search
Back to results

Efficacy and Safety of Fixed-dose Combination of Etoricoxib/Tramadol vs Acetaminophen/Tramadol for Acute Low Back Pain

Primary Purpose

Acute Low Back Pain

Status
Completed
Phase
Phase 3
Locations
Mexico
Study Type
Interventional
Intervention
Etoricoxib 90 mg / Tramadol 50 mg
Acetaminophen 325 mg / Tramadol 37.5 mg
Sponsored by
Laboratorios Silanes S.A. de C.V.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Low Back Pain focused on measuring Back pain, Etoricoxib, Tramadol, Fixed dose

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Any sex.
  • That the subject agree to participate in the study and give informed consent in writing.
  • Age> 18 years and ≤ 60 years of age at the beginning of the study.
  • Diagnosis of acute low back pain as a first-time episode or after another episode, maximum 6 months before and lasting no more than 6 weeks.
  • Patient with low back pain reported as moderate to severe intensity (VAS> 4 cm).
  • Women of childbearing age who have an acceptable contraceptive method (eg barrier, oral hormonal, injectable, subdermal).

Exclusion Criteria:

  • Patients in whom the study drug is contraindicated for medical reasons.
  • Patients with an allergy or hypersensitivity to the active principle, study drugs, related products or excipients.
  • Positive pregnancy test, women who are pregnant, breastfeeding or planning a pregnancy while conducting the study.
  • A significant history of gastrointestinal disorders (for example: Gastric ulcer, Crohn's disease, Ulcerative Colitis, etc.).
  • Previous treatment with opioids and / or NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) reported in the medical history in the last 72 hours at study entry.
  • Patients with a history of alcohol or drug abuse in the last year according to DSM-V (Diagnostic and Statistical Manual of Mental Disorders).
  • Patients who are receiving monoamine oxidase inhibitors (MAOIs) or who have received them within the past 2 weeks.
  • Patients with a history of established ischemic heart disease, peripheral arterial disease and / or cerebrovascular disease (including patients who have recently undergone coronary artery bypass grafting or angioplasty).
  • Patients with status epileptic seizure disorders and grand mal seizures.
  • Patients with a history of severe acute or chronic liver failure.
  • Patients with a history of moderate to severe renal failure.
  • Patient with a history of chronic pain (eg, fibromyalgia, Paget's disease, bone pain induced by metastatic cancer).
  • Low back pain due to major trauma (eg vertebral fracture, post-traumatic spondylolisthesis), or due to a visceral disorder (eg dysmenorrhea, endometriosis).
  • At medical criteria, a disease that affects the prognosis and prevents outpatient management, for example, but not restricted to: intestinal obstruction, paralytic ileus, end-stage cancer, kidney, heart, respiratory or liver failure or mental illness or with surgical procedures or scheduled hospitals.
  • History / presence of any disease or condition that, in the Investigator's opinion, could pose a risk to the patient or confuse the efficacy and safety of the study results. ----Patients with symptoms suggesting an active COVID-19 infection (i.e., fever, cough, dyspnea) and / or contact in the past 14 days with a suspected or positive COVID-19 patient.
  • Oncological patients (except basal cell skin cancer) or with serious diseases that, in the opinion of the investigator, have a serious prognosis or a life expectancy of less than 1 year, as well as mental illnesses.
  • The patient is participating in another clinical study involving an investigational treatment or participated in one in the previous 4 weeks.
  • Patients whose participation in the study may be influenced (employment relationship with the research center or sponsor, inmates, etc.).

Sites / Locations

  • Laboratorio Silanes, S.A. de C.V.

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Group A: Etoricoxib/Tramadol

Group B: Acetaminophen / Tramadol

Arm Description

Administered orally, one packet of etoricoxib / tramadol granules diluted in 100 ml of water, every 24 hours for 7 days.

Administered orally, one tablet, every 8 hours, for 7 days.

