E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Moderate to severe pain following dental surgery. |
Dolor moderado a severo tras cirugía dental |
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E.1.1.1 | Medical condition in easily understood language |
Moderate to severe pain |
Dolor moderado a severo |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03] |
MedDRA Classification |
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 |
The main objective consists on evaluating the analgesic efficacy of oral ibuprofen arginine and tramadol hydrochloride fixed combination versus each component single and placebo, in patients with moderate to severe pain after dental surgery. |
El objetivo principal consiste en evaluar la eficacia analgésica de la combinación a dosis fijas de ibuprofeno arginina y tramadol hidrocloruro frente a cada componente por separado y placebo, en administración oral, en pacientes con dolor moderado a intenso tras cirugía dental. |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives: To assess the safety and tolerability of ibuprofen arginine and tramadol hydrochloride fixed combination and compared to each components single. |
Valorar la seguridad y la tolerabilidad de la combinación a dosis fijas de ibuprofeno arginina y tramadol hidrocloruro y compararlas con la de sus componentes por separado. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Inclusion criteria: 1. Able to understand and sign consent informed before participating in the study and willing to comply with all visits and procedures scheduled and collect the information required by the protocol. 2. Men and women of both sexes at least 18 years of age. 3. For women: postmenopausal women or unable by surgery, not pregnant women of child-bearing age who use acceptable methods of birth control and normal menstrual period 3 months before the clinical study. 4. Body weight of more than 50 Kg and less than 110 Kg. 5. Programed people to ambulatory surgical dental removal, under local anesthesia, at least 2 impacted third molars which require bone removal. If only 2 third molars are removed these should be ipsilaterals and at least one of them should require bone removal. 6. People with moderate to severe pain, reaching at least 45 mm in EVA scale for the first 4 hours after surgery. 7. Surgery without complications, surgery time no more than 1 hour and without re-anesthesia. 8. Must accept don´t take analgesics, except rescue medication until treatment described in the Protocol, up to 24 hours after first administration of study medication. 9. With ordinary or without relevant abnormalities medical records and physical exploration, to the discretion of the investigator. 10. People who have not used up analgesics (including those for prescription and non-prescription sale) until 48 hours before the surgery, or 5 days early in the event of consumption of COX-2 inhibitors. 11. For women of childbearing, they should have a negative pregnancy test prior to randomization. |
Para participar en el estudio los pacientes han de cumplir todos los siguientes: 1. Capaces de entender y firmar el consentimiento informado antes de participar en el estudio y dispuestos a cumplir con todas las visitas y los procedimientos programados y de recoger la información que requiere el protocolo. 2. Hombres o mujeres de ambos sexos con, al menos, 18 años de edad. 3. En el caso de las mujeres, que estén en etapa posmenopáusica o que no pueden tener hijos por intervención quirúrgica, o mujeres en edad fértil no embarazadas que usen métodos aceptables de control de natalidad y un patrón menstrual normal en los tres meses previos a su entrada en el estudio. 4. Peso corporal superior a 50 kg e inferior a 110 kg. 5. Programados para la extracción quirúrgica ambulatoria, bajo anestesia local, de al menos dos terceros molares impactados que requieran eliminación de hueso. Si sólo se extraen 2 terceros molares, éstos deben ser ipsilaterales y al menos uno requerir eliminación de hueso. 6. Que experimenten un dolor de moderado a intenso, alcanzando una puntuación de al menos 45mm en la EVA durante las primeras 4 horas tras finalizar la cirugía. 7. Sin complicaciones durante la cirugía, con duración de la misma no superior a 1 hora y que no hayan requerido reanestesia. 8. Que acepten no tomar analgésicos a excepción de los que el protocolo define como medicación de rescate durante el período de tratamiento, hasta pasadas 24 horas tras la administración de la primera dosis de la medicación del estudio. 9. Con historial médico y exploración física normales o sin anomalías clínicamente relevantes, a criterio del investigador. 10. Que no hayan consumido analgésicos (incluyendo los de prescripción y los de venta sin receta) durante las 48 horas previas a la cirugía, o 5 días previos en el caso de consumo de inhibidores de la COX-2. 11. En el caso de mujeres con capacidad reproductiva, que tengan una prueba de embarazo negativa antes de la aleatorización. |
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E.4 | Principal exclusion criteria |
Exclusion criteria: 1. History of allergy or hypersensitivity to the study medication, to the rescue medication or to the any other NSAID, to the opiates or to the acetylsalicylic acid. 2. History of asthma, bronchospasm, acute rhinitis, nasal polyps, hives or angioneurotic edema. 3. History of peptic ulcers, gastrointestinal disorders caused by NSAID, gastrointestinal bleeding or others active bleedings. 4. Renal, hepatic and cardiac dysfunction moderate to severe. 5. Coagulation disorders. 6. Uncontrolled seizure disorders. 7. Crohn's disease or ulcerative colitis. 8. History of drug addiction and alcohol abuse. According to the study, alcohol abuse is defined in the following manner: average weekly consumption >21 units (men) and >14 units (women), or average daily consumption >3 units (men) and >2 units (women) [1 unit = 125 ml of wine, 200ml of beer, 25ml of liquor] 9. According to the investigator, patients who are not suitable candidates to take the study medication and the rescue medication based on their medical history, concomitant medication systemic concurrent diseases described in the corresponding technical sheets (warnings, precautions, contraindications and adverse events) of ibuprofen, tramadol, paracetamol and metamizole ( paracetamol and metamizole are rescue medication). 