- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04968158
Efficacy and Safety of Fixed-dose Combination of Etoricoxib/Tramadol vs Acetaminophen/Tramadol for Acute Low Back Pain
April 12, 2022 updated by: Laboratorios Silanes S.A. de C.V.
Confirmatory Efficacy and Safety Study of the Fixed-dose Combination of Etoricoxib / Tramadol Versus Acetaminophen / Tramadol for the Management of Acute Low Back Pain.
Phase IIIb, longitudinal, multicenter, randomized, open-label clinical trial to evaluate the efficacy and safety of the fixed-dose combination of etoricoxib 90 mg and tramadol 50 mg compared with fixed-dose therapy of acetaminophen 325 mg and tramadol 37.5 mg for the management of acute low back pain.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Patients with back pain from the level of the lowest rib to the gluteal crease, with or without radiation to the legs, as a first-time episode or after another at least 6 months before and lasting no more than 6 weeks, that in the opinion of the doctor requires treatment with the combination of an anti-inflammatory and an analgesic.
Study to evaluate the efficacy and safety of the fixed-dose combination of etoricoxib 90 mg and tramadol 50 mg compared with the fixed-dose therapy of acetaminophen 325 mg and tramadol 37.5 mg for the management of acute low back pain.
Evaluate and compare the average change in pain reported through the VAS at 3, 5 and 7 days with respect to its baseline measurement by treatment group.
An exploratory analysis of the data will be carried out to identify aberrant, outliers, or missing values.
To present the numerical variables, the measures of central tendency and dispersion appropriate to the distribution of the data will be used and the categorical variables will be expressed as frequency and percentage.
Study Type
Interventional
Enrollment (Actual)
124
Phase
- Phase 3
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
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Mexico City, Mexico, 11000
- Laboratorio Silanes, S.A. de C.V.
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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 60 years (ADULT)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Any sex.
- That the subject agree to participate in the study and give informed consent in writing.
- Age> 18 years and ≤ 60 years of age at the beginning of the study.
- Diagnosis of acute low back pain as a first-time episode or after another episode, maximum 6 months before and lasting no more than 6 weeks.
- Patient with low back pain reported as moderate to severe intensity (VAS> 4 cm).
- Women of childbearing age who have an acceptable contraceptive method (eg barrier, oral hormonal, injectable, subdermal).
Exclusion Criteria:
- Patients in whom the study drug is contraindicated for medical reasons.
- Patients with an allergy or hypersensitivity to the active principle, study drugs, related products or excipients.
- Positive pregnancy test, women who are pregnant, breastfeeding or planning a pregnancy while conducting the study.
- A significant history of gastrointestinal disorders (for example: Gastric ulcer, Crohn's disease, Ulcerative Colitis, etc.).
- Previous treatment with opioids and / or NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) reported in the medical history in the last 72 hours at study entry.
- Patients with a history of alcohol or drug abuse in the last year according to DSM-V (Diagnostic and Statistical Manual of Mental Disorders).
- Patients who are receiving monoamine oxidase inhibitors (MAOIs) or who have received them within the past 2 weeks.
- Patients with a history of established ischemic heart disease, peripheral arterial disease and / or cerebrovascular disease (including patients who have recently undergone coronary artery bypass grafting or angioplasty).
- Patients with status epileptic seizure disorders and grand mal seizures.
- Patients with a history of severe acute or chronic liver failure.
- Patients with a history of moderate to severe renal failure.
- Patient with a history of chronic pain (eg, fibromyalgia, Paget's disease, bone pain induced by metastatic cancer).
- Low back pain due to major trauma (eg vertebral fracture, post-traumatic spondylolisthesis), or due to a visceral disorder (eg dysmenorrhea, endometriosis).
- At medical criteria, a disease that affects the prognosis and prevents outpatient management, for example, but not restricted to: intestinal obstruction, paralytic ileus, end-stage cancer, kidney, heart, respiratory or liver failure or mental illness or with surgical procedures or scheduled hospitals.
- History / presence of any disease or condition that, in the Investigator's opinion, could pose a risk to the patient or confuse the efficacy and safety of the study results. ----Patients with symptoms suggesting an active COVID-19 infection (i.e., fever, cough, dyspnea) and / or contact in the past 14 days with a suspected or positive COVID-19 patient.
- Oncological patients (except basal cell skin cancer) or with serious diseases that, in the opinion of the investigator, have a serious prognosis or a life expectancy of less than 1 year, as well as mental illnesses.
- The patient is participating in another clinical study involving an investigational treatment or participated in one in the previous 4 weeks.
- Patients whose participation in the study may be influenced (employment relationship with the research center or sponsor, inmates, etc.).
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: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
EXPERIMENTAL: Group A: Etoricoxib/Tramadol
Administered orally, one packet of etoricoxib / tramadol granules diluted in 100 ml of water, every 24 hours for 7 days.
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One packet diluted in 100 ml of water, every 24 hours of 90 mg/50 mg.
Other Names:
|
|
ACTIVE_COMPARATOR: Group B: Acetaminophen / Tramadol
Administered orally, one tablet, every 8 hours, for 7 days.
|
One tablet, every 8 hours of 325 mg/ 37.5 m
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Average change in reported pain
Time Frame: Baseline, 3, 5 and 7 days.
|
Compare the average change in pain reported through the VAS (Visual Analog Scale) per treatment group.
In a straight 10 centimeter line in which one end means no pain and the other end means the worst pain imaginable, the participants mark the amount of pain feeling at that moment
|
Baseline, 3, 5 and 7 days.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of patients with a 30% reduction in pain intensity
Time Frame: Baseline and 7 days.
|
Describe the proportion of patients who reported a 30% reduction in pain intensity measure by the VAS (Visual Analog Scale) per treatment group.
