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Tramadol Hydrochloride and Dexketoprofen Trometamol for the Oral Treatment of Moderate to Severe Acute Pain Following Removal of Impacted Lower Third Molar

Phase 4
Completed
Conditions
Acute Pain
Interventions
Registration Number
NCT02777970
Lead Sponsor
Menarini Group
Brief Summary

The study is aimed to evaluate the analgesic efficacy of TRAM.HCl/DKP.TRIS 75mg/25mg oral fixed drug combination in comparison with TRAM.HCl /paracetamol 75mg/650mg in the treatment of moderate to severe acute pain.

Detailed Description

The present phase IV study is a randomised, double-blind, placebo and active-controlled, parallel group study in moderate to severe acute pain after removal of impacted lower third molar.

In this single-dose clinical trial patients are randomized to the following 3 treatment arms in a 2:2:1 ratio:

* TRAM.HCL/DKP.TRIS

* Paracetamol/TRAM.HCL

* Placebo.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
654
Inclusion Criteria
  • Male or female patients aged more than 18 years. Females participating in the study must be either non-childbearing potential or routinely using an effective method of birth control resulting in a low failure rate.
  • Scheduled for outpatient surgical extraction -under local anaesthesia of lower third molar teeth, with at least one partially impacted in the mandible requiring bone manipulation.
  • Pain of at least moderate intensity in the first 4 hours after the end of surgery (NRS score ≥ 4).
Exclusion Criteria
  • History of allergy or hypersensitivity to the study treatments, RM or to any other NSAIDs, opioids and acetyl salicylic acid.
  • History of peptic ulcer, gastrointestinal disorders by NSAIDs or gastrointestinal bleeding or other active bleedings.
  • History of any illness or condition that, in the opinion of the Investigator might pose a risk to the patient or confound the efficacy and safety results of the study.
  • Patients using and not suitable for withdrawing the prohibited medications specified in the protocol.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Tramadol/DexketoprofenPlaceboTramadol Hydrochloride/Dexketoprofen Trometamol 75mg/25mg film-coated tablet oral single dose; Placebo matching Tramadol Hydrochloride/Paracetamol 75 mg/650mg, as 2 x \[37.5mg/325mg\] film-coated tablets, oral single dose.
Tramadol/ParacetamolPlaceboTramadol Hydrochloride/Paracetamol 75 mg/650 mg, as 2 x \[37.5mg/325mg\] film-coated tablets, oral single dose; Placebo matching Tramadol Hydrochloride/Dexketoprofen Trometamol 75mg/25mg film-coated tablet oral single dose. .
PlaceboPlaceboPlacebo matching one film-coated tablet of Tramadol Hydrochloride/Dexketoprofen Trometamol 75mg/25mg oral single dose; Placebo matching two film-coated tablets of Tramadol Hydrochloride/Paracetamol 37.5mg/325mg oral single dose.
Tramadol/ParacetamolTramadol Hydrochloride/ParacetamolTramadol Hydrochloride/Paracetamol 75 mg/650 mg, as 2 x \[37.5mg/325mg\] film-coated tablets, oral single dose; Placebo matching Tramadol Hydrochloride/Dexketoprofen Trometamol 75mg/25mg film-coated tablet oral single dose. .
Tramadol/DexketoprofenTramadol Hydrochloride/Dexketoprofen TrometamolTramadol Hydrochloride/Dexketoprofen Trometamol 75mg/25mg film-coated tablet oral single dose; Placebo matching Tramadol Hydrochloride/Paracetamol 75 mg/650mg, as 2 x \[37.5mg/325mg\] film-coated tablets, oral single dose.
Primary Outcome Measures
NameTimeMethod
TOTPAR6 (Total Pain Relief Over 6 Hours Post-dose)6 hours post-dose

TOTPAR calculated as the weighted sum of the PAR scores, measured according to a 5-point VRS (Verbal Rating Scale) from 0=no relief to 4=complete relief, over 6 hours post-dose (TOTPAR6).

The TOTPAR6 ranges from a minimum of 0 to a maximum of 24.

Secondary Outcome Measures
NameTimeMethod
% of Patients Achieving 50% of Max TOTPAR8 hours post-dose

Percentage of patients who achieved at least 50% of the maximum TOTPAR at 8 hours. In the present trial the achievable TOTPAR over 8 hours ranges between 0 and 32."

% of Patients Achieving at Least 30% of PI (Pain Intensity) Reduction Over 8 Hours Post-dose8 hours post-dose

Percentage of patients who achieve at least 30% of PI Reduction versus baseline Over 8 Hours Post-dose. Percentage change of PI is calculated using the baseline value minus the PI assessed at 8 hours post-dose divided for the baseline value, then multiplied for 100.

Time to Confirmed FPPAR (First Perceptible Pain Relief)2 hours post-dose

Time to confirmed FPPAR (time to onset of analgesia) - i.e. time to FPPAR if confirmed by experiencing Meaningful Pain Relief (MPAR)

FPPAR and MPAR assessed by using stopwatches:

1. 'first perceptible' PAR (FPPAR), i.e, at the moment they first felt any PAR whatsoever;

2. 'meaningful' PAR (MPAR, ie, when the relief from pain became meaningful to them)

% of Patients Requiring RM (Rescue Medication)8 hours post-dose

Percentage of patients who required RM within the first over 8 hours post-dose.

PGE (Patient Global Evaluation)8 hours postdose

PGE of the study medication (measured according to a five-point VRS from 1 = poor to 5 = excellent) at 8 hours post-dose or whenever the patient uses Rescue Medication (RM).

Trial Locations

Locations (18)

Ars-Dent

🇵🇱

Bialystok, Poland

Azienda Ospedaliero-Universitaria Pisana

🇮🇹

Pisa, Italy

Birmingham Community Healthcare NHS Foundation Trust

🇬🇧

Birmingham, United Kingdom

Hospital Médico Quirúrgico de Conxo

🇪🇸

La Coruna, Spain

Dr. Tóth Bagi Zoltán Fogászati Rendeloje

🇭🇺

Budapest, Hungary

Ospedale Civile San Salvatore di L'Aquila

🇮🇹

L'Aquila, Italy

OralMed Studio Fogászati és Szájsebészeti Kft.

🇭🇺

Budapest, Hungary

Universidad de Valencia

🇪🇸

Valencia, Spain

Szegedi Tudományegyetem

🇭🇺

Szeged, Hungary

Charme Clinique Klinika Stomatologii

🇵🇱

Warszawa, Poland

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

🇮🇹

Milan, Italy

University Hospital of Wales

🇬🇧

Cardiff, United Kingdom

Hospital Universitario Virgen del Rocío

🇪🇸

Sevilla, Spain

Azienda Ospedaliera Universitaria Integrata

🇮🇹

Verona, Italy

University of Manchester

🇬🇧

Manchester, United Kingdom

Centro Medico Teknon

🇪🇸

Barcelona, Spain

Gabinet Stomatologiczny Andrzej Wojtowicz AW Clinic

🇵🇱

Warszawa, Poland

University Hospitals of North Midlands NHS Trust

🇬🇧

Stoke on Trent, United Kingdom

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