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Acute PainPhase 3NCT04622735

Nefopam/Paracetamol Fixed Dose Combination in Acute Pain After Impacted Third Molar Extraction

A Phase 3 study testing nefopam hydrochloride 30mg / paracetamol 500mg X2, Paracetamol 500 Mg Oral Tablet X2 and Nefopam HCl 30 MG Oral Tablet X2 in people with Acute Pain, run by Unither Pharmaceuticals, France at 19 sites in 5 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study aims to evaluate the analgesic efficacy of single and multiple doses of a new fixed dose combination of nefopam hydrochloride 30 mg and paracetamol 500mg taken orally in comparison to each single component. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Acute Pain
What is being tested?
nefopam hydrochloride 30mg / paracetamol 500mg X2, Paracetamol 500 Mg Oral Tablet X2 and Nefopam HCl 30 MG Oral Tablet X2
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
321 participants
Where
19 sitesin 5 countries
Study dates
22 Feb 2020to 20 Oct 2022
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Main Inclusion Criteria:

  • Male and female patient aged from 18 years up to 65 years,
  • Patient scheduled to undergo the surgical removal of at least one fully or partially impacted third mandibular molar requiring bone removal under short-acting local anaesthetic (mepivacaine or lidocaine) with or without vasoconstrictor,
  • Patient weighing > 50 kg,
  • Patient who has signed a written informed consent prior to any study-related procedures.

Additional inclusion criteria after surgery (randomization):

  1. Patient experiencing moderate to severe pain within 4 hours after the dental extraction, defined by a baseline pain intensity Visual Analogic Scale (VAS) score ≥ 50 mm,
  2. Third molar extraction(s) completed without any immediate complication, that in the opinion of the investigator, would interfere with the study conduct and/or assessments (e.g., suspected neurosensory complication, incomplete removal of tooth)

Main Exclusion Criteria:

  • Patient treated by analgesics or nonsteroidal anti-inflammatory drugs (NSAIDs) within 3 days preceding the day of randomization or within 5 times the elimination half-life whichever the longest,
  • Woman with positive results on a urine pregnancy test or breastfeeding woman or woman of childbearing potential without an effective contraception,
  • Patient with a history of convulsive disorders,
  • Patient taking mono-amine-oxidase (MAO) inhibitors (including but not limited to selegiline, isocarboxazid, tranylcypromine, phenelzine…),
  • Patient with an abnormal cardiac condition: medically significant disorders of cardiac rate and/or rhythm,
  • Patient with known anaemia,
  • Patient with known pulmonary disease,
  • Patient with known active gastric or duodenal ulcer or a history of recurrent gastrointestinal ulcer/bleeding,
  • Patient with known glaucoma,
  • Patients with a prostatic hyperplasia or urinary retention,
  • Patient with current or chronic history of liver disease, or known hepatic or biliary abnormalities,
  • Patient with a current or chronic history of severe renal impairment (glomerular filtration below 30 mL/min),

Trial locations and contacts

19 sites in 5 countries.

19 sites in 5 countries

Hungary6 sites
  • Clinexpert Kft.

    Budapest

  • Óbudai Egészségügyi Centrum

    Budapest

  • Swan-Med Kft.

