Efficacy of 300mg Ibuprofen Prolonged-Release Tablets for the Treatment of Pain After Surgical Removal of Impacted Third Molars
Primary Purpose
Pain
Status
Recruiting
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Ibuprofen 300 mg Oral Tablet
Ibuprofen 200 mg Oral Tablet
Placebo of PR tablet
Placebo of IR tablet
Sponsored by
About this trial
This is an interventional treatment trial for Pain
Eligibility Criteria
Inclusion Criteria:
- Is male or female ≥ 18 and ≤ 50 years of age.
- Requires extraction of 2 or more third molars. At least 1 of the third molars must be a fully or partially bone impacted mandibular molar. If only 2 molars are removed, then they must be ipsilateral.
- Experiences moderate to severe pain intensity within 6 hours after surgery, as measured by a numeric rating scale (NRS) score of ≥ 5 on a 0-10 scale.
- Has a body weight ≥ 45 kg and a body mass index (BMI) ≤ 35 kg/m2.
Female subjects of child-bearing potential must be willing to use a highly effective method of contraception throughout the study. A highly effective method of birth control is defined as one which results in a low failure rate (i.e. less than 1% per year) when used consistently and correctly, such as the following:
- surgical sterilisation
- contraceptive implants or injectables
- combined oral contraceptives
- some intrauterine devices (IUDs)
- true sexual abstinence, when this is in line with the preferred and usual lifestyle of the subject (periodic abstinence such as calendar, ovulation, symptothermal, or post-ovulation methods; declaration of abstinence for the duration of the trial; or withdrawal are not acceptable methods of contraception), or
- vasectomised partner. To be considered not of child-bearing potential, females must be surgically sterile (defined as bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) or post-menopausal (defined as no menses for 12 months in women not using hormonal contraception or hormone replacement therapy, confirmed by a follicle stimulating hormone (FSH) level in the postmenopausal range at Screening).
- Free of clinically significant abnormal findings as determined by medical history, physical examination, vital signs, laboratory tests and ECG.
- Is able to provide written informed consent.
- Is willing and able to comply with study requirements (including diet and smoking restrictions), complete the pain evaluations, remain at the study site overnight, and return for followup 7 (± 2) days after surgery.
Exclusion Criteria:
- Known hypersensitivity reactions or allergy (e.g., asthma, rhinitis, angioedema or urticaria) in response to nonsteroidal anti-inflammatory drugs (NSAIDs, including ibuprofen), acetylsalicylic acid (aspirin), ingredients of the study drug, or any other drugs used in the study, including anaesthetics and antibiotics that may be required on the day of surgery.
- A history of active or previous peptic ulceration/ haemorrhage, gastrointestinal bleeding or perforation, heart failure, renal or hepatic failure, uncontrolled hypertension, asthma, nasal polyps, or chronic rhinitis.
- Has complications from the tooth extraction or any other clinically significant medical history that, in the opinion of the investigator, would affect the subject's ability to comply or otherwise contraindicate study participation, including but not limited to the following: cardiac, respiratory, gastroenterological, neurological, psychological, immunological, haematological, oncological, or renal disease.
- Has undergone another dental surgery within 60 days prior to the day of surgery.
- A positive urine drugs of abuse screen or alcohol breathalyser test at screening and during the study (with the exception of a positive drugs of abuse screen that is a consequence of permitted prescription medicines).
- If female, has a positive pregnancy test at screening (serum) or on the day of surgery prior to surgery (urine), or is lactating.
- Has known or suspected, (in the opinion of the investigator), history of alcoholism or drug abuse within 2 years of screening or evidence of tolerance or physical dependence before dosing with study drug.
- Taking any concomitant medications that might confound assessments of pain relief, such as psychotropic drugs, antidepressants, sedative-hypnotics (other than those permitted for conscious sedation), or other analgesics taken within five times of their elimination half-lives. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) are permitted if the subject has been on a stable dose for at least four weeks prior to Visit 1 (screening).
- Is considered by the investigator, for any reason (including, but not limited to the risks described as precautions, warnings and contraindications in the current version of the investigator's brochure (IB) for 300 mg ibuprofen PR tablets), to be an unsuitable candidate to receive the study drug.
- Has a history of chronic use (defined as daily use for > 2 weeks) of nonsteroidal anti-inflammatory (NSAIDs), opiates, or glucocorticoids (except inhaled nasal steroids and topical corticosteroids), for any condition within 6 months before dosing with study drug.
