Pain
Conditions
Keywords
Postoperative Pain
Brief summary
The primary purpose of this study was to evaluate analgesic efficacy and safety of hydrocodone/acetaminophen extended release compared to placebo in moderate to severe pain following primary unilateral first metatarsal bunionectomy.
Detailed description
The bunionectomy was performed under regional anesthesia and propofol sedation. Perioperative anesthesia was standardized for all participants. Upon completion of surgery, designated study personnel ensured continued eligibility per the selection criteria of the protocol. After an appropriate period of time following bunionectomy, participants who had a pain intensity score of ≥ 40 mm on a 100 mm visual analog scale (VAS) and moderate or severe pain intensity per the categorical pain intensity scale were eligible for randomization, in equal numbers, into 1 of 5 treatment arms. In order to maintain the single-blind nature of the study, all participants were dosed with study drug (active and/or placebo) every 6 hours.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
\- Subjects who were in general good health, experiencing moderate to severe pain following bunionectomy surgery and who were willing to remain confined for approximately 4 days following surgery for study procedures.
Exclusion criteria
* Subjects who underwent Base wedge osteotomy and/or Long-Z hart bunionectomy procedures * Allergic reaction to study medications * Pregnant or breastfeeding females * Clinically significant lab abnormalities at screening * Positive hepatitis testing at screening * Clinically significant or uncontrolled medical disorders or illness at screening * Active malignancy or chemotherapy * Any history of drug or alcohol abuse/addiction * Known or suspected history of human immunodeficiency virus (HIV); requires treatment with monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs) or butyrophenones * History of major depressive episode or major psychiatric disorder * Current systemic corticosteroid therapy * Inability to refrain from smoking during or alcohol during stay at investigative site
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sum of Pain Intensity Difference (SPID) Using the Pain Intensity Visual Analogue Scale (VAS) | From time of first study drug administration to 48 hours following first study drug administration | Participants assessed pain intensity on a 100 mm visual analogue scale (VAS) with 0 meaning no pain and 100 meaning the worst pain imaginable. The SPID VAS score for 0 to 48 hours following initial study drug dose measured the cumulative pain intensity difference during treatment with higher mean SPID VAS scores indicating greater improvement from Baseline. The SPID score is a measure of the cumulative pain intensity difference during treatment and the area under the curve was estimated using the linear trapezoidal rule. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Participant's Global Assessment of Study Drug | From time of first study drug administration to 48 hours following first study drug administration | The participant's overall impression of the study drug was obtained on a 5-point categorical scale: excellent; very good; good; fair; poor. |
| Time to Perceptible and Meaningful Pain Relief | From time of first study drug administration to 12 hours following first study drug administration | The median time (minutes) from first perceptible pain relief (onset of pain relief) and time until first meaningful pain relief. |
| TOTPAR (Total Pain Relief) | From time of first study drug administration to 48 hours following first study drug administration | TOTPAR was the time-interval weighted sum of pain relief. Pain relief was assessed by participants' responses to how their pain relief was compared with the pain they had just before receiving the first dose of study drug: no relief, a little relief, some relief, a lot of relief, or complete relief. Higher mean TOTPAR scores indicate better pain relief. The TOTPAR score is a measure of the cumulative pain intensity difference during treatment and the area under the curve was estimated using the linear trapezoidal rule. |
| Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | At specified intervals from Screening through 7 days after first dose of study drug | Potentially clinically significant criteria: Systolic blood pressure (BP) ≤90 mm Hg and ≥20 mm Hg decrease (low) or ≥180 mm Hg and ≥20 mm Hg increase (high); Diastolic BP ≤50 mm Hg and ≥15 mm Hg decrease (low) or ≥105 mm Hg and ≥15 mm Hg increase (high). Heart rate ≤50 beats per minute (bpm) and ≥15 bpm decrease (low) or ≥120 bpm and ≥15 bpm increase (high). Respiratory rate \<10 respirations per minute (rpm) (low) or \>24 rpm (high). |
| Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | At specified intervals from Screening through 7 days after first dose of study drug | Potentially clinically significant criteria: alanine aminotransferase/aspartate aminotransferase (ALT/AST) ≥3 times upper limit of normal (ULN); calcium ≤1.8 mmol/L. |
| Participants With Adverse Events (AEs) | AEs were recorded from study drug administration until 30 days following discontinuation of study drug (total 32 days); SAEs were recorded from the time informed consent was obtained until 30 days following discontinuation of study drug (total 51 days). | An adverse event (AE) is defined as any untoward medical occurrence in a participant, which does not necessarily have a causal relationship with treatment. If an adverse event meets any of the following criteria, it is considered a serious adverse event (SAE): results in death or is life-threatening, results in admission or prolongation of hospitalization, results in congenital anomaly or persistent or significant disability/incapacity, or is an important medical event requiring medical or surgical intervention to prevent serious outcome. AEs were categorized by severity (mild, moderate, severe) and relationship to treatment (probably, possibly, probably not, not related). Please see Adverse Events section below for more details. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Acetaminophen 1 dose of 1 placebo capsule (for morphine extended release) plus 1 acetaminophen tablet, administered once every 12 hours, and 1 dose of 1 acetaminophen tablet, administered once every 6 hours (for a total of 8 doses). | 50 |
| Morphine Extended Release 1 dose of 1 placebo tablet (for hydrocodone/acetaminophen extended release) plus 1 morphine extended release capsule, administered once every 12 hours, and 1 dose of 1 placebo tablet (for hydrocodone/acetaminophen extended release), administered once every 6 hours (for a total of 8 doses). | 52 |
| Morphine Extended Release / Acetaminophen 1 dose of 1 morphine extended release capsule plus 1 acetaminophen tablet, administered once every 12 hours, and 1 dose of 1 acetaminophen tablet, administered once every 6 hours (for a total of 8 doses). | 49 |
| Hydrocodone/Acetaminophen Extended Release 1 dose of 1 hydrocodone/acetaminophen extended release tablet plus 1 placebo capsule (for morphine extended release), administered once every 12 hours, and 1 dose of 1 placebo tablet (for hydrocodone/acetaminophen extended release), administered once every 6 hours (for a total of 8 doses). | 48 |
| Placebo 1 dose of 1 placebo tablet (for hydrocodone/acetaminophen extended release) plus 1 placebo capsule (for morphine extended release), administered once every 12 hours, and 1 dose of 1 placebo tablet (for hydrocodone/acetaminophen extended release), administered once every 6 hours (for a total of 8 doses). | 51 |
| Total | 250 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 |
|---|---|---|---|---|---|---|
| Overall Study | Adverse Event | 0 | 0 | 1 | 0 | 0 |
| Overall Study | Death in the Family | 1 | 0 | 0 | 0 | 0 |
| Overall Study | Dosing Error | 0 | 0 | 0 | 1 | 1 |
| Overall Study | Refusal of Blood Draws | 0 | 1 | 0 | 0 | 0 |
Baseline characteristics
| Characteristic | Acetaminophen | Morphine Extended Release | Morphine Extended Release / Acetaminophen | Hydrocodone/Acetaminophen Extended Release | Placebo | Total |
|---|---|---|---|---|---|---|
| Age, Continuous | 44.9 years STANDARD_DEVIATION 13.83 | 44.0 years STANDARD_DEVIATION 12.93 | 40.2 years STANDARD_DEVIATION 11.31 | 40.4 years STANDARD_DEVIATION 13.16 | 45.2 years STANDARD_DEVIATION 12.47 | 43.0 years STANDARD_DEVIATION 12.85 |
| Sex: Female, Male Female | 45 Participants | 44 Participants | 39 Participants | 41 Participants | 45 Participants | 214 Participants |
| Sex: Female, Male Male | 5 Participants | 8 Participants | 10 Participants | 7 Participants | 6 Participants | 36 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk |
|---|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 19 / 50 | 21 / 52 | 26 / 49 | 27 / 48 | 20 / 51 |
| serious Total, serious adverse events | 0 / 50 | 0 / 52 | 0 / 49 | 0 / 48 | 0 / 51 |
Outcome results
Sum of Pain Intensity Difference (SPID) Using the Pain Intensity Visual Analogue Scale (VAS)
Participants assessed pain intensity on a 100 mm visual analogue scale (VAS) with 0 meaning no pain and 100 meaning the worst pain imaginable. The SPID VAS score for 0 to 48 hours following initial study drug dose measured the cumulative pain intensity difference during treatment with higher mean SPID VAS scores indicating greater improvement from Baseline. The SPID score is a measure of the cumulative pain intensity difference during treatment and the area under the curve was estimated using the linear trapezoidal rule.
