Hallux Valgus
Conditions
Keywords
Bunionectomy, Acute pain, Post-operative pain, Tapentadol IR, Analgesia, Hallux valgus
Brief summary
The purpose of this study is to evaluate the analgesic efficacy and safety of tapentadol immediate-release (IR \[CG5503\]) for use in the relief of moderate to severe acute pain, compared with placebo, in adult Taiwanese patients with acute pain following bunionectomy.
Detailed description
Patients undergoing bunionectomy (a surgical procedure to remove a bunion, an enlargement of the joint at the base of the big toe comprised of bone and soft tissue) often experience moderate to severe acute pain post-surgery. Normally such pain is controlled when patients receive repeated doses of opioid analgesics. Tapentadol (CG5503) is a newly synthesized opioid drug acting as a centrally acting analgesic like opioid analgesics but has a different mode of action. This study, a randomized (patients are assigned different treatments based on chance), double-blind (neither investigator nor patient knows which treatment the patient receives), placebo-controlled (placebo is an inactive substance that is compared with a drug to test whether the drug has a real effect in a clinical trial), parallel-group (each group of patients will be treated at the same time), multicenter study (the study is performed at more than one clinic) is designed to evaluate the effectiveness (level of pain control) and safety (side effects) of tapentadol immediate-release (IR) 50 mg or 75 mg versus placebo. The study will consist of a screening phase, during which the patients will be evaluated for study entry (Days -28 to -2) followed by the surgical period (Day -1) during which the bunionectomy will be performed and which will start with the first surgical incision and continues until termination of the popliteal sciatic block (PSB) infusion. During the qualification period (Day 1) which starts after termination of the post-operative continuous PSB infusion, patients will be evaluated for entry in the double blind treatment phase. Patients will be randomly assigned to one of three treatment groups to receive either 50 mg tapentadol IR, 75 mg tapentadol IR or a placebo if their PI is equal to or greater than 4 on a 0-10 numerical rating scale. The inpatient double-blind treatment period will be 72 hours in duration and will include a final end-of-double-blind evaluation (on Day 4, i.e., 72 hours after the administration of the first dose) for all patients. Any patient requiring analgesia for pain relief in addition to study drug during the double-blind treatment period will be discontinued from the study due to lack of efficacy. All patients who discontinue for lack of efficacy will complete pain assessments and the Patient Global Impression of Change (PGIC) before receiving rescue medication. Pain intensity and pain relief will be periodically assessed during the treatment period using rating scales. Safety evaluations include monitoring of adverse events, physical examinations, and clinical laboratory tests. The study length, including the screening period, will be up to a maximum duration of 32 days.
Interventions
Tapentadol IR 50 mg will be administered as a single oral dose once every 4 to 6 hours, during the double blind treatment period.
Tapentadol IR 75 mg will be administered as a single oral dose once every 4 to 6 hours, during the double blind treatment period.
DRUGPlacebo
Placebo will be administered as a single oral dose once every 4 to 6 hours, during the double blind treatment period.
Sponsors
Grünenthal GmbH
Janssen-Cilag International NV
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients must be undergoing primary unilateral first metatarsal bunionectomy that includes a distal Chevron osteotomy only, with or without the Akin procedure * Patients must be healthy or medically stable on the basis of clinical laboratory tests performed at screening * Women must be postmenopausal, surgically sterile, abstinent, or practicing or agree to practice an effective method of birth control and have a negative serum pregnancy test at screening and a negative urine pregnancy test before surgery * If a male, must use an approved method of birth control and does not donate sperm from the day of study drug administration until 3 months afterwards * Qualifying baseline Pain Intensity must be rated as greater than or equal to 4 on an 11-point (0 to 10) PI NRS, recorded within 30 minutes before randomization, no earlier than 10 hours after the first surgical incision and within 9 hours after termination of the continuous Popliteal Sciatic Block (PSB) infusion
Exclusion criteria