- Has significant difficulties swallowing capsules or tablets or is unable to tolerate oral medication.
- Previously participated in another clinical study of 300 mg ibuprofen PR tablets, or received any investigational drug, device, or therapy within 90 days before screening.
- Enrolment of the Investigator, his / her family members, employees and other dependent persons.
- Failure to satisfy the investigator of fitness to participate for any other reason.
Sites / Locations
- JBR Clinical ResearchRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Active Comparator
Placebo Comparator
Arm Label
Prolonged Release Group
Immediate Release Group
Placebo Group
Arm Description
Ibuprofen 300 mg Oral Tablet Placebo of IR tablet Placebo of PR tablet
Ibuprofen 200 mg Oral Tablet Placebo of IR tablet Placebo of PR tablet
Placebo of IR tablet Placebo of PR tablet
Outcomes
Primary Outcome Measures
Summed Pain Intensity Difference 0-12 hours (SPID12) vs placebo using the Numeric Rating Scale (NRS) for pain
SPID12 will be used to compare the test product (2×300 mg ibuprofen PR tablets) against the placebo product. The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Secondary Outcome Measures
Summed Pain Intensity Difference 0-24 hours (SPID24) vs active comparator using the NRS for pain
SPID24 will be used to compare the test product (2×300 mg ibuprofen PR tablets twice daily (BID)) and comparator product (2×200 mg ibuprofen IR tablets three times a day (TID)). The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Summed Pain Intensity Difference 0-4hours (SPID4) using NRS for pain
SPID4 after Time 0 will be assessed using the NRS to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Summed Pain Intensity Difference 0-8 hours (SPID8) using NRS for pain
SPID8 after Time 0 will be assessed using the NRS to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Summed Pain Intensity Difference 0-12 hours (SPID12) using NRS for pain
SPID12 after Time 0 will be assessed using the NRS to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Sum of Total Pain Relief 0-4 hours (TOTPAR4) using Pain Relief Scale (PRS)
TOTPAR4 after Time 0 will be assessed using the PRS. PRS is used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Sum of Total Pain Relief 0-8 hours (TOTPAR8) using PRS
TOTPAR8 after Time 0 will be assessed using the PRS. PRS is used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Sum of Total Pain Relief 0-12 hours (TOTPAR12) using PRS
TOTPAR12 after Time 0 will be assessed using the PRS. PRS is used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Sum of Total Pain Relief 0-24 hours (TOTPAR24) using PRS
TOTPAR24 after Time 0 will be assessed using the PRS. PRS is used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Summed pain relief and intensity difference (sum of TOTPAR and SPID [SPRID]) 0-4 hours (SPRID4) using PRS and NRS for pain.
SPRID4 after Time 0 will be assessed using the PRS and NRS for pain. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?". The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain. SPRID4 will be determined by calculating the difference in NRS for pain at the 4-hour time point and the 0-hour timepoint and adding this value to the difference in the PRS at the 4-hour time point and the 0-hour timepoint.
Summed pain relief and intensity difference 0-8 hours (SPRID8) using PRS and NRS for pain
SPRID8 after Time 0 will be assessed using the PRS and NRS for pain. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?". The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain. SPRID8 will be determined by calculating the difference in NRS for pain at the 8-hour time point and the 0-hour timepoint and adding this value to the difference in the PRS at the 8-hour time point and the 0-hour timepoint.
Summed pain relief and intensity difference 0-12 hours (SPRID12) using PRS and NRS for pain
SPRID12 after Time 0 will be assessed using the PRS and NRS for pain. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?". The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain. SPRID12 will be determined by calculating the difference in NRS for pain at the 12-hour time point and the 0-hour timepoint and adding this value to the difference in the PRS at the 12-hour time point and the 0-hour timepoint.
Summed pain relief and intensity difference 0-24 hours (SPRID24) using PRS and NRS for pain
SPRID24 after Time 0 will be assessed using the PRS and NRS for pain. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?". The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.SPRID24 will be determined by calculating the difference in NRS for pain at the 24-hour time point and the 0-hour timepoint and adding this value to the difference in the PRS at the 24-hour time point and the 0-hour timepoint.
