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Phase 3 N=12 Randomized Quadruple-blind Treatment

Oral Dexamethasone for the Treatment of Acute Migraine Recurrence in the Pediatric Emergency Department

Migraine

Enrolled (actual)
12
Serious AEs
0.0%
Results posted
Dec 2019
Primary outcome: Primary: Headache Recurrence at 48 Hours — 1; 1 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Dexamethasone (Drug); Placebo (Other)
Age
Pediatric, Adult · 8+ yrs
Sex
All
Sponsor
Children's Hospital of Eastern Ontario
Primary completion
Jun 2017

Outcome Measures

OutcomeResultp-value
PRIMARY
Headache Recurrence at 48 Hours
1; 1
SECONDARY
Pain Intensity
2; 1; 2; 2; 2; 2
SECONDARY
Persistent Pain Freedom
1; 1
SECONDARY
Patient Satisfaction
6; 4; 0; 1; 6; 4
SECONDARY
Headache Recurrence at 7 Day Follow-up
0; 0
SECONDARY
Revisits Within 7 Days of Discharge From the ED
1; 0
SECONDARY
Adverse Events at Discharge
0; 0; 6; 5
SECONDARY
Adverse Events at 48 Hours Post-discharge
1; 1; 0; 1; 1; 0
SECONDARY
Adverse Events at 7 Days Post-discharge
0; 1; 0; 1; 6; 3

Summary

Migraine recurrence is common amongst pediatric patients being discharged from the emergency department after treatment for migraine. Despite the commonality of migraine recurrence within the week following discharge, no known effective therapies are available in the pediatric population, though dexamethasone has been established as efficacious in the adult migraine population. The proposed study will randomly assign children and adolescents visiting the emergency department (ED) for migraine to receive either one dose of oral dexamethasone or oral placebo. Twenty patients will be recruited to this randomized, double-blind, pilot trial over a 6 month period, and the aim of the study will be to determine the feasibility and acceptability of the protocol.

Eligibility Criteria

Inclusion Criteria

  • Between the ages of 8 and 18 years (ie. > 8.0 years and < 18.0 years)
  • Diagnosed with migraine according to a modified version of International Classification of Headache Disorders 3rd edition (ICHD-3, beta version) where criterion A (ie. minimum of 5 prior episodes meeting criteria B-D) has been removed to increase sensitivity of diagnosis in the emergency department setting

Exclusion Criteria

  • Received a dose of a steroid medication in the past 7 days
  • Known allergy to dexamethasone
  • Immunosuppressed
  • Cushing's syndrome
  • Known diabetes mellitus
  • Known peptic or duodenal ulcer or other major gastrointestinal illness (ex. ulcerative colitis)
  • Known myasthenia gravis
  • Glaucoma
  • Febrile at triage
  • History of head trauma in the past 7 days
  • Presence of any known active infection (eg. on antibiotics or antivirals, diagnosed with active infection in the ED, etc)
  • Current secondary headache (as per the treating physician's clinical impression)
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02794441). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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