- History of seizure disorder or epilepsy, severe traumatic brain injury, episode(s) of unconsciousness of more than 24 hours duration, malignancy in the past 2 years with the exception of successfully treated basal cell carcinoma * Mild or moderate traumatic brain injury, stroke, transient ischemic attack, or brain neoplasm within 1 year of screening * Renal insufficiency, impaired hepatic function * Use of anticonvulsants, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), neuroleptics, serotonin norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs) or triptans
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sum of Pain Intensity Difference (SPID) Over 48 Hours | 48 hours | Pain Intensity (PI) was assessed on an 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. PID was the difference between baseline PI (prior to the first dose) and current PI at assessment. SPID was calculated as the time-weighted Sum of PID scores over 48 hours. Total score ranges from -480 (worst) to 480 (best) for SPID48. A higher value of SPID indicates greater pain relief. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 12, 24, 48 and 72 hours | Response rate was defined as the percentage of participants with a 30 percent or greater reduction in pain intensity from baseline to 12, 24, 48, and 72 hours. Pain intensity was assessed on a 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. Participants with no assessment at the given time point, who used an analgesic medication prior to the time point, or who had worse pain intensity at the time point compared to baseline were assigned a percent reduction of 0 percent. |
| Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 12, 24, 48 and 72 hours | Response rate was defined as the percentage of participants with a 50 percent or greater reduction in pain intensity from baseline to 12, 24, 48, and 72 hours. Pain intensity was assessed on a 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. Participants with no assessment at the given time point, who used an analgesic medication prior to the time point, or who had worse pain intensity at the time point compared to baseline were assigned a percent reduction of 0 percent. |
| Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 12, 24 and 72 hours | Pain Intensity (PI) was assessed on an 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. PID was the difference between baseline PI (prior to the first dose) and current PI at assessment. SPID was calculated as the time-weighted Sum of PID scores over 12, 24, and 72 hours. Total score ranges from -120 (worst) to 120 (best) for SPID12, -240 (worst) to 240 (best) for SPID24, -720 (worst) to 720 (best) for SPID72. A higher value of SPID indicates greater pain relief. |
| Time to First Rescue Medication Use | up to 48 hours | Rescue medication was defined as any analgesic medication used for participants discontinued due to lack of efficacy (including those started at time of discontinuation) or analgesic medication used during the double-blind period for completed participants. |
| Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 12, 24, 48 and 72 hours | Participants rated pain relief on 5-point categorical scale of 0-4 (0=none, 1=A little, 2=Some, 3=A lot, 4=Complete). Pain Intensity (PI) was assessed on an 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. PID was the difference between baseline PI (prior to the first dose) and current PI at assessment. PRID is the sum of pain relief and PID at the same assessment time. SPRID was calculated as the time-weighted Sum of PRID scores over 12, 24, 48, and 72 hours. Total score ranges from -120 (worst) to 168 (best) for SPRID12, -240 (worst) to 336 (best) for SPRID24, -480 (worst) to 672 (best) for SPRID48, and -720 (worst) to 1008 (best) for SPRID72. A higher value of SPRID indicates greater pain relief. |
| Patient Global Impression of Change (PGI-C) Score at 72 Hours | Baseline (Day 1) and 72 hours | The PGI-C is a 7-point scale that requires the participants to assess how much their illness has improved or worsened relative to a baseline state at the beginning of the intervention. The response options are: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; and 7=very much worse. Higher scores indicate worsening. |
| Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 12, 24, 48, and 72 hours | Participants rated pain relief on 5-point categorical scale of 0-4 (0=none, 1=A little, 2=Some, 3=A lot, 4=Complete). Total Pain Relief (TOTPAR) was calculated as the time-weighted sum of pain relief scores up to Hour 12, 24, 48, and 72. Total score ranges from 0 (worst) to 48 (best) for TOTPAR12, 0 (worst) to 96 (best) for TOTPAR24, 0 (worst) to 192 (best) for TOTPAR48, and 0 (worst) to 288 (best) for TOTPAR72. A higher value of TOTPAR indicated greater pain relief. |
Countries
Taiwan
Participant flow
Recruitment details
The study was conducted from 11 January 2013 to 12 January 2014. Participants were recruited at 3 study centers in Taiwan.