Proportion of participants who show response to study drug using NRS for pain
A responder will be defined as a subject with ≥30% improvement in pain intensity without rescue medication during the first 8 hours. The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
NRS (for pain) Pain Intensity Difference at each timepoint
NRS pain intensity difference (PID) at each scheduled time point after Time 0. The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Peak Pain intensity score using NRS for pain
Pain intensity score at each scheduled time point will be assessed using the NRS for pain. The NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Pain relief score using Pain Relief Scale
Pain relief score at each scheduled time point after Time 0 will be measured using the PRS. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Peak Pain Relief at all timepoints using PRS
Peak Pain relief at each time point will be measured using PRS. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Time to onset of analgesia using double stopwatch assessment
Time to onset of analgesia (measured as time to perceptible pain relief confirmed by time to meaningful pain relief) using double stopwatch. Two stopwatches will be started immediately after the subject has swallowed the study drug with 8 ounces of water. Each subject will be instructed, "Stop the first stopwatch when you first feel any pain relief whatsoever. This does not mean you feel completely better, although you might, but when you first feel any relief in the pain you have now" (perceptible pain relief). The subject will also be instructed, "Stop the second stopwatch when you feel the pain relief is meaningful to you" (meaningful pain relief). If the subject does not press the stopwatches within 8 hours after Time 0 the subject will discontinue use of the stopwatches.
Time to first perceptible pain relief using double stopwatch assessment
Time to first perceptible pain relief using stopwatch assessment. Two stopwatches will be started immediately after the subject has swallowed the study drug with 8 ounces of water. Each subject will be instructed, "Stop the first stopwatch when you first feel any pain relief whatsoever. This does not mean you feel completely better, although you might, but when you first feel any relief in the pain you have now" (perceptible pain relief). If the subject does not press the stopwatches within 8 hours after Time 0 the subject will discontinue use of the stopwatches.
Time to meaningful pain relief using double stopwatch assessment
Time to meaningful pain relief. Two stopwatches will be started immediately after the subject has swallowed the study drug with 8 ounces of water. The subject will be instructed, "Stop the second stopwatch when you feel the pain relief is meaningful to you" (meaningful pain relief). If the subject does not press the stopwatches within 8 hours after Time 0 the subject will discontinue use of the stopwatches.
Time to peak pain relief using PRS
Time to peak pain relief. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Proportion of subjects using rescue medication
Proportion of subjects using rescue medication.
Time to first use of rescue medication
Time to first use of rescue medication.
Full Information
NCT ID
NCT03785756
First Posted
December 17, 2018
Last Updated
August 28, 2019
Sponsor
Reckitt Benckiser Healthcare (UK) Limited
Collaborators
Premier Research Group plc
1. Study Identification
Unique Protocol Identification Number
NCT03785756
Brief Title
Efficacy of 300mg Ibuprofen Prolonged-Release Tablets for the Treatment of Pain After Surgical Removal of Impacted Third Molars
Official Title
A Randomised, Double-Blind, Double-Dummy, Parallel-Group, Multiple-Dose, Active and Placebo-Controlled Efficacy Study of Ibuprofen Prolonged-Release Tablets for the Treatment of Pain After Surgical Removal of Impacted Third Molars
Study Type
Interventional
2. Study Status
Record Verification Date
August 2019
Overall Recruitment Status
Recruiting
Study Start Date
April 29, 2019 (Actual)
Primary Completion Date
December 2019 (Anticipated)
Study Completion Date
December 2019 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Reckitt Benckiser Healthcare (UK) Limited
Collaborators
Premier Research Group plc
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a single centre, randomised, double-blind, double-dummy, parallel group, multiple-dose, active and placebo-controlled efficacy study to evaluate the efficacy and safety of 2×300mg ibuprofen Prolonged Release (PR) tablets in subjects with postoperative dental pain.
Detailed Description
This is a single centre, randomised, double blind, double-dummy, parallel group , multiple-dose, active and placebo controlled efficacy study to evaluate the efficacy and safety of ibuprofen 2×300 mg ibuprofen PR tablets in subjects with postoperative dental pain.
Eligible subjects will complete all screening procedures within 28 days before the surgery and randomisation.
At Screening, subjects will provide written informed consent to participate in the study before any protocol specified procedures or assessments are completed. On Day 1, subjects who continue to be eligible for study participation after completing screening procedures and assessments will undergo extraction of 2 or more third molars. At least 1 of the third molars must be a fully or partially bone impacted mandibular molar. If only 2 molars are removed, then they must be ipsilateral.