Time frame: From time of first study drug administration to 48 hours following first study drug administration
Population: All randomized participants who received at least 1 dose of study drug. Analyses were performed based on the treatment participants actually received (as-treated).
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Acetaminophen | Sum of Pain Intensity Difference (SPID) Using the Pain Intensity Visual Analogue Scale (VAS) | 720.5 scores on a scale | Standard Error 154.89 |
| Morphine Extended Release | Sum of Pain Intensity Difference (SPID) Using the Pain Intensity Visual Analogue Scale (VAS) | 239.9 scores on a scale | Standard Error 151.41 |
| Morphine Extended Release / Acetaminophen | Sum of Pain Intensity Difference (SPID) Using the Pain Intensity Visual Analogue Scale (VAS) | 614.4 scores on a scale | Standard Error 156.92 |
| Hydrocodone/Acetaminophen Extended Release | Sum of Pain Intensity Difference (SPID) Using the Pain Intensity Visual Analogue Scale (VAS) | 450.8 scores on a scale | Standard Error 159.62 |
| Placebo | Sum of Pain Intensity Difference (SPID) Using the Pain Intensity Visual Analogue Scale (VAS) | -57.6 scores on a scale | Standard Error 153.99 |
Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria
Potentially clinically significant criteria: alanine aminotransferase/aspartate aminotransferase (ALT/AST) ≥3 times upper limit of normal (ULN); calcium ≤1.8 mmol/L.
Time frame: At specified intervals from Screening through 7 days after first dose of study drug
Population: All randomized participants who received at least 1 dose of study drug. Analyses were performed based on the treatment participants actually received (as-treated).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Acetaminophen | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | AST >= 3 * ULN | 1 participants |
| Acetaminophen | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | ALT >= 3 * ULN | 1 participants |
| Acetaminophen | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | Calcium <= 1.8 mmol/L | 0 participants |
| Morphine Extended Release | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | AST >= 3 * ULN | 2 participants |
| Morphine Extended Release | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | ALT >= 3 * ULN | 2 participants |
| Morphine Extended Release | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | Calcium <= 1.8 mmol/L | 0 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | AST >= 3 * ULN | 3 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | ALT >= 3 * ULN | 3 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | Calcium <= 1.8 mmol/L | 1 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | ALT >= 3 * ULN | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | Calcium <= 1.8 mmol/L | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | AST >= 3 * ULN | 0 participants |
| Placebo | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | AST >= 3 * ULN | 0 participants |
| Placebo | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | ALT >= 3 * ULN | 0 participants |
| Placebo | Number of Participants With Chemistry Values Meeting Potentially Clinically Significant Criteria | Calcium <= 1.8 mmol/L | 2 participants |
Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria
Potentially clinically significant criteria: Systolic blood pressure (BP) ≤90 mm Hg and ≥20 mm Hg decrease (low) or ≥180 mm Hg and ≥20 mm Hg increase (high); Diastolic BP ≤50 mm Hg and ≥15 mm Hg decrease (low) or ≥105 mm Hg and ≥15 mm Hg increase (high). Heart rate ≤50 beats per minute (bpm) and ≥15 bpm decrease (low) or ≥120 bpm and ≥15 bpm increase (high). Respiratory rate \<10 respirations per minute (rpm) (low) or \>24 rpm (high).