Participants by arm
| Arm | Count |
|---|---|
| Placebo Placebo matched to tapentadol tablet administered orally,every 4 to 6 hours for 3 days. | 20 |
| Tapentadol IR 50 mg Tapentadol 50 milligram (mg) immediate release (IR) tablet administered orally, every 4 to 6 hours for 3 days. | 21 |
| Tapentadol IR 75 mg Tapentadol 75 mg IR tablet administered orally, every 4 to 6 hours for 3 days. | 19 |
| Total | 60 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Adverse Event | 0 | 3 | 4 |
| Overall Study | Lack of Efficacy | 9 | 1 | 2 |
Baseline characteristics
| Characteristic | Placebo | Tapentadol IR 50 mg | Tapentadol IR 75 mg | Total |
|---|---|---|---|---|
| Age, Continuous | 44.4 years STANDARD_DEVIATION 14.98 | 42.3 years STANDARD_DEVIATION 14.27 | 43.3 years STANDARD_DEVIATION 11.81 | 43.3 years STANDARD_DEVIATION 13.59 |
| Age Customized Greater than or equal (>=) to 65 years | 2 participants | 1 participants | 1 participants | 4 participants |
| Age Customized Less than (<) 65 years | 18 participants | 20 participants | 18 participants | 56 participants |
| Sex: Female, Male Female | 19 Participants | 21 Participants | 18 Participants | 58 Participants |
| Sex: Female, Male Male | 1 Participants | 0 Participants | 1 Participants | 2 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 3 / 20 | 19 / 21 | 18 / 19 |
| serious Total, serious adverse events | 0 / 20 | 0 / 21 | 0 / 19 |
Outcome results
Primary
Sum of Pain Intensity Difference (SPID) Over 48 Hours
Pain Intensity (PI) was assessed on an 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. PID was the difference between baseline PI (prior to the first dose) and current PI at assessment. SPID was calculated as the time-weighted Sum of PID scores over 48 hours. Total score ranges from -480 (worst) to 480 (best) for SPID48. A higher value of SPID indicates greater pain relief.
Time frame: 48 hours
Population: Intent-to-treat (ITT) analysis set, which included all randomly assigned participants with at least 1 dose of study medication. Last-observation-carried-forward imputation method was used for missing values.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Sum of Pain Intensity Difference (SPID) Over 48 Hours | 50.8 units on a scale | Standard Deviation 158.52 |
| Tapentadol IR 50 mg | Sum of Pain Intensity Difference (SPID) Over 48 Hours | 168.4 units on a scale | Standard Deviation 84.5 |
| Tapentadol IR 75 mg | Sum of Pain Intensity Difference (SPID) Over 48 Hours | 194.9 units on a scale | Standard Deviation 131.13 |
Comparison: Based on participant availability in Taiwan it was expected that 60 subjects (20 per group) would be enrolled. In consultation with the Taiwan health authority, the overall two-sided significance level was set at 0.20 (0.10 for each tapentadol versus placebo comparison). Assuming a standard deviation of 134.4, this sample size would provide 71.5% power to detect a between-group difference in SPID48 of 94.1 and 81.2% power to detect a between-group difference of 107.52.p-value: 0.00695% CI: [32, 179.2]ANCOVA
Comparison: Based on participant availability in Taiwan it was expected that 60 subjects (20 per group) would be enrolled. In consultation with the Taiwan health authority, the overall two-sided significance level was set at 0.20 (0.10 for each tapentadol versus placebo comparison). Assuming a standard deviation of 134.4, this sample size would provide 71.5% power to detect a between-group difference in SPID48 of 94.1 and 81.2% power to detect a between-group difference of 107.52.p-value: 0.00495% CI: [49.5, 203.7]ANCOVA
Secondary
Patient Global Impression of Change (PGI-C) Score at 72 Hours
The PGI-C is a 7-point scale that requires the participants to assess how much their illness has improved or worsened relative to a baseline state at the beginning of the intervention. The response options are: 1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; and 7=very much worse. Higher scores indicate worsening.
Time frame: Baseline (Day 1) and 72 hours
Population: ITT analysis set, which included all randomly assigned participants with at least 1 dose of study medication. Last-observation-carried-forward imputation method was used for missing values.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Much Worse | 0.0 Percentage of participants |
| Placebo | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Much Improved | 10.0 Percentage of participants |
| Placebo | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Very Much Worse | 25.0 Percentage of participants |
| Placebo | Patient Global Impression of Change (PGI-C) Score at 72 Hours | No Change | 20.0 Percentage of participants |
| Placebo | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Minimally Improved | 5.0 Percentage of participants |
| Placebo | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Minimally Worse | 0.0 Percentage of participants |
| Placebo | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Very Much Improved | 40.0 Percentage of participants |
| Tapentadol IR 50 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Minimally Worse | 0.0 Percentage of participants |
| Tapentadol IR 50 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Much Worse | 0.0 Percentage of participants |
| Tapentadol IR 50 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Very Much Improved | 71.4 Percentage of participants |
| Tapentadol IR 50 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Very Much Worse | 0.0 Percentage of participants |
| Tapentadol IR 50 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Minimally Improved | 9.5 Percentage of participants |
| Tapentadol IR 50 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | No Change | 4.8 Percentage of participants |
| Tapentadol IR 50 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Much Improved | 14.3 Percentage of participants |
| Tapentadol IR 75 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Very Much Worse | 10.5 Percentage of participants |
| Tapentadol IR 75 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Minimally Improved | 10.5 Percentage of participants |
| Tapentadol IR 75 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | No Change | 0.0 Percentage of participants |
| Tapentadol IR 75 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Very Much Improved | 73.7 Percentage of participants |
| Tapentadol IR 75 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Much Improved | 5.3 Percentage of participants |
| Tapentadol IR 75 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Minimally Worse | 0.0 Percentage of participants |
| Tapentadol IR 75 mg | Patient Global Impression of Change (PGI-C) Score at 72 Hours | Much Worse | 0.0 Percentage of participants |
Secondary
Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours
Response rate was defined as the percentage of participants with a 30 percent or greater reduction in pain intensity from baseline to 12, 24, 48, and 72 hours. Pain intensity was assessed on a 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. Participants with no assessment at the given time point, who used an analgesic medication prior to the time point, or who had worse pain intensity at the time point compared to baseline were assigned a percent reduction of 0 percent.