All subjects will receive local anaesthesia (2% lidocaine with 1:100,000 epinephrine). Nitrous oxide will be allowed at the discretion of the investigator. Subjects who experience moderate to severe pain intensity (a score of ≥ 5 on a numeric rating scale [NRS] from 0-10 where 0 = no pain, 10 = worst pain ever) within 6 hours after surgery and who continue to meet all study entry criteria will be randomised in a 3:3:1 ratio to receive 2×300 mg ibuprofen PR tablets every 12 hours (Q12h), 2×200 mg ibuprofen IR tablets every 8 hours (Q8h), or placebo. The randomisation will be stratified by baseline pain category (moderate or severe) using a categorical scale that includes the categories of none (0), mild (1-4), moderate (5-7), and severe (8-10).
Subjects will re-assess their baseline pain intensity using the NRS immediately before receiving study drug (pre-dose, Time 0) and their pain intensity (NRS) and pain relief (5 point categorical scale) at the following time points (pre-dose, if at one of the dosing timepoints of 0, 8, 12 and/or 16 hours): 15, 30, and 45 minutes, and 1, 1.5, 2, 3, 4, 5, 6, 7, 8, 10, 12, 16, and 24 hours after Time 0; and immediately before each dose of rescue medication, if any. For assessments less than 1 hour apart a window of +/-2 min is allowable whilst for assessments at least 1 hour apart a +/-5 min window is allowable.
The double stopwatch method will be used to record the time to perceptible pain relief and time to meaningful pain relief during the 8 hours following the first dose or until subject takes rescue medication. Subjects will complete a global evaluation of study drug 24 hours (+/- 5 minutes) after Time 0 or immediately before the first dose of rescue medication (whichever occurs first). Vital signs will be recorded after the subject has been in a sitting position for 3 minutes at the following times: before surgery, within 30 minutes before Time 0, 12 and 24 hours after Time 0, and/or immediately before the first dose of rescue medication. Adverse events (AEs) will be monitored and recorded from the time of signing of the informed consent form (ICF) until the Follow up Visit (or Early Termination Visit). During the 24 hours following Time 0, subjects will complete efficacy and safety assessments. Subjects will remain at the study site overnight and will be discharged on Day 2.
Paracetamol / acetaminophen (1000 mg) will be permitted as the initial rescue medication. Subjects will be encouraged to wait at least 60 minutes after receiving study drug before taking rescue medication. If acetaminophen rescue medication is not effective in relieving the subject's pain, 5 mg oxycodone rescue medication may be administered at the discretion of the investigator.
Subjects are not permitted to take any concomitant medications that might confound assessments of pain relief, such as psychotropic drugs, antidepressants, sedative-hypnotics (other than those permitted for conscious sedation), or other analgesics taken within five times of their elimination half-lives (other than those used at the surgery). Selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) are permitted if the subject has been on a stable dose for at least four weeks prior to Visit 1 (screening).
Other restrictions include the following: alcohol use is prohibited from 24 hours before surgery until discharge on Day 2; nothing by mouth from midnight before surgery until 1 hour after surgery; clear liquids only are allowed starting 1 hour after surgery until 1 hour after dosing; 1 hour after dosing, the subject's diet may be advanced according to standard practice.
Upon discharge from the study site, subjects may be prescribed pain medication for use at home according to the standard practice of the study site. On Day 8 (± 2 days), subjects will return to the study site for an abbreviated confirmatory physical assessment and AE assessments.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
The dental pain model used in this study is a robust and well established postsurgical pain model that produces pain that is predictable in its character, duration, and intensity. The model is widely accepted and has a proven record of assay sensitivity (i.e. separating active drugs from each other, as well as from placebo). The model is frequently used to evaluate NSAID type analgesics. Results from dental pain studies are accepted by the US Food and Drug Administration (FDA) and European authorities and have been widely extrapolated to other general pain conditions.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
This is a double-blind, double dummy study. There will be two placebo tablets designed to be comparable to each of the active products (PR and Immediate Release (IR)) in both shape, size, colour and weight. All subject packs have been designed and labelled to ensure blinding is maintained. Subjects, investigators and site staff will all be blind to the treatments.