Time frame: At specified intervals from Screening through 7 days after first dose of study drug
Population: All randomized participants who received at least 1 dose of study drug. Analyses were performed based on the treatment participants actually received (as-treated).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP decrease | 3 participants |
| Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP increase | 1 participants |
| Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP decrease | 2 participants |
| Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP increase | 0 participants |
| Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate decrease | 3 participants |
| Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate increase | 1 participants |
| Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate < 10 rpm | 0 participants |
| Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate > 24 rpm | 0 participants |
| Morphine Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP decrease | 5 participants |
| Morphine Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate increase | 0 participants |
| Morphine Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP decrease | 6 participants |
| Morphine Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP increase | 0 participants |
| Morphine Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP increase | 0 participants |
| Morphine Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate > 24 rpm | 0 participants |
| Morphine Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate decrease | 1 participants |
| Morphine Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate < 10 rpm | 0 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate < 10 rpm | 0 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate > 24 rpm | 0 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP increase | 2 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate increase | 0 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP decrease | 6 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP increase | 0 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP decrease | 8 participants |
| Morphine Extended Release / Acetaminophen | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate decrease | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP increase | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP decrease | 5 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP increase | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate decrease | 2 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate increase | 1 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate > 24 rpm | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP decrease | 2 participants |
| Hydrocodone/Acetaminophen Extended Release | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate < 10 rpm | 0 participants |
| Placebo | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP increase | 0 participants |
| Placebo | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate > 24 rpm | 0 participants |
| Placebo | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Diastolic BP decrease | 2 participants |
| Placebo | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Respiratory rate < 10 rpm | 0 participants |
| Placebo | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP decrease | 5 participants |
| Placebo | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate increase | 0 participants |
| Placebo | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Systolic BP increase | 1 participants |
| Placebo | Number of Participants With Vital Signs Values Meeting Potentially Clinically Significant Criteria | Heart rate decrease | 0 participants |
Participant's Global Assessment of Study Drug
The participant's overall impression of the study drug was obtained on a 5-point categorical scale: excellent; very good; good; fair; poor.
Time frame: From time of first study drug administration to 48 hours following first study drug administration
Population: All randomized participants who received at least 1 dose of study drug. Analyses were performed based on the treatment participants actually received (as-treated).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Acetaminophen | Participant's Global Assessment of Study Drug | Excellent | 9 participants |
| Acetaminophen | Participant's Global Assessment of Study Drug | Fair | 10 participants |
| Acetaminophen | Participant's Global Assessment of Study Drug | Poor | 0 participants |
| Acetaminophen | Participant's Global Assessment of Study Drug | Good | 16 participants |
| Acetaminophen | Participant's Global Assessment of Study Drug | Very Good | 15 participants |
| Morphine Extended Release | Participant's Global Assessment of Study Drug | Good | 14 participants |
| Morphine Extended Release | Participant's Global Assessment of Study Drug | Poor | 11 participants |
| Morphine Extended Release | Participant's Global Assessment of Study Drug | Fair | 3 participants |
