E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Moderate to severe acute low-back pain (12 weeks or less of symptoms). |
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E.1.1.1 | Medical condition in easily understood language |
Moderate to severe acute low-back pain (12 weeks or less of symptoms). |
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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.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 19.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10024891 |
E.1.2 | Term | Low back pain |
E.1.2 | System Organ Class | 100000004859 |
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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 |
Main objective of the trial is to evaluate the efficacy, safety and effects on Quality of Life (QOL) of the medicines Doreta IR and Doreta SR produced by Krka, d.d., Novo mesto, Slovenia in patients with moderate to severe acute low-back pain. |
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E.2.2 | Secondary objectives of the trial |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Patients diagnosed with acute low back pain (12 weeks or less of symptoms).
• Patients whose average pain intensity is more than or equal to 40 millimeters on horizontal Visual Analog Scale (VAS) over the last 48 hours after the completion of screening.
• Female and male patients aged 18-75 years.
• Written informed consent. |
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E.4 | Principal exclusion criteria |
• Hypersensitivity to the active substances or to any of the excipients.
• Patients taking Monoamine oxidase (MAO) inhibitors or are within two weeks of their withdrawal.
• Patients taking neuroleptics or drugs for seizures.
• Severe hepatic impairment.
• Patients on maintenance tramadol and/or paracetamol therapy.
• Patients taking sedative hypnotics, short-acting analgesics, topical medications and anesthetics, and/or muscle relaxants.
• Pregnant, lactating or breastfeeding participants.
• Known or suspected alcohol or drug abuse or addiction within three years preceding screening.
• Patients with unstable angina pectoris or after acute myocardial infarction (4 weeks after acute myocardial infarction).
• Other mental disorders (possible interactions with mental disorder medicines).
• Surgical procedures planned to occur during trial (patients may be rescreened following completion of and recovery from the surgical procedure).
• Concomitant treatment that might influence the final therapeutic effect of the tested active substances.
• Concomitant therapy with either selective serotonin reuptake inhibitors (SSRI) or serotonin–norepinephrine reuptake inhibitors (SNRI).
• Patients who under the opinion of the investigator will not be compliant to the treatment. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The proportion of patients with clinically meaningful improvement of low back pain. Reduction of low back pain intensity is considered as clinically meaningful if pain intensity not exceeding 30 mm on VAS is achieved on the day of therapy discontinuation or at the end of the trial. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
After 28 days of treatment |
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E.5.2 | Secondary end point(s) |
The secondary end points of the trial are:
• Pain intensity difference (PID) at the end of dosing interval on day 6 (one endpoint).
• Cumulative pain intensity (CPI) throughout the dosing interval (five endpoints).
• Pain intensity difference between each control visit value and the baseline value at Visit 1 (three endpoints).
• Quality of life difference (two endpoints).
• Pain interference score difference (assessed by Brief pain inventory - Short form) between the value at each visit and the baseline value at Visit 1 (three endpoints).
• Proportion of patients with excellent pain response (one endpoint).
• Proportion of patients with reduced pain at each control visit (three endpoints).
• Proportion of patients with eliminated pain: at each control visit (three endpoints).
• Proportion of compliant patients, i.e. those having a compliance of more than 80 % at the regular therapy end visit (one endpoint). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
After 28 days of treatment |
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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 | Yes |
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) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Different dosage forms and doses of the tramadol/paracetamol combination |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.5 | The trial involves multiple Member States | Yes |
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 | 1 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |