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    Clinical Trial Results:
    Phase IV study comparing the efficacy and safety of an alcohol-free formulation of 0.15% benzydamine hydrochloride spray and benzydamine hydrochloride 3mg lozenges in paediatric patients (6-12 years) with sore throat.

    Summary
    EudraCT number
    2022-003285-20
    Trial protocol
    HU   BG  
    Global end of trial date
    18 Jan 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Apr 2025
    First version publication date
    16 Apr 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    030(Z)MD22061
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Angelini Pharma S.p.A.
    Sponsor organisation address
    Via Amelia 70, Roma, Italy, 00181
    Public contact
    Study Manager, Angelini Pharma S.p.A., 0039 3472274815, martina.barcaroli@angelinipharma.com
    Scientific contact
    Study Manager, Angelini Pharma S.p.A., 0039 3472274815, martina.barcaroli@angelinipharma.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    18 Jan 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Jan 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to assess the local analgesic effect of benzydamine hydrochloride (spray or lozenges) in reducing sore throat pain at T15 min after a single dose administration to paediatric patients.
    Protection of trial subjects
    This trial was conducted in accordance with the study protocol, GCPs, Declaration of Helsinki (including up-to-date versions) and applicable regulatory requirements. The child participated the study only after parents/legal guardian signature of the ICF and GDPR Consent and (whenever possible) by giving his/her own assent. The Investigator asked to confirm the occurrence of the parents/legal guardian’s consent (and child's assent,) to participate to the study and to process personal data by signing the relevant ICF and GDPR Consent , respectively. Original signed versions of the ICFs, GDPR Consents and Assents availabled for monitoring and auditing visits at the investigational site.
    Background therapy
    -
    Evidence for comparator
    The purpose of this study was generate new clinical data and update available information on the use of benzydamine in children. The local analgesic effect in reducing throat pain provided by a single application of benzydamine hydrochloride 3 mg lozenges and benzydamine hydrochloride 0.15 % spray was investigated.
    Actual start date of recruitment
    16 Jun 2023
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Bulgaria: 138
    Country: Number of subjects enrolled
    Hungary: 116
    Country: Number of subjects enrolled
    Romania: 109
    Worldwide total number of subjects
    363
    EEA total number of subjects
    363
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    343
    Adolescents (12-17 years)
    20
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 363 subjects, male and female pediatric patients (aged 6-12 years) with sore throat symptoms were enrolled, 185 and 178 in the spray and lozenges groups, respectively.

    Pre-assignment
    Screening details
    -

    Pre-assignment period milestones
    Number of subjects started
    363
    Number of subjects completed
    363

    Period 1
    Period 1 title
    Overall (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Test drug: 0.15% Benzydamine hydrochloride spray
    Arm description
    The first dose (4 puffs) was administered at the site by the investigator, the subject and parents/legal guardian was instructed to administer the dose of 4 puffs from 2 to 6 times a day until sore throat disappearance or for a maximum of 7 days.
    Arm type
    Experimental

    Investigational medicinal product name
    Benzydamine hydrochloride 0.15%, oromucosal spray
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oromucosal spray
    Routes of administration
    Oromucosal use
    Dosage and administration details
    The dose of 4 puffs from 2 to 6 times a day until sore throat disappearance or for a maximum of 7 days. 1 puff is equivalent to 0.255mg of benzydamine hydrochloride, thus the first dose is equivalent to 1.02mg and total daily dose ranges from 2.04mg to 6.12mg benzydamine hydrochloride.

    Arm title
    Test Comparator: Benzydamine hydrochloride lozenges 3mg
    Arm description
    A single 3mg lozenge of benzydamine hydrochloride was administered at the investigational site.
    Arm type
    Active comparator

    Investigational medicinal product name
    Lozenge of benzydamine hydrochloride
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Lozenge
    Routes of administration
    Oral use
    Dosage and administration details
    Dose: 3mg lozenge of benzydamine hydrochloride was administered. Then, parents will take the drug at home, according to the product’s relevant SmPC, 3 times a day for a maximum of 7 days from the first application

    Number of subjects in period 1
    Test drug: 0.15% Benzydamine hydrochloride spray Test Comparator: Benzydamine hydrochloride lozenges 3mg
    Started
    185
    178
    Completed
    185
    178

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall
    Reporting group description
    -

    Reporting group values
    Overall Total
    Number of subjects
    363 363
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    343 343
        Adolescents (12-17 years)
    20 20
        Adults (18-64 years)
    0 0
        From 65-84 years
    0 0
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    8.6 ( 1.8 ) -
    Gender categorical
    Units: Subjects
        Female
    170 170
        Male
    193 193
    Subject analysis sets

    Subject analysis set title
    Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety analyses were performed on the safety population (SP), which included all randomized subjects who have taken at least one dose of the IMP.

    Subject analysis set title
    m-ITT
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All randomized subjects who have taken at least one dose of the IMP and having the T15 min posttreatment efficacy assessment with the WBS score were included in the m-ITT population.