| Morphine Extended Release | Participant's Global Assessment of Study Drug | Excellent | 8 participants |
| Morphine Extended Release | Participant's Global Assessment of Study Drug | Very Good | 16 participants |
| Morphine Extended Release / Acetaminophen | Participant's Global Assessment of Study Drug | Poor | 3 participants |
| Morphine Extended Release / Acetaminophen | Participant's Global Assessment of Study Drug | Good | 12 participants |
| Morphine Extended Release / Acetaminophen | Participant's Global Assessment of Study Drug | Excellent | 4 participants |
| Morphine Extended Release / Acetaminophen | Participant's Global Assessment of Study Drug | Fair | 11 participants |
| Morphine Extended Release / Acetaminophen | Participant's Global Assessment of Study Drug | Very Good | 19 participants |
| Hydrocodone/Acetaminophen Extended Release | Participant's Global Assessment of Study Drug | Poor | 2 participants |
| Hydrocodone/Acetaminophen Extended Release | Participant's Global Assessment of Study Drug | Very Good | 20 participants |
| Hydrocodone/Acetaminophen Extended Release | Participant's Global Assessment of Study Drug | Fair | 4 participants |
| Hydrocodone/Acetaminophen Extended Release | Participant's Global Assessment of Study Drug | Excellent | 7 participants |
| Hydrocodone/Acetaminophen Extended Release | Participant's Global Assessment of Study Drug | Good | 15 participants |
| Placebo | Participant's Global Assessment of Study Drug | Excellent | 3 participants |
| Placebo | Participant's Global Assessment of Study Drug | Very Good | 17 participants |
| Placebo | Participant's Global Assessment of Study Drug | Poor | 4 participants |
| Placebo | Participant's Global Assessment of Study Drug | Good | 12 participants |
| Placebo | Participant's Global Assessment of Study Drug | Fair | 15 participants |
Participants With Adverse Events (AEs)
An adverse event (AE) is defined as any untoward medical occurrence in a participant, which does not necessarily have a causal relationship with treatment. If an adverse event meets any of the following criteria, it is considered a serious adverse event (SAE): results in death or is life-threatening, results in admission or prolongation of hospitalization, results in congenital anomaly or persistent or significant disability/incapacity, or is an important medical event requiring medical or surgical intervention to prevent serious outcome. AEs were categorized by severity (mild, moderate, severe) and relationship to treatment (probably, possibly, probably not, not related). Please see Adverse Events section below for more details.
Time frame: AEs were recorded from study drug administration until 30 days following discontinuation of study drug (total 32 days); SAEs were recorded from the time informed consent was obtained until 30 days following discontinuation of study drug (total 51 days).
Population: All randomized participants who received at least 1 dose of study drug. Analyses were performed based on the treatment participants actually received (as-treated).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Acetaminophen | Participants With Adverse Events (AEs) | Any AE | 28 participants |
| Acetaminophen | Participants With Adverse Events (AEs) | Death | 0 participants |
| Acetaminophen | Participants With Adverse Events (AEs) | Any AE leading to death | 0 participants |
| Acetaminophen | Participants With Adverse Events (AEs) | Any severe AE | 1 participants |
| Acetaminophen | Participants With Adverse Events (AEs) | Any AE at least possibly drug related | 23 participants |
| Acetaminophen | Participants With Adverse Events (AEs) | Any SAE | 0 participants |
| Acetaminophen | Participants With Adverse Events (AEs) | Any AE leading to discontinuation of study drug | 0 participants |
| Morphine Extended Release | Participants With Adverse Events (AEs) | Any AE leading to discontinuation of study drug | 0 participants |
| Morphine Extended Release | Participants With Adverse Events (AEs) | Any SAE | 0 participants |
| Morphine Extended Release | Participants With Adverse Events (AEs) | Any AE at least possibly drug related | 23 participants |
| Morphine Extended Release | Participants With Adverse Events (AEs) | Any AE | 29 participants |
| Morphine Extended Release | Participants With Adverse Events (AEs) | Any AE leading to death | 0 participants |
| Morphine Extended Release | Participants With Adverse Events (AEs) | Any severe AE | 1 participants |
| Morphine Extended Release | Participants With Adverse Events (AEs) | Death | 0 participants |
| Morphine Extended Release / Acetaminophen | Participants With Adverse Events (AEs) | Any SAE | 0 participants |
| Morphine Extended Release / Acetaminophen | Participants With Adverse Events (AEs) | Any AE | 28 participants |
| Morphine Extended Release / Acetaminophen | Participants With Adverse Events (AEs) | Any AE at least possibly drug related | 23 participants |
| Morphine Extended Release / Acetaminophen | Participants With Adverse Events (AEs) | Any severe AE | 2 participants |
