- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04763876
Intramuscular Ketorolac at Two Single-Dose Regimens
February 18, 2021 updated by: William Beaumont Army Medical Center
Comparison of Intramuscular Ketorolac at Two Single-Dose Regimens for Treatment of Acute Musculoskeletal Pain in a Military Emergency Department: A Randomized Controlled Non-Inferiority Trial
The purpose of this study was to evaluate a single 15 mg intramuscular (IM) dose of ketorolac for analgesic non-inferiority versus a single 60 mg IM dose for the treatment of acute MSK pain in a military emergency department (ED) that services Department of Defense (DoD), Department of Veteran Affairs (VA), and foreign military beneficiaries
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
The primary purpose of this study is to evaluate a single 15 mg IM dose of ketorolac for analgesic non-inferiority versus a single 60 mg IM dose for the treatment of acute MSK pain in a military ED that services Department of Defense (DoD), Department of Veteran Affairs (VA), and foreign military beneficiaries.
The authors chose to evaluate 15 mg rather than the previously identified 10 mg dose for ease of administration as ketorolac is manufactured in 15 mg/mL, 30 mg/mL, and 60 mg/2mL vials in the U.S. The dose of ketorolac served as the primary independent variable for the study and the change in Visual Analog Scale (VAS) score served as the dependent variable.
Prescribing the minimally effective doses of NSAIDs is pertinent to prevent and reduce the number of adverse events.
Thus, the secondary outcome assessed for the dose-dependence of subjective and objective adverse events with ketorolac.
Study Type
Interventional
Enrollment (Actual)
110
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Texas
-
El Paso, Texas, United States, 79920
- William Beaumont Army Medical Center
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 55 years (ADULT)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Tricare beneficiaries between 18-55 years of age
- Triaged as Emergency Severity Index 4 or 5
- Presenting to the William Beaumont Army Medical Center Emergency Department with a chief complaint of acute MSK pain (i.e., general muscular, neck, back, shoulder, arm, forearm, elbow, wrist, finger, hip, knee, thigh, leg, ankle, foot, or digits)
- Pain intensity of 20 mm or greater on a standard 100 mm visual analog scale
- Who the attending provider concurred with ketorolac IM administration for analgesia.
Exclusion Criteria:
- Body weight less than 50 kg (110 lbs.)
- Younger than 18 or older than 55 years
- Pregnant or breast feeding
- History of: confirmed, unconfirmed, known, unknown, or suspected peptic ulcer disease, intestinal hemorrhage, renal insufficiency, hepatic insufficiency, cerebrovascular bleeding, hemorrhagic diathesis, incomplete hemostasis, dark stools, bright red blood per rectum, hemoptysis, easy bruising, or high risk of bleeding
- Unable to confidently convey or unknown medical history
- Allergy or hypersensitivity to nonsteroidal anti-inflammatory drugs or aspirin
- Systolic blood pressure <90 or >180 mmHg
- Pulse rate <50 or >150 beats/min
- Any over-the-counter or prescribed opioid and/or non-opioid analgesic medication (oral, per rectum, topical or parenteral) taken within 12 hours of ED presentation
- Advised by any medical provider to not receive NSAIDs for any reason
- Pain duration greater than 30 days (including acute on chronic pain)
- Refusal to remain in the WBAMC ED for up to 60 minutes after injection of ketorolac
- Patients currently taking anticoagulant medications
- Concurrent use of medications which are contraindicated with concomitant NSAID use (drugs include aspirin, probenecid and pentoxifylline).
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: 15 mg ketorolac intramuscular
Patients who received a single 15 mg dose of ketorolac administered intramuscularly
|
A single dose of 15 mg ketorolac administered intramuscularly.
Other Names:
|
ACTIVE_COMPARATOR: 60 mg ketorolac intramuscular
Patients who received a single 60 mg dose of ketorolac administered intramuscularly
|
A single dose of 60 mg ketorolac administered intramuscularly.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean difference of Visual Analog Scale scores between the two groups
Time Frame: 60 minutes from administration of medication
|
The mean difference of Visual Analog Scale scores between the two treatment groups measured at 60-minutes.
The Visual Analog Scale used measures from 0 mm to 100mm.
A higher score represents more degree of change.
13 mm was used as the non-inferiority margin.
A difference between the two groups less than 13 mm demonstrates that 15 mg is non-inferior to 60 mg.
|
60 minutes from administration of medication
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean difference of Visual Analog Scale scores between the two groups
Time Frame: 30 minutes from administration of medication
|
The mean difference of Visual Analog Scale scores between the two treatment groups measured at 60-minutes.
The Visual Analog Scale used measures from 0 mm to 100mm.
A higher score represents more degree of change.
13 mm was used as the non-inferiority margin.
A difference between the two groups less than 13 mm demonstrates that 15 mg is non-inferior to 60 mg.
|
30 minutes from administration of medication
|
Incidence of adverse events related to the administration of ketorolac
Time Frame: At time of administration, 30 minutes after administration, and 60 minutes after administration.
|
The incidence of observed objective and reported subjective adverse events related to the administration of ketorolac.
|
At time of administration, 30 minutes after administration, and 60 minutes after administration.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Nathaniel J Turner, MPAS, Department of Emergency Medicine, William Beaumont Army Medical Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (ACTUAL)
June 27, 2020
Primary Completion (ACTUAL)
November 9, 2020
Study Completion (ACTUAL)
November 9, 2020
Study Registration Dates
First Submitted
February 1, 2021
First Submitted That Met QC Criteria
February 18, 2021
First Posted (ACTUAL)
February 21, 2021
Study Record Updates
Last Update Posted (ACTUAL)
February 21, 2021
Last Update Submitted That Met QC Criteria
February 18, 2021
Last Verified
February 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pain
- Neurologic Manifestations
- Musculoskeletal Diseases
- Muscular Diseases
- Musculoskeletal Pain
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Cyclooxygenase Inhibitors
- Ketorolac
- Ketorolac Tromethamine
Other Study ID Numbers
- C.2019.088
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
Yes
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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