    Létavértes

  • Szabolcs-Szatmár-Bereg Megyei Kórházak és Egyetemi Oktatókórház,

    Nyíregyháza

  • Szent Borbála Kórház,

    Tatabánya

  • Óbudai Egészségügyi Centrum

    Zalaegerszeg

Other trials in Hungary

France5 sites
  • CHU Angers

    Angers, 49933

  • CHU Marseille

    Marseille, 13385

  • Centre Hospitalier de Pontoise

    Pontoise, 95300

  • HIA Toulon

    Toulon, 83800

  • CHU de tours

    Tours, 37170

Other trials in France

United Kingdom4 sites
  • Birmingham School of Dentistry

    Birmingham, B5 7EG

  • University Dental Hospital

    Cardiff, CF14 4XY

  • Edinburgh Dental Institute

    Edinburgh, EH3 9HX

  • BARTS HEALTH NHS TRUST Royal London Hospital

    London, E1 1FR

Other trials in United Kingdom

Russia3 sites
  • LLC Center for interdisciplinary dentistry & neuro

    Moscow, 141207

  • State Medico-stomato Univ., by A.I. Evdokimov

    Moscow

  • Regional clinical hospital

    Yaroslavl, 150062

Other trials in Russia

Belgium1 site
  • Hôpital Leuven

    Leuven

Other trials in Belgium

About this study

Official title: A Comparative, Randomized, Double-blind, 3-arm Parallel, Phase III Study to Evaluate the Efficacy and Safety of a Fixed Dose Combination of Nefopam/Paracetamol Taken Orally in Moderate to Severe Pain After Impacted Third Molar Extraction

This study aims to evaluate the analgesic efficacy of single and multiple doses of a new fixed dose combination of nefopam hydrochloride 30 mg and paracetamol 500mg taken orally in comparison to each single component.

Conditions
Acute Pain
Being tested
nefopam hydrochloride 30mg / paracetamol 500mg X2, Paracetamol 500 Mg Oral Tablet X2, Nefopam HCl 30 MG Oral Tablet X2
Keywords
Moderate to severe acute pain, Postoperative pain, Third molar extraction, Analgesics, Nefopam, Paracetamol, Multimodal analgesia, Fixed drug combination
Medical subject headings
Acute Pain, Pain, Postoperative

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • nefopam hydrochloride 30mg / paracetamol 500mg X2Combination product

    The first intake is taken right after randomization. Then on-demand period (5 days maximum) respecting a 6-hour interval between intakes, and up to 3 intakes per day.

  • Paracetamol 500 Mg Oral Tablet X2Drug

    Also called Acetaminophen

    The first intake is taken right after randomization. Then on-demand period (5 days maximum) respecting a 6-hour interval between intakes, and up to 3 intakes per day.

  • Nefopam HCl 30 MG Oral Tablet X2Drug

    The first intake is taken right after randomization. Then on-demand period (5 days maximum) respecting a 6-hour interval between intakes, and up to 3 intakes per day.

Study groups in NCT04622735
Study groupRoleWhat they receive
FDC nefopam hydrochloride 30 mg / paracetamol 500 mg (X2)ExperimentalEach dose: 2 tablets (included in masking capsule)
Receives: Combination Product: nefopam hydrochloride 30mg / paracetamol 500mg X2
Paracetamol 500 mg (X2)Active comparatorEach dose: 2 tablets (included in masking capsule)
Receives: Drug: Paracetamol 500 Mg Oral Tablet X2
Nefopam hydrochloride 30 mg (X2)Active comparatorEach dose: 2 tablets (included in masking capsule)
Receives: Drug: Nefopam HCl 30 MG Oral Tablet X2

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ranked Endpoints : 1. Sum of Pain Intensity Differences at 6 Hours (SPID0-6h)

    Pain intensity difference (PID) will be calculated using the score of pain intensity assessed by the patient at defined time points (T30, T45, T60, T90, T120, T150, T180, T240, T300, T360 min,) after the first Investigational Medicinal Product (IMP) intake and/or right before first intake of rescue medication using a 100-mm Visual Analogic Scale (VAS) compared to baseline.