| Morphine Extended Release / Acetaminophen | Participants With Adverse Events (AEs) | Any AE leading to discontinuation of study drug | 1 participants |
| Morphine Extended Release / Acetaminophen | Participants With Adverse Events (AEs) | Any AE leading to death | 0 participants |
| Morphine Extended Release / Acetaminophen | Participants With Adverse Events (AEs) | Death | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Participants With Adverse Events (AEs) | Any severe AE | 5 participants |
| Hydrocodone/Acetaminophen Extended Release | Participants With Adverse Events (AEs) | Any AE leading to discontinuation of study drug | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Participants With Adverse Events (AEs) | Any AE at least possibly drug related | 24 participants |
| Hydrocodone/Acetaminophen Extended Release | Participants With Adverse Events (AEs) | Death | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Participants With Adverse Events (AEs) | Any AE leading to death | 0 participants |
| Hydrocodone/Acetaminophen Extended Release | Participants With Adverse Events (AEs) | Any AE | 33 participants |
| Hydrocodone/Acetaminophen Extended Release | Participants With Adverse Events (AEs) | Any SAE | 0 participants |
| Placebo | Participants With Adverse Events (AEs) | Any severe AE | 1 participants |
| Placebo | Participants With Adverse Events (AEs) | Death | 0 participants |
| Placebo | Participants With Adverse Events (AEs) | Any AE leading to death | 0 participants |
| Placebo | Participants With Adverse Events (AEs) | Any AE leading to discontinuation of study drug | 0 participants |
| Placebo | Participants With Adverse Events (AEs) | Any AE at least possibly drug related | 19 participants |
| Placebo | Participants With Adverse Events (AEs) | Any AE | 28 participants |
| Placebo | Participants With Adverse Events (AEs) | Any SAE | 0 participants |
Time to Perceptible and Meaningful Pain Relief
The median time (minutes) from first perceptible pain relief (onset of pain relief) and time until first meaningful pain relief.
Time frame: From time of first study drug administration to 12 hours following first study drug administration
Population: All randomized participants who received at least 1 dose of study drug. Analyses were performed based on the treatment participants actually received (as-treated).
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Acetaminophen | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Meaningful Pain Relief | 62.5 minutes |
| Acetaminophen | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Perceptible Pain Relief | 25.5 minutes |
| Morphine Extended Release | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Perceptible Pain Relief | 32.0 minutes |
| Morphine Extended Release | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Meaningful Pain Relief | 142.0 minutes |
| Morphine Extended Release / Acetaminophen | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Meaningful Pain Relief | 101.0 minutes |
| Morphine Extended Release / Acetaminophen | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Perceptible Pain Relief | 31.0 minutes |
| Hydrocodone/Acetaminophen Extended Release | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Perceptible Pain Relief | 22.5 minutes |
| Hydrocodone/Acetaminophen Extended Release | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Meaningful Pain Relief | 60.5 minutes |
| Placebo | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Meaningful Pain Relief | 220.0 minutes |
| Placebo | Time to Perceptible and Meaningful Pain Relief | Time to Onset of Perceptible Pain Relief | 23.0 minutes |
TOTPAR (Total Pain Relief)
TOTPAR was the time-interval weighted sum of pain relief. Pain relief was assessed by participants' responses to how their pain relief was compared with the pain they had just before receiving the first dose of study drug: no relief, a little relief, some relief, a lot of relief, or complete relief. Higher mean TOTPAR scores indicate better pain relief. The TOTPAR score is a measure of the cumulative pain intensity difference during treatment and the area under the curve was estimated using the linear trapezoidal rule.
Time frame: From time of first study drug administration to 48 hours following first study drug administration
Population: All randomized participants who received at least 1 dose of study drug. Analyses were performed based on the treatment participants actually received (as-treated).
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Acetaminophen | TOTPAR (Total Pain Relief) | 65.9 scores on a scale | Standard Error 7.17 |
| Morphine Extended Release | TOTPAR (Total Pain Relief) | 42.7 scores on a scale | Standard Error 7.01 |
| Morphine Extended Release / Acetaminophen | TOTPAR (Total Pain Relief) | 49.5 scores on a scale | Standard Error 7.24 |
| Hydrocodone/Acetaminophen Extended Release | TOTPAR (Total Pain Relief) | 56.3 scores on a scale | Standard Error 7.34 |
| Placebo | TOTPAR (Total Pain Relief) | 32.9 scores on a scale | Standard Error 7.12 |