Time frame: 12, 24, 48 and 72 hours
Population: ITT analysis set, which included all randomly assigned participants with at least 1 dose of study medication.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 12 hours | 35.0 Percentage of Participants |
| Placebo | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 24 hours | 40.0 Percentage of Participants |
| Placebo | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 48 hours | 45.0 Percentage of Participants |
| Placebo | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 72 hours | 45.0 Percentage of Participants |
| Tapentadol IR 50 mg | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 72 hours | 81.0 Percentage of Participants |
| Tapentadol IR 50 mg | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 12 hours | 66.7 Percentage of Participants |
| Tapentadol IR 50 mg | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 48 hours | 81.0 Percentage of Participants |
| Tapentadol IR 50 mg | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 24 hours | 66.7 Percentage of Participants |
| Tapentadol IR 75 mg | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 72 hours | 68.4 Percentage of Participants |
| Tapentadol IR 75 mg | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 24 hours | 73.7 Percentage of Participants |
| Tapentadol IR 75 mg | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 48 hours | 68.4 Percentage of Participants |
| Tapentadol IR 75 mg | Response Rate for 30 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 12 hours | 73.7 Percentage of Participants |
Secondary
Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours
Response rate was defined as the percentage of participants with a 50 percent or greater reduction in pain intensity from baseline to 12, 24, 48, and 72 hours. Pain intensity was assessed on a 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. Participants with no assessment at the given time point, who used an analgesic medication prior to the time point, or who had worse pain intensity at the time point compared to baseline were assigned a percent reduction of 0 percent.
Time frame: 12, 24, 48 and 72 hours
Population: ITT analysis set, which included all randomly assigned participants with at least 1 dose of study medication.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 12 hours | 20.0 Percentage of Participants |
| Placebo | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 24 hours | 35.0 Percentage of Participants |
| Placebo | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 48 hours | 40.0 Percentage of Participants |
| Placebo | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 72 hours | 45.0 Percentage of Participants |
| Tapentadol IR 50 mg | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 72 hours | 81.0 Percentage of Participants |
| Tapentadol IR 50 mg | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 12 hours | 42.9 Percentage of Participants |
| Tapentadol IR 50 mg | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 48 hours | 76.2 Percentage of Participants |
| Tapentadol IR 50 mg | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 24 hours | 61.9 Percentage of Participants |
| Tapentadol IR 75 mg | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 72 hours | 68.4 Percentage of Participants |
| Tapentadol IR 75 mg | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 24 hours | 73.7 Percentage of Participants |
| Tapentadol IR 75 mg | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 48 hours | 68.4 Percentage of Participants |
| Tapentadol IR 75 mg | Response Rate for 50 Percent or Greater Reduction in Pain Intensity at 12, 24, 48 and 72 Hours | 12 hours | 57.9 Percentage of Participants |
Secondary
Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours
Pain Intensity (PI) was assessed on an 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. PID was the difference between baseline PI (prior to the first dose) and current PI at assessment. SPID was calculated as the time-weighted Sum of PID scores over 12, 24, and 72 hours. Total score ranges from -120 (worst) to 120 (best) for SPID12, -240 (worst) to 240 (best) for SPID24, -720 (worst) to 720 (best) for SPID72. A higher value of SPID indicates greater pain relief.