Outcomes

Primary Outcome Measures

Average change in reported pain
Compare the average change in pain reported through the VAS (Visual Analog Scale) per treatment group. In a straight 10 centimeter line in which one end means no pain and the other end means the worst pain imaginable, the participants mark the amount of pain feeling at that moment

Secondary Outcome Measures

Proportion of patients with a 30% reduction in pain intensity
Describe the proportion of patients who reported a 30% reduction in pain intensity measure by the VAS (Visual Analog Scale) per treatment group. In a straight 10 centimeter line in which one end means no pain and the other end means the worst pain imaginable, the participants mark the amount of pain feeling at that moment.
Degree of disability due to low back pain
Evaluate the degree of disability due to low back pain measured through the Oswestry disability scale per treatment group. It measures the limitations in daily activities in the presence of pain in the lumbar region, consists of 10 questions with 6 possible answers considering the intensity of the pain, basic activities of daily life such as: personal care, sexual activity, sleep, travel and social life.
Degree of inability to perform daily activities
Assess the degree of inability to perform daily activities through the Roland-Morris scale per group. It´s a self-applied scale where the extreme values range between 0 (absence of disability) and 24 (maximum disability) and is categorized according to the relevance of the score obtained where the optimal threshold of variation is 3 and 4 points.
Adverse events
Compare the frequency of adverse events presented during the study between the treatment groups.

Full Information

First Posted
July 13, 2021
Last Updated
April 12, 2022
Sponsor
Laboratorios Silanes S.A. de C.V.
search

1. Study Identification

Unique Protocol Identification Number
NCT04968158
Brief Title
Efficacy and Safety of Fixed-dose Combination of Etoricoxib/Tramadol vs Acetaminophen/Tramadol for Acute Low Back Pain
Official Title
Confirmatory Efficacy and Safety Study of the Fixed-dose Combination of Etoricoxib / Tramadol Versus Acetaminophen / Tramadol for the Management of Acute Low Back Pain.
Study Type
Interventional

2. Study Status

Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
November 29, 2021 (Actual)
Primary Completion Date
March 15, 2022 (Actual)
Study Completion Date
April 10, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Laboratorios Silanes S.A. de C.V.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Phase IIIb, longitudinal, multicenter, randomized, open-label clinical trial to evaluate the efficacy and safety of the fixed-dose combination of etoricoxib 90 mg and tramadol 50 mg compared with fixed-dose therapy of acetaminophen 325 mg and tramadol 37.5 mg for the management of acute low back pain.
Detailed Description
Patients with back pain from the level of the lowest rib to the gluteal crease, with or without radiation to the legs, as a first-time episode or after another at least 6 months before and lasting no more than 6 weeks, that in the opinion of the doctor requires treatment with the combination of an anti-inflammatory and an analgesic. Study to evaluate the efficacy and safety of the fixed-dose combination of etoricoxib 90 mg and tramadol 50 mg compared with the fixed-dose therapy of acetaminophen 325 mg and tramadol 37.5 mg for the management of acute low back pain. Evaluate and compare the average change in pain reported through the VAS at 3, 5 and 7 days with respect to its baseline measurement by treatment group. An exploratory analysis of the data will be carried out to identify aberrant, outliers, or missing values. To present the numerical variables, the measures of central tendency and dispersion appropriate to the distribution of the data will be used and the categorical variables will be expressed as frequency and percentage.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Low Back Pain
Keywords
Back pain, Etoricoxib, Tramadol, Fixed dose