Allocation
Randomized
Enrollment
280 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Prolonged Release Group
Arm Type
Experimental
Arm Description
Ibuprofen 300 mg Oral Tablet Placebo of IR tablet Placebo of PR tablet
Arm Title
Immediate Release Group
Arm Type
Active Comparator
Arm Description
Ibuprofen 200 mg Oral Tablet Placebo of IR tablet Placebo of PR tablet
Arm Title
Placebo Group
Arm Type
Placebo Comparator
Arm Description
Placebo of IR tablet Placebo of PR tablet
Intervention Type
Drug
Intervention Name(s)
Ibuprofen 300 mg Oral Tablet
Other Intervention Name(s)
Prolonged Release Tablet
Intervention Description
2 x 300 mg tablets twice in 24 hours
Intervention Type
Drug
Intervention Name(s)
Ibuprofen 200 mg Oral Tablet
Other Intervention Name(s)
Nurofen, Immediate Release Tablet
Intervention Description
2 x 200 mg tablets three times in 24 hours
Intervention Type
Other
Intervention Name(s)
Placebo of PR tablet
Intervention Description
Up to 2 tablets four times in 24 hours
Intervention Type
Other
Intervention Name(s)
Placebo of IR tablet
Intervention Description
Up to 2 tablets four times in 24 hours
Primary Outcome Measure Information:
Title
Summed Pain Intensity Difference 0-12 hours (SPID12) vs placebo using the Numeric Rating Scale (NRS) for pain
Description
SPID12 will be used to compare the test product (2×300 mg ibuprofen PR tablets) against the placebo product. The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Time Frame
0-12 hours
Secondary Outcome Measure Information:
Title
Summed Pain Intensity Difference 0-24 hours (SPID24) vs active comparator using the NRS for pain
Description
SPID24 will be used to compare the test product (2×300 mg ibuprofen PR tablets twice daily (BID)) and comparator product (2×200 mg ibuprofen IR tablets three times a day (TID)). The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Time Frame
0-24 hours
Title
Summed Pain Intensity Difference 0-4hours (SPID4) using NRS for pain
Description
SPID4 after Time 0 will be assessed using the NRS to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Time Frame
0-4 hours
Title
Summed Pain Intensity Difference 0-8 hours (SPID8) using NRS for pain
Description
SPID8 after Time 0 will be assessed using the NRS to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Time Frame
0-8 hours
Title
Summed Pain Intensity Difference 0-12 hours (SPID12) using NRS for pain
Description
SPID12 after Time 0 will be assessed using the NRS to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Time Frame
0-12 hours
Title
Sum of Total Pain Relief 0-4 hours (TOTPAR4) using Pain Relief Scale (PRS)
Description
TOTPAR4 after Time 0 will be assessed using the PRS. PRS is used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Time Frame
0-4 hours
Title
Sum of Total Pain Relief 0-8 hours (TOTPAR8) using PRS
Description
TOTPAR8 after Time 0 will be assessed using the PRS. PRS is used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Time Frame
0-8 hours
Title
Sum of Total Pain Relief 0-12 hours (TOTPAR12) using PRS
Description
TOTPAR12 after Time 0 will be assessed using the PRS. PRS is used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Time Frame
0-12 hours
Title
Sum of Total Pain Relief 0-24 hours (TOTPAR24) using PRS
Description
TOTPAR24 after Time 0 will be assessed using the PRS. PRS is used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Time Frame
0-24 hours
Title
Summed pain relief and intensity difference (sum of TOTPAR and SPID [SPRID]) 0-4 hours (SPRID4) using PRS and NRS for pain.
Description
SPRID4 after Time 0 will be assessed using the PRS and NRS for pain. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?". The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain. SPRID4 will be determined by calculating the difference in NRS for pain at the 4-hour time point and the 0-hour timepoint and adding this value to the difference in the PRS at the 4-hour time point and the 0-hour timepoint.
Time Frame
0-4 hours
Title
Summed pain relief and intensity difference 0-8 hours (SPRID8) using PRS and NRS for pain
Description
SPRID8 after Time 0 will be assessed using the PRS and NRS for pain. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?". The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain. SPRID8 will be determined by calculating the difference in NRS for pain at the 8-hour time point and the 0-hour timepoint and adding this value to the difference in the PRS at the 8-hour time point and the 0-hour timepoint.
Time Frame
0-8 hours
Title
Summed pain relief and intensity difference 0-12 hours (SPRID12) using PRS and NRS for pain
Description
SPRID12 after Time 0 will be assessed using the PRS and NRS for pain. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?". The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain. SPRID12 will be determined by calculating the difference in NRS for pain at the 12-hour time point and the 0-hour timepoint and adding this value to the difference in the PRS at the 12-hour time point and the 0-hour timepoint.
