E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
acute moderate-to-severe post-surgical pain from dental surgery (impacted 3rd molar extraction) |
|
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10044049 |
E.1.2 | Term | Dental pain and sensation disorders |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the analgesic efficacy of a single s.c. injection of Diclofenac HPBCD (1 ml), at the strength of 25 and 50 mg/ml in the treatment of acute moderate-to-severe pain after dental impaction surgery. |
|
E.2.2 | Secondary objectives of the trial |
To compare the analgesic efficacy of a single s.c. injection of Diclofenac HPBCD (1 ml), at the strength of 25 and 50 mg/ml, with a single s.c. injection of Diclofenac HPBCD (1 ml), at the strength of 75 mg/ml; to evaluate the general safety and local tolerability of Diclofenac HPBCD s.c at the three different strengths. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Inclusion criteria: General 1. Out-patients of both genders. 2. Patients aged ≥ 18 to ≤ 65 years old. 3. Subjects able and willing to give their written consent prior to inclusion in the study. 4. Female subjects of childbearing potential must have a negative urine pregnancy test at screening and inclusion visit (i.e. not status post hysterectomy or tubal ligation) must be using an appropriate method of contraception according to the definition of Note of ICH M3 Guideline (implants, injectables, combined oral contraceptives, some IUDs, sexual abstinence of vasectomised partner) and must be willing to continue using it throughout the entire study period. 5. Subjects must be able to comprehend the full nature and purpose of the study, including possible risks and side effects, to co-operate with the Investigator, to comply with the requirements of the entire study and to return for the required examinations. Trial specific 6. Patients undergoing surgical extraction of a single fully or partially impacted mandibular 3rd molar requiring bone removal. 7. Patients experiencing moderate to severe post-operative pain, defined as a pain intensity ≥ 50 mm (VAS), within 6 hours from end of surgery. 8. Pre-operative laboratory tests (haematology, blood chemistry, urinalysis), performed within 30 days before inclusion (Visit 1) in the reference ranges or without clinically significant abnormalities as judged by the Investigator.
|
|
E.4 | Principal exclusion criteria |
General 1. Patients refusing to give a written informed consent. 2. Patients not able to understand the purposes of the study. 3. Patients not reliable, according to the investigator’s opinion. 4. Patients with major psychiatric disorders that could compromise the patient’s participation in the study. 5. Patients previously enrolled in this study or having used any investigational drug/device or participated in any clinical trial in the previous 3 months. 6. Employees of the Investigator or study centre (i.e. Principal Investigator, sub-investigator, study coordinators, other study staff, employees, or contractors of each), with direct involvement in the proposed study or other studies under the direction of that investigator and/or study centre, as well as family members of the employees or investigator. 7. Pregnant or breast-feeding women. 8. Alcohol or drug abuse within previous 12 months. 9. Clinically significant or unstable concurrent diseases whose sequeleae or treatment might interfere with the study evaluation parameters. Trial specific 10. Contra-lateral lower 3rd molar extraction or any other concomitant extraction. 11. Surgery performed under general anaesthesia, or sedation (including nitrous oxide by inhalation). 12. Complications occurring during the surgical procedure or in the period before randomisation as judged by the investigator. 13. Acute local or systemic infection at the time of surgery that could confound the post-surgical evaluation. 14. Patients with clinical signs of gastritis, gastro-duodenal ulcer, GI bleeding. Other GI disturbances or disease that in the opinion of the investigator could be negatively affected by the administration of NSAIDs. 15. Clinical signs or history of coagulation disorders that could be negatively affected by NSAIDs administration. 16. Hepatic or renal impairment. 17. Patients with significant cardiac impairment (i.e. severe heart failure, severe ischemic heart disease) history of cerebrovascular disease (i.e. ictus), history or peripheral arterial disease, uncontrolled hypertension, (i.e. not stable = repeated measurements of systolic pressure > 160 mm Hg or diastolic pressure > 95 mm Hg, despite pharmacological treatment). 18. Hypersensitivity to diclofenac or other NSAIDs or to one of the study medication components. 19. Patients under chronic treatment with topical or systemic analgesics/NSAIDs.
Non-permitted medications 20. Patients under treatment with any medication reported in the table below:
Non-permitted medications Period of wash-out before surgery Systemic NSAIDs or analgesics 24 hours Long acting aspirin 24 hours Long-acting NSAIDs 7 days Opioids 7 days Major or minor tranquillizers* 24 hours Muscle relaxant 24 hours Antihistaminesº 24 hours MAO inhibitors 2 weeks Other antidepressant: SSRI, serotonin/norepinephrine reuptake inhibitors, and triciclics. 3 weeks Corticosteroids (by any route of administration) 60 days *Benzodiazepine-type anxiolytics with analgesic or muscle relaxant effect are allowed if their use had been started at least 6 months earlier for other medical reasons: in this latter case, their dose must be maintained unchanged throughout the whole trial period ºUnless their use had been started at least 6 months earlier for other medical reasons: in this latter case, their dose must be maintained unchanged throughout the whole trial period
21. Patients under treatment with any medication whose concomitant use may be susceptible to interactions with diclofenac or may affect safety: lithium, digoxin, fenitoin, anticoagulants, antidiabetic agents, cysclosporin, methotrexate, quinolone antimicrobials, other NSAIDs, corticosteroids and diuretics.
|
|
E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint of the study will be the pain intensity difference (PID) after 1.5 hours following drug administration. Pain intensity difference (PID) is derived by subtracting each pain intensity score (PI) from the baseline PI score (t0), where PI is assessed by the patient on a 0-100 mm VAS (from 0 = no pain to 100 = worst pain imaginable). |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 6 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
| |
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 10 |
E.8.9.2 | In all countries concerned by the trial days | 0 |