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Childhood and Adolescent Migraine Prevention ( CHAMP ) Study: A Double‐Blinded, Placebo‐Controlled, Comparative Effectiveness Study of Amitriptyline, Topiramate, and Placebo in the Prevention of Childhood and Adolescent Migraine
Author(s) -
Hershey Andrew D.,
Powers Scott W.,
Coffey Christopher S.,
Eklund Dixie D.,
Chamberlin Leigh Ann,
Korbee Leslie L.
Publication year - 2013
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12105
Subject(s) - topiramate , migraine , amitriptyline , placebo , medicine , double blinded , anesthesia , psychology , psychiatry , pediatrics , epilepsy , alternative medicine , pathology
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 C hildhood and A dolescent M igraine P revention ( 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 N ational I nstitute of N eurological D isorders and S troke/ N ational I nstitutes of H ealth ( 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 I nternational C lassification of H eadache D isorders, 2nd E dition, 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.