Time Frame
0-12 hours
Title
Summed pain relief and intensity difference 0-24 hours (SPRID24) using PRS and NRS for pain
Description
SPRID24 after Time 0 will be assessed using the PRS and NRS for pain. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?". The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.SPRID24 will be determined by calculating the difference in NRS for pain at the 24-hour time point and the 0-hour timepoint and adding this value to the difference in the PRS at the 24-hour time point and the 0-hour timepoint.
Time Frame
0-24 hours
Title
Proportion of participants who show response to study drug using NRS for pain
Description
A responder will be defined as a subject with ≥30% improvement in pain intensity without rescue medication during the first 8 hours. The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Time Frame
0-8 hours
Title
NRS (for pain) Pain Intensity Difference at each timepoint
Description
NRS pain intensity difference (PID) at each scheduled time point after Time 0. The NRS will be used to assess the Pain Intensity, the NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Time Frame
0-24 hours
Title
Peak Pain intensity score using NRS for pain
Description
Pain intensity score at each scheduled time point will be assessed using the NRS for pain. The NRS for pain is an 11-point scale (0-10) where a higher score indicates a greater amount of pain.
Time Frame
0-24 hours
Title
Pain relief score using Pain Relief Scale
Description
Pain relief score at each scheduled time point after Time 0 will be measured using the PRS. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Time Frame
0-24hours
Title
Peak Pain Relief at all timepoints using PRS
Description
Peak Pain relief at each time point will be measured using PRS. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Time Frame
0-24hours
Title
Time to onset of analgesia using double stopwatch assessment
Description
Time to onset of analgesia (measured as time to perceptible pain relief confirmed by time to meaningful pain relief) using double stopwatch. Two stopwatches will be started immediately after the subject has swallowed the study drug with 8 ounces of water. Each subject will be instructed, "Stop the first stopwatch when you first feel any pain relief whatsoever. This does not mean you feel completely better, although you might, but when you first feel any relief in the pain you have now" (perceptible pain relief). The subject will also be instructed, "Stop the second stopwatch when you feel the pain relief is meaningful to you" (meaningful pain relief). If the subject does not press the stopwatches within 8 hours after Time 0 the subject will discontinue use of the stopwatches.
Time Frame
0-24 hours
Title
Time to first perceptible pain relief using double stopwatch assessment
Description
Time to first perceptible pain relief using stopwatch assessment. Two stopwatches will be started immediately after the subject has swallowed the study drug with 8 ounces of water. Each subject will be instructed, "Stop the first stopwatch when you first feel any pain relief whatsoever. This does not mean you feel completely better, although you might, but when you first feel any relief in the pain you have now" (perceptible pain relief). If the subject does not press the stopwatches within 8 hours after Time 0 the subject will discontinue use of the stopwatches.
Time Frame
0-8 hours
Title
Time to meaningful pain relief using double stopwatch assessment
Description
Time to meaningful pain relief. Two stopwatches will be started immediately after the subject has swallowed the study drug with 8 ounces of water. The subject will be instructed, "Stop the second stopwatch when you feel the pain relief is meaningful to you" (meaningful pain relief). If the subject does not press the stopwatches within 8 hours after Time 0 the subject will discontinue use of the stopwatches.
Time Frame
0-8 hours
Title
Time to peak pain relief using PRS
Description
Time to peak pain relief. The PRS will be used to measure pain relief and is a 5 point categorical scale, response choices of none = 0, a little = 1, some = 2, a lot = 3, and complete = 4 to be completed in response to the question "How much relief have you had since your starting pain?".
Time Frame
0-24 hours
Title
Proportion of subjects using rescue medication
Description
Proportion of subjects using rescue medication.
Time Frame
0-24 hours
Title
Time to first use of rescue medication
Description
Time to first use of rescue medication.
Time Frame
0-24 hours
Other Pre-specified Outcome Measures:
Title
Incidence of Treatment Emergent Adverse Events as assessed by patient response to questions and spontaneous reporting of TEAEs
Description
Incidence of treatment emergent adverse events (TEAEs). Data listings will be provided for protocol specified safety data.
