary Treatment: Levcromakalim
Phase:
Study Start date:
April 16, 2021
Estimated Completion Date:
January 01, 2025

Study Description

Hyperpolarization-activated cation (HCN) channels have recently been implicated in neuropathic and inflammatory pain processes through their hyperfunction and/or overexpression.

HCN channels may play a significant role in migraine pathophysiology, as 1) both an inflammatory and a neuropathic component has been hypothesized to contribute to migraine, and 2) HCN channel activity is facilitated by cyclic nucleotides, e.g. cAMP and cGMP (molecules thought to be central in migraine pathophysiology) and increases in extracellular K+ concentration.

Opening of adenosine 5'-triphosphate-sensitive potassium channels (KATP channels) using Levcromakalim causes migraine attacks with and without aura in a high proportion of patients. KATP channel activation leads to hyperpolarization, which in turn could increase the open probability of HCN channels.

This study aims to explore the effects of Ivabradine on Levcromakalim-induced migraine in individuals with migraine without aura.

The investigators anticipate that this project will contribute greatly to the current understanding of migraine pathophysiology and the hypothesized role of HCN channels in migraine pain mechanisms. This is of great interest in future research, as such knowledge is an important prerequisite for further investigation and understanding of intracellular signalling mechanisms in migraine, which in turn will lead to the development of more effective and mechanism-based drugs.

Connect with a study center

  • Rigshospitalet-Glostrup

    Glostrup, Nordre Ringvej 57 2600
    Denmark

    Active - Recruiting

  • Danish Headache Centre, Rigshospitalet-Glostrup

    Glostrup, Zealand 2600
    Denmark

    Active - Recruiting

  • Danish Headache Center

    Glostrup, 2600
    Denmark

    Active - Recruiting

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