    Subject analysis set title
    PP Population
    Subject analysis set type
    Per protocol
    Subject analysis set description
    All randomized subjects who have taken at least the first dose of the IMP and having all Day 0 (up to T45 min) WBS score evaluations, with no major protocol violations were included in the PP population

    Subject analysis sets values
    Safety Population m-ITT PP Population
    Number of subjects
    363
    362
    347
    Age categorical
    Units: Subjects
        In utero
    0
    0
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
    0
    0
        Newborns (0-27 days)
    0
    0
    0
        Infants and toddlers (28 days-23 months)
    0
    0
    0
        Children (2-11 years)
    343
    342
    328
        Adolescents (12-17 years)
    20
    20
    19
        Adults (18-64 years)
    0
    0
    0
        From 65-84 years
    0
    0
    0
        85 years and over
    0
    0
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    8.6 ( 1.8 )
    8.6 ( 1.8 )
    8.6 ( 1.8 )
    Gender categorical
    Units: Subjects
        Female
    170
    169
    166
        Male
    193
    193
    181

    End points

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    End points reporting groups
    Reporting group title
    Test drug: 0.15% Benzydamine hydrochloride spray
    Reporting group description
    The first dose (4 puffs) was administered at the site by the investigator, the subject and parents/legal guardian was instructed to administer the dose of 4 puffs from 2 to 6 times a day until sore throat disappearance or for a maximum of 7 days.

    Reporting group title
    Test Comparator: Benzydamine hydrochloride lozenges 3mg
    Reporting group description
    A single 3mg lozenge of benzydamine hydrochloride was administered at the investigational site.

    Subject analysis set title
    Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety analyses were performed on the safety population (SP), which included all randomized subjects who have taken at least one dose of the IMP.

    Subject analysis set title
    m-ITT
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All randomized subjects who have taken at least one dose of the IMP and having the T15 min posttreatment efficacy assessment with the WBS score were included in the m-ITT population.

    Subject analysis set title
    PP Population
    Subject analysis set type
    Per protocol
    Subject analysis set description
    All randomized subjects who have taken at least the first dose of the IMP and having all Day 0 (up to T45 min) WBS score evaluations, with no major protocol violations were included in the PP population

    Primary: WBS at 15 mins

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    End point title
    WBS at 15 mins
    End point description
    The primary endpoint was the non-inferiority of the test product (defined as the difference between test and reference product 95% CI lower bound of WBS score reduction above 10%) when compared to the reference product with respect to the differences in the percentage of participants who reported a reduction of at least one face (equal to two points) in the WBS score at T15 min after the first application vs. baseline.
    End point type
    Primary
    End point timeframe
    15 min
    End point values
    Test drug: 0.15% Benzydamine hydrochloride spray Test Comparator: Benzydamine hydrochloride lozenges 3mg
    Number of subjects analysed
    185
    178
    Units: Percentage (%)
    83
    86
    Statistical analysis title
    Wald 95% CI
    Statistical analysis description
    Wald 95% CI
    Comparison groups
    Test drug: 0.15% Benzydamine hydrochloride spray v Test Comparator: Benzydamine hydrochloride lozenges 3mg
    Number of subjects included in analysis
    363
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority
    Method
    Wald 95% CI
    Parameter type
    95% CI
    Point estimate
    -4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -11.6
         upper limit
    3.5

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Subjects administered with Benzydamine hydrochloride 0.5% spray
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.1
    Reporting groups
    Reporting group title
    Benzydamine hydrochloride - spray
    Reporting group description
    -

    Reporting group title
    Benzydamine hydrochloride Lozenges 3mg
    Reporting group description
    -

    Serious adverse events
    Benzydamine hydrochloride - spray Benzydamine hydrochloride Lozenges 3mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 185 (0.00%)
    0 / 178 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Frequency threshold for reporting non-serious adverse events: 0.5%
    Non-serious adverse events
    Benzydamine hydrochloride - spray Benzydamine hydrochloride Lozenges 3mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    13 / 185 (7.03%)
    7 / 178 (3.93%)
    Nervous system disorders
    headache
         subjects affected / exposed
    1 / 185 (0.54%)
    1 / 178 (0.56%)
         occurrences all number
    1
    1
    General disorders and administration site conditions
    application site hypoaesthesia
         subjects affected / exposed
    0 / 185 (0.00%)
    1 / 178 (0.56%)
         occurrences all number
    0
    1
    Fatigue
         subjects affected / exposed
    0 / 185 (0.00%)
    1 / 178 (0.56%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Hypoaesthesia oral
         subjects affected / exposed
    1 / 185 (0.54%)
    1 / 178 (0.56%)
         occurrences all number
    1
    1
    Nausea
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    Salivary Hypersecretion
         subjects affected / exposed
    0 / 185 (0.00%)
    1 / 178 (0.56%)
         occurrences all number
    0
    1
    Stomatitis
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    Tongue discomfort
         subjects affected / exposed
    0 / 185 (0.00%)
    1 / 178 (0.56%)
         occurrences all number
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Rhinorrhoea
         subjects affected / exposed
    3 / 185 (1.62%)
    0 / 178 (0.00%)
         occurrences all number
    3
    0
    cough
         subjects affected / exposed
    1 / 185 (0.54%)
    1 / 178 (0.56%)
         occurrences all number
    1
    1
    dysphonia
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    nasal obstruction
         subjects affected / exposed
    0 / 185 (0.00%)
    1 / 178 (0.56%)
         occurrences all number
    0
    1
    oropharyngeal discomfort
         subjects affected / exposed
    0 / 185 (0.00%)
    1 / 178 (0.56%)
         occurrences all number
    0
    1
    productive cough
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    drug eruption
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    pruritus
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    Musculoskeletal and connective tissue disorders
    myalgia
         subjects affected / exposed
    0 / 185 (0.00%)
    1 / 178 (0.56%)
         occurrences all number
    0
    1
    Infections and infestations
    Ear infection
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    rhinitis
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    sinusitis
         subjects affected / exposed
    0 / 185 (0.00%)
    1 / 178 (0.56%)
         occurrences all number
    0
    1
    tonsillitis bacterial
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0
    viral rash
         subjects affected / exposed
    1 / 185 (0.54%)
    0 / 178 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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