Time Frame
0-10 days
Title
Vital signs measurements - Blood pressure in mm/Hg
Description
Incidence of changes in vital sign measurements. Descriptive statistics will be provided at each scheduled time point for each treatment group. Changes from Baseline for vital signs will be calculated for each subject.
Time Frame
0-10 days
Title
Vital signs measurements - Heart rate in beats per minute
Description
Incidence of changes in vital sign measurements. Descriptive statistics will be provided at each scheduled time point for each treatment group. Changes from Baseline for vital signs will be calculated for each subject.
Time Frame
0-10 days
Title
Vital signs measurements - Respiratory rate in breaths per minute
Description
Incidence of changes in vital sign measurements. Descriptive statistics will be provided at each scheduled time point for each treatment group. Changes from Baseline for vital signs will be calculated for each subject.
Time Frame
0-10 days
Title
Vital signs measurements - Body Temperature in ºC
Description
Incidence of changes in vital sign measurements. Descriptive statistics will be provided at each scheduled time point for each treatment group. Changes from Baseline for vital signs will be calculated for each subject.
Time Frame
0-10 days
Title
Global Evaluation of efficacy using 5 point categorical scale
Description
Patient's global evaluation of study drug using 5 point categorical scale, response choices of 0 = poor, 1 = fair, 2 = good, 3 = very good, or 4 = excellent to be completed by the patient in response to the question "How effective do you think the study drug is as a treatment for pain?". Subjects will complete the global evaluation of study drug 24 hours after Time 0 or immediately before the first dose of rescue medication (whichever occurs first).
Time Frame
0-24 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Is male or female ≥ 18 and ≤ 50 years of age.
Requires extraction of 2 or more third molars. At least 1 of the third molars must be a fully or partially bone impacted mandibular molar. If only 2 molars are removed, then they must be ipsilateral.
Experiences moderate to severe pain intensity within 6 hours after surgery, as measured by a numeric rating scale (NRS) score of ≥ 5 on a 0-10 scale.
Has a body weight ≥ 45 kg and a body mass index (BMI) ≤ 35 kg/m2.
Female subjects of child-bearing potential must be willing to use a highly effective method of contraception throughout the study. A highly effective method of birth control is defined as one which results in a low failure rate (i.e. less than 1% per year) when used consistently and correctly, such as the following:
surgical sterilisation
contraceptive implants or injectables
combined oral contraceptives
some intrauterine devices (IUDs)
true sexual abstinence, when this is in line with the preferred and usual lifestyle of the subject (periodic abstinence such as calendar, ovulation, symptothermal, or post-ovulation methods; declaration of abstinence for the duration of the trial; or withdrawal are not acceptable methods of contraception), or
vasectomised partner. To be considered not of child-bearing potential, females must be surgically sterile (defined as bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) or post-menopausal (defined as no menses for 12 months in women not using hormonal contraception or hormone replacement therapy, confirmed by a follicle stimulating hormone (FSH) level in the postmenopausal range at Screening).
Free of clinically significant abnormal findings as determined by medical history, physical examination, vital signs, laboratory tests and ECG.
Is able to provide written informed consent.
Is willing and able to comply with study requirements (including diet and smoking restrictions), complete the pain evaluations, remain at the study site overnight, and return for followup 7 (± 2) days after surgery.
Exclusion Criteria:
Known hypersensitivity reactions or allergy (e.g., asthma, rhinitis, angioedema or urticaria) in response to nonsteroidal anti-inflammatory drugs (NSAIDs, including ibuprofen), acetylsalicylic acid (aspirin), ingredients of the study drug, or any other drugs used in the study, including anaesthetics and antibiotics that may be required on the day of surgery.
A history of active or previous peptic ulceration/ haemorrhage, gastrointestinal bleeding or perforation, heart failure, renal or hepatic failure, uncontrolled hypertension, asthma, nasal polyps, or chronic rhinitis.
Has complications from the tooth extraction or any other clinically significant medical history that, in the opinion of the investigator, would affect the subject's ability to comply or otherwise contraindicate study participation, including but not limited to the following: cardiac, respiratory, gastroenterological, neurological, psychological, immunological, haematological, oncological, or renal disease.
Has undergone another dental surgery within 60 days prior to the day of surgery.
A positive urine drugs of abuse screen or alcohol breathalyser test at screening and during the study (with the exception of a positive drugs of abuse screen that is a consequence of permitted prescription medicines).
If female, has a positive pregnancy test at screening (serum) or on the day of surgery prior to surgery (urine), or is lactating.