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
124 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group A: Etoricoxib/Tramadol
Arm Type
Experimental
Arm Description
Administered orally, one packet of etoricoxib / tramadol granules diluted in 100 ml of water, every 24 hours for 7 days.
Arm Title
Group B: Acetaminophen / Tramadol
Arm Type
Active Comparator
Arm Description
Administered orally, one tablet, every 8 hours, for 7 days.
Intervention Type
Drug
Intervention Name(s)
Etoricoxib 90 mg / Tramadol 50 mg
Other Intervention Name(s)
E/T
Intervention Description
One packet diluted in 100 ml of water, every 24 hours of 90 mg/50 mg.
Intervention Type
Drug
Intervention Name(s)
Acetaminophen 325 mg / Tramadol 37.5 mg
Other Intervention Name(s)
A/T
Intervention Description
One tablet, every 8 hours of 325 mg/ 37.5 m
Primary Outcome Measure Information:
Title
Average change in reported pain
Description
Compare the average change in pain reported through the VAS (Visual Analog Scale) per treatment group. In a straight 10 centimeter line in which one end means no pain and the other end means the worst pain imaginable, the participants mark the amount of pain feeling at that moment
Time Frame
Baseline, 3, 5 and 7 days.
Secondary Outcome Measure Information:
Title
Proportion of patients with a 30% reduction in pain intensity
Description
Describe the proportion of patients who reported a 30% reduction in pain intensity measure by the VAS (Visual Analog Scale) per treatment group. In a straight 10 centimeter line in which one end means no pain and the other end means the worst pain imaginable, the participants mark the amount of pain feeling at that moment.
Time Frame
Baseline and 7 days.
Title
Degree of disability due to low back pain
Description
Evaluate the degree of disability due to low back pain measured through the Oswestry disability scale per treatment group. It measures the limitations in daily activities in the presence of pain in the lumbar region, consists of 10 questions with 6 possible answers considering the intensity of the pain, basic activities of daily life such as: personal care, sexual activity, sleep, travel and social life.
Time Frame
Baseline and 7 days.
Title
Degree of inability to perform daily activities
Description
Assess the degree of inability to perform daily activities through the Roland-Morris scale per group. It´s a self-applied scale where the extreme values range between 0 (absence of disability) and 24 (maximum disability) and is categorized according to the relevance of the score obtained where the optimal threshold of variation is 3 and 4 points.
Time Frame
Baseline and 7 days.
Title
Adverse events
Description
Compare the frequency of adverse events presented during the study between the treatment groups.
Time Frame
7 days.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Any sex. That the subject agree to participate in the study and give informed consent in writing. Age> 18 years and ≤ 60 years of age at the beginning of the study. Diagnosis of acute low back pain as a first-time episode or after another episode, maximum 6 months before and lasting no more than 6 weeks. Patient with low back pain reported as moderate to severe intensity (VAS> 4 cm). Women of childbearing age who have an acceptable contraceptive method (eg barrier, oral hormonal, injectable, subdermal). Exclusion Criteria: Patients in whom the study drug is contraindicated for medical reasons. Patients with an allergy or hypersensitivity to the active principle, study drugs, related products or excipients. Positive pregnancy test, women who are pregnant, breastfeeding or planning a pregnancy while conducting the study. A significant history of gastrointestinal disorders (for example: Gastric ulcer, Crohn's disease, Ulcerative Colitis, etc.). Previous treatment with opioids and / or NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) reported in the medical history in the last 72 hours at study entry. Patients with a history of alcohol or drug abuse in the last year according to DSM-V (Diagnostic and Statistical Manual of Mental Disorders). Patients who are receiving monoamine oxidase inhibitors (MAOIs) or who have received them within the past 2 weeks. Patients with a history of established ischemic heart disease, peripheral arterial disease and / or cerebrovascular disease (including patients who have recently undergone coronary artery bypass grafting or angioplasty). Patients with status epileptic seizure disorders and grand mal seizures. Patients with a history of severe acute or chronic liver failure. Patients with a history of moderate to severe renal failure. Patient with a history of chronic pain (eg, fibromyalgia, Paget's disease, bone pain induced by metastatic cancer). Low back pain due to major trauma (eg vertebral fracture, post-traumatic spondylolisthesis), or due to a visceral disorder (eg dysmenorrhea, endometriosis). At medical criteria, a disease that affects the prognosis and prevents outpatient management, for example, but not restricted to: intestinal obstruction, paralytic ileus, end-stage cancer, kidney, heart, respiratory or liver failure or mental illness or with surgical procedures or scheduled hospitals. History / presence of any disease or condition that, in the Investigator's opinion, could pose a risk to the patient or confuse the efficacy and safety of the study results. ----Patients with symptoms suggesting an active COVID-19 infection (i.e., fever, cough, dyspnea) and / or contact in the past 14 days with a suspected or positive COVID-19 patient. Oncological patients (except basal cell skin cancer) or with serious diseases that, in the opinion of the investigator, have a serious prognosis or a life expectancy of less than 1 year, as well as mental illnesses. The patient is participating in another clinical study involving an investigational treatment or participated in one in the previous 4 weeks. Patients whose participation in the study may be influenced (employment relationship with the research center or sponsor, inmates, etc.).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Miguel A Zurqui Ramírez, M.D
Organizational Affiliation
Icaro Investigación en Medicina S.A. de C.V.
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Adelfia Urenda Quezada, M.D
Organizational Affiliation
Mediadvance Clinical S.A.P.I. de Quezada
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Alejandro González Rebatu y González, M.D
Organizational Affiliation
Clinical Research Institute S.C.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Laboratorio Silanes, S.A. de C.V.
City
Mexico City
ZIP/Postal Code
11000
Country
Mexico

