Consistency of Response to Liquid Celecoxib in Adults With Migraine: Post Hoc Analysis of Results From Two Randomized, Placebo-Controlled Studies
Daniel Serrano1, Stewart Tepper2, Mancia Ko3, Todd Kunkel3, Richard Lipton4
1OPEN Health group, 2Geisel School of Medicine At Dartmouth, 3Collegium Pharmaceutical, 4Albert Einstein College of Medicine
Objective:

Compare the consistency of treatment response of celecoxib oral solution 120 mg (COS) with placebo in adults with migraine.

Background:
Celecoxib oral solution (Elyxyb) is an oral liquid formulation of the cyclooxygenase-2 (COX-2)–selective nonsteroidal anti-inflammatory drug indicated for the acute treatment of migraine in adults.
Design/Methods:

Post-hoc analysis of pooled data from 2 randomized, double-blind, placebo-controlled trials in which adults completed 2 double-blind randomizations and treatment periods. During the first double-blind period, subjects used COS to treat 1 migraine attack of moderate to severe pain intensity. Within 2-7 days (ie, ≥48 hours of pain and symptom freedom), eligible subjects were rerandomized into a second double-blind period and instructed to treat a single migraine attack of any headache pain intensity. This analysis included randomized subjects who treated 2 attacks with COS or treated 2 attacks with placebo. Efficacy endpoints included pain freedom, freedom from the most bothersome symptoms (MBS), and pain relief at 2 hours postdose. Consistent responders achieved treatment success in both double-blind periods with either COS or placebo. A separate regression model was fit to the data for each endpoint. Risk rates (proportions) were presented and significance evaluated using relative risk models.

Results:

Altogether, 1253 subjects were randomized in the first double-blind period, 1080 (86%) were independently rerandomized to celecoxib (n=521) or placebo (n=517) in the second double-blind period, and 771 (celecoxib n=399) or placebo (n=372) treated 2 attacks with study medication. Rates of consistent endpoint achievement at 2 hours postdose between COS and placebo across pain freedom, MBS freedom, and pain relief were, respectively, 18% vs 11%, p=0.016; 40% vs 32%, p=0.033; and 54% vs 45%, p=0.012.

Conclusions:

Across 2 attacks, consistent response to COS was higher than consistent response to placebo for pain freedom, freedom from the MBS, and pain relief at 2 hours postdose.

10.1212/WNL.0000000000202240