Has known or suspected, (in the opinion of the investigator), history of alcoholism or drug abuse within 2 years of screening or evidence of tolerance or physical dependence before dosing with study drug.
Taking any concomitant medications that might confound assessments of pain relief, such as psychotropic drugs, antidepressants, sedative-hypnotics (other than those permitted for conscious sedation), or other analgesics taken within five times of their elimination half-lives. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) are permitted if the subject has been on a stable dose for at least four weeks prior to Visit 1 (screening).
Is considered by the investigator, for any reason (including, but not limited to the risks described as precautions, warnings and contraindications in the current version of the investigator's brochure (IB) for 300 mg ibuprofen PR tablets), to be an unsuitable candidate to receive the study drug.
Has a history of chronic use (defined as daily use for > 2 weeks) of nonsteroidal anti-inflammatory (NSAIDs), opiates, or glucocorticoids (except inhaled nasal steroids and topical corticosteroids), for any condition within 6 months before dosing with study drug.
Has significant difficulties swallowing capsules or tablets or is unable to tolerate oral medication.
Previously participated in another clinical study of 300 mg ibuprofen PR tablets, or received any investigational drug, device, or therapy within 90 days before screening.
Enrolment of the Investigator, his / her family members, employees and other dependent persons.
Failure to satisfy the investigator of fitness to participate for any other reason.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Paul Brittain, M.P.H
Phone
+15128526917
Email
paul.brittain@premier-research.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Todd Bertoch, MD
Organizational Affiliation
JBR Clinical Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
JBR Clinical Research
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84107
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Todd M Bertoch, MD
Phone
928-830-7354
Email
tbertoch@jbrutah.com
First Name & Middle Initial & Last Name & Degree
Todd M Bertoch, MD
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
11690728
Citation
Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole MR. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001 Nov;94(2):149-158. doi: 10.1016/S0304-3959(01)00349-9.
Results Reference
background
PubMed Identifier
9515184
Citation
Davies NM. Clinical pharmacokinetics of ibuprofen. The first 30 years. Clin Pharmacokinet. 1998 Feb;34(2):101-54. doi: 10.2165/00003088-199834020-00002.
Results Reference
background
PubMed Identifier
29667449
Citation
Miles L, Hall J, Jenner B, Addis R, Hutchings S. Predicting rapid analgesic onset of ibuprofen salts compared with ibuprofen acid: Tlag, Tlow, Tmed, and a novel parameter, TCmaxRef. Curr Med Res Opin. 2018 Aug;34(8):1483-1490. doi: 10.1080/03007995.2018.1466697. Epub 2018 Apr 27.
Results Reference
background
PubMed Identifier
26683233
Citation
Cooper SA, Desjardins PJ, Turk DC, Dworkin RH, Katz NP, Kehlet H, Ballantyne JC, Burke LB, Carragee E, Cowan P, Croll S, Dionne RA, Farrar JT, Gilron I, Gordon DB, Iyengar S, Jay GW, Kalso EA, Kerns RD, McDermott MP, Raja SN, Rappaport BA, Rauschkolb C, Royal MA, Segerdahl M, Stauffer JW, Todd KH, Vanhove GF, Wallace MS, West C, White RE, Wu C. Research design considerations for single-dose analgesic clinical trials in acute pain: IMMPACT recommendations. Pain. 2016 Feb;157(2):288-301. doi: 10.1097/j.pain.0000000000000375.
Results Reference
background
PubMed Identifier
24012952
Citation
Singla NK, Desjardins PJ, Chang PD. A comparison of the clinical and experimental characteristics of four acute surgical pain models: dental extraction, bunionectomy, joint replacement, and soft tissue surgery. Pain. 2014 Mar;155(3):441-456. doi: 10.1016/j.pain.2013.09.002. Epub 2013 Sep 6.
Results Reference
background
Links:
URL
https://wayback.archive-it.org/7993/20170405155045/https://www.fda.gov/ohrms/dockets/ac/02/briefing/3882B2_04_Wyeth-Ibuprophen.pdf
Description
Wyeth Consumer Healthcare. (2002). Nonprescription Drug Advisory Committee (NDAC) Meeting on Risks of NSAIDs
Learn more about this trial
Efficacy of 300mg Ibuprofen Prolonged-Release Tablets for the Treatment of Pain After Surgical Removal of Impacted Third Molars
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