    Calculation: Sum of Pain intensity difference (SPID) is the time-weighted summary measure of the total area under the pain intensity difference (PID) curve that integrates serial assessments of pain during x times after the first Investigational Medicinal Product

    SPID0-6h= SPID0-30min+SPID30min-45min+SPID45min-1h+SPID1h-1h30+SPID1h30-2h+SPID2h-2h30+SPID2h30-3h+SPID3h-4h+SPID4h-5h+SPID5h-6h With: SPIDTime1-Time2 = (PID Theoretical Time1 + PID Theoretical Time2) * (Theoretical Time2- Theoretical Time1) / 2 SPID min 0-6h = 0 SPID max 0-6h = 36000 The lower score mean a better score

    Measured: 6 hours post-dose

  2. Total Pain Relief at 6 Hours (TOTPAR0-6h)

    Pain Relief will be assessed by the patient at defined time points (T30, T45, T60, T90, T120, T150, T180, T240, T300, T360 min) after the first IMP intake and/or right before first intake of rescue medication using a 5-point verbal rating scale (VRS).

    Calculation: TOTPAR is the time-weighted summary measure of the total area under the pain release difference curve that integrates serial assessments of pain release during x times after the first Investigational Medicinal Product TOTPAR0-6h=TOTPAR0-30min+TOTPAR30min-45min+TOTPAR45min-1h+TOTPAR1h-1h30+TOTPAR1h30-2h+TOTPAR2h-2h30+TOTPAR2h30-3h+ TOTPAR 3h-4h+ TOTPAR 4h-5h+ TOTPAR 5h-6h With: TOTPARTime1-Time2 = (PAR Time1 + PAR Time2) * (Time2-Time1) / 2 And with the score of pain relief at T0 = 0 ("none") TOTPAR min 0-6h = 0 TOTPAR max 0-6h = 1800 The higher score mean a better outcome

    Measured: 6 hours post-dose

  3. Proportion of Responder Patients

    A responder patient is a subject who achieves a reduction of 50% of pain intensity compared to baseline.

    Measured: 6 hours post-dose

  4. The Patient's Global Impression of Change (PGIC) Questionnaire

    Measured: 6 hours post-dose

  5. The Onset of Pain Relief

    Score of pain intensity will be assessed by the patient at defined time points (T30, T45, T60, T90, T120, T150, T180, T240, T300, T360 min). The time point of the first assessment obtaining a score ≤ 30 mm will be retained as time score of onset of pain relief.

    Measured: during the first 6 hours

Secondary outcomes (12)
  1. Total Pain Relief at 1 Hour (TOTPAR0-1h), 2 Hours (TOTPAR0-2h), 3 Hours (TOTPAR0-3h), and 4 Hours (TOTPAR0-4h)

    Pain relief (PAR) will be assessed by the patient at defined time points (T30, T45, T60, T90, T120, T150, T180, T240 min) after the first IMP intake and/or right before first intake of rescue medication using a 5-point verbal rating scale

    Calculation: TOTPAR is the time-weighted summary measure of the total area under the pain release difference curve that integrates serial assessments of pain release during x times after the first Investigational Medicinal Product TOTPAR0-6h=TOTPAR0-30min+TOTPAR30min-45min+TOTPAR45min-1h+TOTPAR1h-1h30+TOTPAR1h30-2h+TOTPAR2h-2h30+TOTPAR2h30-3h+ TOTPAR 3h-4h+ TOTPAR 4h-5h+ TOTPAR 5h-6h With: TOTPARTime1-Time2 = (PAR Time1 + PAR Time2) * (Time2-Time1) / 2 And with the score of pain relief at T0 = 0 ("none") TOTPAR min 0-any time = 0 TOTPAR max 0-1h = 300 ; TOTPAR max 0-2h = 600 ;TOTPAR max 0-3h = 900 ;TOTPAR max 0-4h = 1200 ; The higher score mean a better outcome

    Measured: At 1 hour, 2 hours, 3 hours, and 4 hours

  2. Sum of Pain Intensity Differences at 1 Hour (SPID0-1h), 2 Hours (SPID0-2h), 3 Hours (SPID0-3h), and 4 Hours (SPID0-4h)

    PID will be calculated using the score of pain intensity assessed by the patient at defined time points (T30, T45, T60, T90, T120, T150, T180, T240 min) after the first IMP intake and/or right before first intake of rescue medication using a 100-mm VAS compared to baseline.

