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A Single-dose Study of Intranasal Ketorolac in the Treatment of Pain Secondary to Dental Impaction Surgery

Phase 2
Completed
Conditions
Dental Impaction
Pain
Interventions
Registration Number
NCT01356225
Lead Sponsor
Egalet Ltd
Brief Summary

The purpose of this study is to evaluate the analgesic efficacy of a single intranasal (IN) administration of ketorolac after dental impaction surgery.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Men or women, age 18 years or older.
  • Body weight > or = to 100 pounds and < or = 300 pounds.
  • Women of childbearing potential must have a negative serum pregnancy test result prior to entry into the study.
  • Able to provide written informed consent.
  • At least moderate pain as determined by a PI score of > or = to 50 mm on a 100-mm VAS.
  • Willing and able to comply with all testing and requirements defined in the protocol.
  • Willing and able to complete the posttreatment visit.
  • Immediately prior to entering the study, surgical removal of 3 or 4 third molars (at least 1 mandibular partial bony or complete bony impaction).
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Exclusion Criteria
  • Allergy or sensitivity to ketorolac or EDTA.
  • Allergic reaction to aspirin or other NSAIDs.
  • Current upper respiratory tract infection or other respiratory tract condition that could interfere with the absorption of the nasal spray or with the assessment of adverse events (AEs).
  • Use of any IN product within 24 hours prior to study entry.
  • Clinically significant abnormality on screening laboratory tests.
  • History of cocaine use resulting in nasal mucosal damage.
  • Active peptic ulcer disease, recent (defined as within 6 months) history of peptic ulcer disease or gastrointestinal bleeding considered by the investigator to be clinically significant.
  • Advanced renal impairment (serum creatinine >1.5 mg/dL) or a risk for renal failure due to volume depletion.
  • A history of any other clinically significant medical problem, which in the opinion of the investigator would interfere with study participation.
  • Participation within 30 days of study entry or within 5 times the half- life, whichever is longer, in another investigational drug study.
  • Pregnancy or breastfeeding.
  • Extraction of teeth other than third molars during the surgical procedure; exceptions:(1) supernumerary third molars; (2) cases whereby extraction of a third molar requires the removal of an adjacent molar.
  • Previous participation in this study.
  • Use of any short-acting NSAID (such as aspirin or ibuprofen) or acetaminophen within 12 hours of surgery.
  • Use of longer-acting NSAIDs (such as naproxen sodium) within 48 hours of surgery or piroxicam within 7 days of surgery.
  • Use of steroids (other than oral contraceptives) within 72 hours of surgery.
  • Use of mood-altering drugs, such a cannabis or alcohol, within 12 hours of surgery.
  • Surgical anesthesia including narcotic agents except fentanyl. Short-acting anesthetics, both DEA scheduled and unscheduled, were allowed. Naloxone in any form was not permitted.
  • Use of any other medication within 24 hours prior to surgery that, in the opinion of the investigator, could confound the subject's efficacy assessments (eg, sedatives, tranquilizers, MAO inhibitors, phenothiazines).
  • Consumption of any caffeine-containing products within 4 hours of surgery.
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intranasal placeboPlacebo-
Intranasal Ketorolac tromethamineKetorolac tromethamine-
Primary Outcome Measures
NameTimeMethod
Summed Pain Intensity Difference (SPID)8 hours postdose

Ratings of Pain Intensity (PI) were made using a 100-mm Visual Analog Scale (VAS) on which 0 = no pain and 100 = worst pain possible. The PI values were obtained at 20 and 40 minutes, and at 1, 1.5, 2, 3, 4, 5, 6, 7, and 8 hours following the first dose of study medication on Day 1. Pain intensity difference (PID) was calculated by subtracting the posttreatment score from the baseline score, where the baseline score was the PI rating made prior to the first dose of study medication. A summed PID (SPID) on the first postoperative day was calculated at 8 hours.

Secondary Outcome Measures
NameTimeMethod
Summed Pain Intensity Difference (SPID)4 and 6 hours postdose

Ratings of Pain Intensity (PI) were made using a 100-mm Visual Analog Scale (VAS) on which 0 = no pain and 100 = worst pain possible. The PI values were obtained at 20 and 40 minutes, and at 1, 1.5, 2, 3, 4, 5, 6, 7, and 8 hours following the first dose of study medication on Day 1. Pain intensity difference (PID) was calculated by subtracting the posttreatment score from the baseline score, where the baseline score was the PI rating made prior to the first dose of study medication. A summed PID (SPID) on the first postoperative day was calculated at 4 and 6 hours.

Total Pain Relief (TOTPAR)4, 6, and 8 hours postdose

Scores were obtained from the pain relief evaluations by taking a weighted sum of pain relief scores. Pain relief was measured at 20 and 40 minutes, and at 1, 1.5, 2, 3, 4, 5, 6, 7, and 8 hours on a 5-point categorical scale where 0 = no pain relief, 1 = a little pain relief, 2 = some pain relief, 3 = a lot of pain relief, and 4 = complete pain relief.

Pain intensity difference (PID) and pain relief scoresBefore receiving study drug (baseline), at 20 and 40 minutes, and at 1, 1.5, 2, 3, 4, 5, 6, 7, and 8 hours postdose

Ratings of Pain Intensity (PI) were made using a 100-mm Visual Analog Scale (VAS) on which 0 = no pain and 100 = worst pain possible. PID was calculated by subtracting the posttreatment score from the baseline score, where the baseline score was the PI rating made prior to the first dose of study medication. Pain relief was measured on a 5-point categorical scale with 0 = no pain relief, 1 = a little pain relief, 2 = some pain relief, 3 = a lot of pain relief, and 4 = complete pain relief.

Peak PID score4, 6, and 8 hours postdose

PID was calculated by subtracting the posttreatment score from the baseline score, where the baseline score was the PI rating made prior to the first dose of study medication. Peak PID was defined as the maximum PID score.

Peak pain relief scores4, 6, and 8 hours postdose

Pain relief was measured on a 5-point categorical scale with 0 = no pain relief, 1 = a little pain relief, 2 = some pain relief, 3 = a lot of pain relief, and 4 = complete pain relief. Peak pain relief was defined as the maximum peak pain relief score.

Time to onset of perceptible pain and meaningful pain reliefAfter study drug administration until perceptible and meaningful pain relief was felt (during the 8-hour postdose observation period)

The onset of pain relief was measured by the subjects stopping stopwatches when perceptible and meaningful relief was felt.

Time to first use of rescue medicationAfter study drug administration until rescue analgesic therapy was requested (during the 8-hour postdose observation period)

Duration of analgesia represented by the time until rescue analgesic therapy was requested.

Proportion of subjects taking rescue medicationDuring 8-hour postdose observation period

Proportion of subjects taking rescue medication in either group during the 8-hour postdose observation period.

Global pain controlAt the end of the 8-hour observation period, or at the time the subject took rescue analgesic medication if prior to 8 hours

The subject was asked the question "How was your pain control overall?" This evaluation was measured on a 5-point categorical scale with 0 = poor, 1 = fair, 2 = good, 3 = very good, and 4 = excellent.

Trial Locations

Locations (1)

Austin Oral Surgery - PPD Development

🇺🇸

Austin, Texas, United States

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