In a straight 10 centimeter line in which one end means no pain and the other end means the worst pain imaginable, the participants mark the amount of pain feeling at that moment.
|
Baseline and 7 days.
|
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Degree of disability due to low back pain
Time Frame: Baseline and 7 days.
|
Evaluate the degree of disability due to low back pain measured through the Oswestry disability scale per treatment group.
It measures the limitations in daily activities in the presence of pain in the lumbar region, consists of 10 questions with 6 possible answers considering the intensity of the pain, basic activities of daily life such as: personal care, sexual activity, sleep, travel and social life.
|
Baseline and 7 days.
|
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Degree of inability to perform daily activities
Time Frame: Baseline and 7 days.
|
Assess the degree of inability to perform daily activities through the Roland-Morris scale per group.
It´s a self-applied scale where the extreme values range between 0 (absence of disability) and 24 (maximum disability) and is categorized according to the relevance of the score obtained where the optimal threshold of variation is 3 and 4 points.
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Baseline and 7 days.
|
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Adverse events
Time Frame: 7 days.
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Compare the frequency of adverse events presented during the study between the treatment groups.
|
7 days.
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Adelfia Urenda Quezada, M.D, Mediadvance Clinical S.A.P.I. de Quezada
- Principal Investigator: Alejandro González Rebatu y González, M.D, Clinical Research Institute S.C.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 10;392(10159):1789-1858. doi: 10.1016/S0140-6736(18)32279-7. Epub 2018 Nov 8. Erratum In: Lancet. 2019 Jun 22;393(10190):e44.
- Soto-Padilla M, Espinosa-Mendoza RL, Sandoval-Garcia JP, Gomez-Garcia F. [Comparative study between plate-graft, cage-plate and peek cage in cervical arthrodesis for cervical stenosis]. Acta Ortop Mex. 2015 Jan-Feb;29(1):40-5. Spanish.
- Casser HR, Seddigh S, Rauschmann M. Acute Lumbar Back Pain. Dtsch Arztebl Int. 2016 Apr 1;113(13):223-34. doi: 10.3238/arztebl.2016.0223.
- Guevara-Lopez U, Covarrubias-Gomez A, Elias-Dib J, Reyes-Sanchez A, Rodriguez-Reyna TS; Consensus Group of Practice Parameters to Manage Low Back Pain. Practice guidelines for the management of low back pain. Consensus Group of Practice Parameters to Manage Low Back Pain. Cir Cir. 2011 May-Jun;79(3):264-79, 286-302. English, Spanish.
- Gonzalez Maza C, Moscoso Lopez L, Ramirez Elizalde G, Abdo Andrade A. [Multimodal treatment of chronic unspecific low back pain]. Acta Ortop Mex. 2010 Mar-Apr;24(2):88-94. Spanish.
- Chandanwale AS, Sundar S, Latchoumibady K, Biswas S, Gabhane M, Naik M, Patel K. Efficacy and safety profile of combination of tramadol-diclofenac versus tramadol-paracetamol in patients with acute musculoskeletal conditions, postoperative pain, and acute flare of osteoarthritis and rheumatoid arthritis: a Phase III, 5-day open-label study. J Pain Res. 2014 Aug 12;7:455-63. doi: 10.2147/JPR.S67817. eCollection 2014.
- Bravo L, Mico JA, Berrocoso E. Discovery and development of tramadol for the treatment of pain. Expert Opin Drug Discov. 2017 Dec;12(12):1281-1291. doi: 10.1080/17460441.2017.1377697. Epub 2017 Sep 17.
- Dhillon S. Tramadol/paracetamol fixed-dose combination: a review of its use in the management of moderate to severe pain. Clin Drug Investig. 2010;30(10):711-38. doi: 10.2165/11205830-000000000-00000. Erratum In: Clin Drug Investig. 2010;30(12):866.
- Subedi M, Bajaj S, Kumar MS, Yc M. An overview of tramadol and its usage in pain management and future perspective. Biomed Pharmacother. 2019 Mar;111:443-451. doi: 10.1016/j.biopha.2018.12.085. Epub 2018 Dec 27.
Helpful Links
- World Health Organization. Musculoskeletal disorders [Internet]. Descriptive notes. 2019.
- "That establishes the tests and procedures to demonstrate that a drug is interchangeable. Requirements to which the Authorized Third Parties that carry out the interchangeability tests must be ".
- "Installation and operation of pharmacovigilance: This document establishes the guidelines on which pharmacovigilance activities must be carried out"
- "That establishes the criteria for the execution of research projects for health in human beings"
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)
November 29, 2021
Primary Completion (ACTUAL)
March 15, 2022
Study Completion (ACTUAL)
April 10, 2022
Study Registration Dates
First Submitted
July 13, 2021
First Submitted That Met QC Criteria
July 13, 2021
First Posted (ACTUAL)
July 20, 2021
Study Record Updates
Last Update Posted (ACTUAL)
April 13, 2022
Last Update Submitted That Met QC Criteria
April 12, 2022
Last Verified
April 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Pain
- Neurologic Manifestations
- Back Pain
- Low Back Pain
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- 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
- Antipyretics
- Analgesics, Opioid
- Narcotics
- Cyclooxygenase 2 Inhibitors
- Acetaminophen
- Tramadol
- Etoricoxib
Other Study ID Numbers
- SIL-30138-III-21(1)
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
No
Studies a U.S. FDA-regulated device product
No
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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