    Calculation: SPID is the time-weighted summary measure of the total area under the pain intensity difference curve that integrates serial assessments of pain during x times after the first IMP

    SPID0-4h= SPID0-30min+SPID30min-45min+SPID45min-1h+SPID1h-1h30+SPID1h30-2h+SPID2h-2h30+SPID2h30-3h+SPID3h-4h With: SPIDTime1-Time2 = (PID Theoretical Time1 + PID Theoretical Time2) * (Theoretical Time2- Theoretical Time1) / 2 SPID min 0-any time = 0 SPID max 0-1h = 6000 ; SPID max 0-2h = 12000; SPID max 0-3h = 18000; SPID max 0-4h = 24000 The lower score mean a better score

    Measured: At 1 hour, 2 hours, 3 hours, and 4 hours

  3. The Pain Intensity Differences (PID) Assessment

    PID will be calculated using the scores of pain intensity (VAS) at each time point compared to baseline.

    PID30min = VAS of pain intensity 30min - VAS of pain intensity baseline PID min = 0 / PID max = 100 A higher PID is a better outcome

    Measured: At each timepoint: 30min, At 45min, until at 360 min post-dose

  4. Proportion of Responder Patients.

    Measured: At 1 hour, 2 hours, 3 hours and 4 hours.

  5. Time to the Second Investigational Medicinal Product (IMP) Intake

    Measured: Up to 5 days after first dose

  6. Participant Having Taken a Rescue Analgesic Treatment

    Measured: Up to 10 days after first dose

  7. Sum of Pain Intensity Differences

    Pain Intensity Difference (PID) will be calculated using the score of pain intensity assessed by the patient at defined time points using a 100-mm visual Analog Scale (VAS) compared to baseline.

    Calculation: Sum of Pain Intensity Difference (SPID) is the time-weighted summary measure of the total area under the pain intensity difference curve that integrates serial assessments of pain during x times after the first Investigational Medicinal Product

    With: SPIDTime1-Time2 = (VAS Theoretical Time1 + VAS Theoretical Time2) * (Theoretical Time2- Theoretical Time1) / 2 SPID min 0-any time = 0 SPID max 0-day 1 = 144000 ; SPID max 0-day 2 = 288000 ; SPID max 0-day 3 = 432000 ; SPID max 0-day 4 = 576000 ; SPID max 0-day 5 = 720000 ; The lower score means a better outcome

    Measured: At days 1, 2, 3, 4 and 5

  8. Proportion of Patients Having Taken a Rescue Analgesic Treatment Throughout the Study.

    Measured: Up to 10 days after first dose

  9. The Total Dose of Rescue Medication Taken.

    Measured: Up to 10 days after first dose

  10. Mean Duration Under Rescue Medication Over the 5 Days.

    Measured: Up to 5 days after first dose

  11. Number of Investigational Medicinal Product (IMP) Intakes

    Measured: Up to 5 days after first dose

  12. Patient's Global Impression of Change (PGIC) Score

    Measured: Up to 10 days after first dose

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Nov 2020
  2. Study start22 Feb 2020
  3. Primary completion12 Oct 2022
  4. Study completion20 Oct 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
321 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04622735
Sponsor's protocol ID
UP-CLI-2019-002
Status last verified
Nov 2024
First submitted
22 Oct 2020
Last updated
27 Nov 2024
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing nefopam hydrochloride 30mg / paracetamol 500mg X2, Paracetamol 500 Mg Oral Tablet X2 and Nefopam HCl 30 MG Oral Tablet X2 in people with Acute Pain, run by Unither Pharmaceuticals, France at 19 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Hungary, France, United Kingdom, Russia, Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 27 Nov 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ranked Endpoints : 1. Sum of Pain Intensity Differences at 6 Hours (SPID0-6h) (time frame: 6 hours post-dose). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Nov 2024.

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