10. Inability to abstain from alcohol, psychotropic drugs and sedative medications or others drugs banned (*) until 48 hours or 5 half-lives (the longest possible) before the start of surgery and until 24 hours after of administration of study medication. (*)different analgesics from study medication, anticoagulants, thrombolytic and antiplatelet agents, corticosteroids, MAO inhibitors, antiepileptic drugs, antipsychotics, SSRIs and tricyclic antidepressants, lithium, methotrexate, sulfonamides. 11. Patients using and don´t be able to interrupt other drugs, prescribed or not, that could interfere with the study medication and study procedures, or could endanger the patient´ safety according to related documentation with the medications included in the study and the rescue medication, until 48 hours or 5 half-lives (the longest possible) before the start of surgery and until 24 hours after of administration of study medication. 12. Patients who have taken an experimental medication or patients who have used an experimental medical device within 30 days before to selection. 13. Pregnant or nursing women. 14. History of any liver disease or disorder which, according to investigator, might constitute a risk to the patient or to alter the results of the study (e.g. patients with severe pain of different origins or location at the surgery moment.) 15. Patients who cannot meet the requirements of the study or must not take part according to the investigator. |
Para participar en el estudio, los pacientes no han de cumplir ninguno de los siguientes: 12. Antecedentes de alergia o hipersensibilidad a la medicación del estudio, la medicación de rescate o a cualquier otro antiinflamatorio no esteroideo (AINE), a los opiáceos o al ácido acetilsalicílico, o a alguno de sus excipientes. 13. Antecedentes de asma, broncoespasmo, rinitis aguda, pólipos nasales, urticaria o edema angioneurótico. 14. Antecedentes de úlcera péptica, trastornos gastrointestinales por AINE, hemorragia gastrointestinal u otras hemorragias activas. 15. Insuficiencia renal, hepática o cardiaca de moderada a grave. 16. Diátesis hemorrágica u otros trastornos de la coagulación. 17. Epilepsia no controlada. 18. Enfermedad de Crohn o colitis ulcerosa. 19. Antecedentes de dependencia de drogas de abuso o alcohol. A efectos del estudio, la dependencia de alcohol se define de la siguiente manera: consumo semanal promedio >21 unidades (hombres) y >14 unidades (mujeres), o consumo diario promedio de >3 unidades (hombres) y >2 unidades (mujeres) (Una unidad corresponde a aprox. 125 ml de vino, 200 ml de cerveza, 25 ml de licores). 20. Pacientes incapaces de abstenerse de consumir alcohol, psicofármacos o sedantes (p.ej. benzodiacepinas) u otros medicamentos prohibidos como los relacionados más abajo durante 48 horas o 5 semividas (lo que sea más prolongado) antes del inicio de la cirugía y durante las 24 horas siguientes a la administración de la medicación del estudio. Los medicamentos prohibidos son los siguientes: analgésicos diferentes de la medicación de estudio, anticoagulantes, trombolíticos y antiagregantes plaquetarios, corticoesteroides, Inhibidores de la MAO, antiepilépticos, antipsicóticos, inhibidores de la recaptación de serotonina y antidepresivos tricíclicos, litio, metotrexato, sulfonamidas. 21. Que hayan recibido un fármaco experimental o usado un dispositivo médico experimental en el plazo de los 30 días previos a la selección. 22. Mujeres embarazadas o en período de lactancia. 23. Antecedentes de cualquier enfermedad o trastorno que, a criterio del investigador, pudiera constituir un riesgo para el paciente o alterar los resultados del estudio (p.ej. pacientes con dolor agudo de cualquier otro origen o localización en el momento de la cirugía). 24. Que no puedan cumplir con los requisitos del estudio o que en opinión del investigador no deben participar. |
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E.5 End points |
E.5.1 | Primary end point(s) |
? Main parameter for judging the efficacy and main efficacy analysis: The main variable of the study will be the pain intensity 6 hours after the start of treatment, measured as of EVA points (0-100) at that moment |
La variable principal del estudio es la intensidad del dolor, medida a través de una Escala Visual Analógica (EVA) de 100mm y valorada por el paciente. La variable principal de eficacia para el análisis será la Intensidad de dolor a las 6 horas de inicio del tratamiento. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Sum of Pain Intensity Differences (SPID), pain intensity difference (PID), pain relief (PAR), total pain relief (TOTPAR), the percentage of patients that respond to treatment, the percentage of patient that needed rescue medication, time to first intake of rescue medication, time to achieve pain relief and global assessment of study medication. |
Suma de las diferencias de intensidad del dolor (SPID), Diferencia de intensidad del dolor (PID), Alivio del dolor (PAR), Alivio del dolor total (TOTPAR), porcentaje de pacientes que necesitaron medicación de rescate, tiempo hasta la primera ingestión de medicación de rescate, tiempo hasta lograr un alivio significativo del dolor, porcentaje de pacientes que responden al tratamiento y evaluación global de la medicación del estudio por el paciente |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
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 | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
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 | No |
E.8.2.4 | Number of treatment arms in the trial | 6 |
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 | 8 |
E.8.5 | The trial involves multiple Member States | No |
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 | No |
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
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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 | 9 |
E.8.9.1 | In the Member State concerned days | 0 |