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
30496104
Citation
GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018 Nov 10;392(10159):1789-1858. doi: 10.1016/S0140-6736(18)32279-7. Epub 2018 Nov 8. Erratum In: Lancet. 2019 Jun 22;393(10190):e44.
Results Reference
background
PubMed Identifier
26999925
Citation
Soto-Padilla M, Espinosa-Mendoza RL, Sandoval-Garcia JP, Gomez-Garcia F. [Comparative study between plate-graft, cage-plate and peek cage in cervical arthrodesis for cervical stenosis]. Acta Ortop Mex. 2015 Jan-Feb;29(1):40-5. Spanish.
Results Reference
background
PubMed Identifier
27120496
Citation
Casser HR, Seddigh S, Rauschmann M. Acute Lumbar Back Pain. Dtsch Arztebl Int. 2016 Apr 1;113(13):223-34. doi: 10.3238/arztebl.2016.0223.
Results Reference
background
PubMed Identifier
22381000
Citation
Guevara-Lopez U, Covarrubias-Gomez A, Elias-Dib J, Reyes-Sanchez A, Rodriguez-Reyna TS; Consensus Group of Practice Parameters to Manage Low Back Pain. Practice guidelines for the management of low back pain. Consensus Group of Practice Parameters to Manage Low Back Pain. Cir Cir. 2011 May-Jun;79(3):264-79, 286-302. English, Spanish.
Results Reference
background
PubMed Identifier
20831016
Citation
Gonzalez Maza C, Moscoso Lopez L, Ramirez Elizalde G, Abdo Andrade A. [Multimodal treatment of chronic unspecific low back pain]. Acta Ortop Mex. 2010 Mar-Apr;24(2):88-94. Spanish.
Results Reference
background
PubMed Identifier
25152629
Citation
Chandanwale AS, Sundar S, Latchoumibady K, Biswas S, Gabhane M, Naik M, Patel K. Efficacy and safety profile of combination of tramadol-diclofenac versus tramadol-paracetamol in patients with acute musculoskeletal conditions, postoperative pain, and acute flare of osteoarthritis and rheumatoid arthritis: a Phase III, 5-day open-label study. J Pain Res. 2014 Aug 12;7:455-63. doi: 10.2147/JPR.S67817. eCollection 2014.
Results Reference
background
PubMed Identifier
28920461
Citation
Bravo L, Mico JA, Berrocoso E. Discovery and development of tramadol for the treatment of pain. Expert Opin Drug Discov. 2017 Dec;12(12):1281-1291. doi: 10.1080/17460441.2017.1377697. Epub 2017 Sep 17.
Results Reference
background
PubMed Identifier
20701403
Citation
Dhillon S. Tramadol/paracetamol fixed-dose combination: a review of its use in the management of moderate to severe pain. Clin Drug Investig. 2010;30(10):711-38. doi: 10.2165/11205830-000000000-00000. Erratum In: Clin Drug Investig. 2010;30(12):866.
Results Reference
background
PubMed Identifier
30594783
Citation
Subedi M, Bajaj S, Kumar MS, Yc M. An overview of tramadol and its usage in pain management and future perspective. Biomed Pharmacother. 2019 Mar;111:443-451. doi: 10.1016/j.biopha.2018.12.085. Epub 2018 Dec 27.
Results Reference
background
Links:
URL
http://www.who.int/es/news-room/fact-sheets/detail/musculoskeletal-conditions
Description
World Health Organization. Musculoskeletal disorders [Internet]. Descriptive notes. 2019.
URL
http://www.dof.gob.mx/nota_detalle.php?codigo=5314833&fecha=20/09/2013
Description
"That establishes the tests and procedures to demonstrate that a drug is interchangeable. Requirements to which the Authorized Third Parties that carry out the interchangeability tests must be ".
URL
http://dof.gob.mx/nota_detalle.php?codigo=5490830&fecha=19/07/2017
Description
"Installation and operation of pharmacovigilance: This document establishes the guidelines on which pharmacovigilance activities must be carried out"
URL
http://dof.gob.mx/nota_detalle.php?codigo=5284148&fecha=04/01/2013
Description
"That establishes the criteria for the execution of research projects for health in human beings"

Learn more about this trial

Efficacy and Safety of Fixed-dose Combination of Etoricoxib/Tramadol vs Acetaminophen/Tramadol for Acute Low Back Pain

We'll reach out to this number within 24 hrs