Time frame: 12, 24 and 72 hours
Population: ITT analysis set, which included all randomly assigned participants with at least 1 dose of study medication. Last-observation-carried-forward imputation method was used for missing values.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 24 hours | 16.7 units on a scale | Standard Deviation 69.37 |
| Placebo | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 12 hours | 7.6 units on a scale | Standard Deviation 32.22 |
| Placebo | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 72 hours | 91.6 units on a scale | Standard Deviation 252.89 |
| Tapentadol IR 50 mg | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 24 hours | 67.5 units on a scale | Standard Deviation 40.9 |
| Tapentadol IR 50 mg | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 12 hours | 30.3 units on a scale | Standard Deviation 17.24 |
| Tapentadol IR 50 mg | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 72 hours | 281.3 units on a scale | Standard Deviation 129.48 |
| Tapentadol IR 75 mg | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 12 hours | 34.7 units on a scale | Standard Deviation 25.7 |
| Tapentadol IR 75 mg | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 72 hours | 316.1 units on a scale | Standard Deviation 206.81 |
| Tapentadol IR 75 mg | Sum of Pain Intensity Differences (SPID) Over 12, 24 and 72 Hours | 24 hours | 82.0 units on a scale | Standard Deviation 57.65 |
Secondary
Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours
Participants rated pain relief on 5-point categorical scale of 0-4 (0=none, 1=A little, 2=Some, 3=A lot, 4=Complete). Pain Intensity (PI) was assessed on an 11-point numerical rating scale from 0=no pain to 10=pain as bad as you can imagine. PID was the difference between baseline PI (prior to the first dose) and current PI at assessment. PRID is the sum of pain relief and PID at the same assessment time. SPRID was calculated as the time-weighted Sum of PRID scores over 12, 24, 48, and 72 hours. Total score ranges from -120 (worst) to 168 (best) for SPRID12, -240 (worst) to 336 (best) for SPRID24, -480 (worst) to 672 (best) for SPRID48, and -720 (worst) to 1008 (best) for SPRID72. A higher value of SPRID indicates greater pain relief.
Time frame: 12, 24, 48 and 72 hours
Population: ITT analysis set, which included all randomly assigned participants with at least 1 dose of study medication. Last-observation-carried-forward imputation method was used for missing values.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 12 hours | 20.7 units on a scale | Standard Deviation 41.51 |
| Placebo | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 24 hours | 44.7 units on a scale | Standard Deviation 90.14 |
| Placebo | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 48 hours | 119.1 units on a scale | Standard Deviation 214.14 |
| Placebo | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 72 hours | 204.3 units on a scale | Standard Deviation 346.52 |
| Tapentadol IR 50 mg | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 72 hours | 468.6 units on a scale | Standard Deviation 185.43 |
| Tapentadol IR 50 mg | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 12 hours | 52.8 units on a scale | Standard Deviation 25.66 |
| Tapentadol IR 50 mg | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 48 hours | 284.0 units on a scale | Standard Deviation 122.07 |
| Tapentadol IR 50 mg | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 24 hours | 115.7 units on a scale | Standard Deviation 59.74 |
| Tapentadol IR 75 mg | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 72 hours | 510.2 units on a scale | Standard Deviation 268.96 |
| Tapentadol IR 75 mg | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 24 hours | 136.0 units on a scale | Standard Deviation 72.59 |
| Tapentadol IR 75 mg | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 48 hours | 318.4 units on a scale | Standard Deviation 171.5 |
| Tapentadol IR 75 mg | Sum of Pain Relief and Pain Intensity Differences (SPRID) Over 12, 24, 48, and 72 Hours | 12 hours | 59.1 units on a scale | Standard Deviation 33.2 |
Secondary
Time to First Rescue Medication Use
Rescue medication was defined as any analgesic medication used for participants discontinued due to lack of efficacy (including those started at time of discontinuation) or analgesic medication used during the double-blind period for completed participants.
Time frame: up to 48 hours
Population: ITT analysis set, which included all randomly assigned participants with at least 1 dose of study medication.
| Arm | Measure | Value (MEDIAN) | Dispersion |
|---|---|---|---|
| Placebo | Time to First Rescue Medication Use | NA Hours | Inter-Quartile Range 84.5 |
| Tapentadol IR 50 mg | Time to First Rescue Medication Use | NA Hours | Inter-Quartile Range 131.13 |
| Tapentadol IR 75 mg | Time to First Rescue Medication Use | NA Hours | Inter-Quartile Range 158.52 |
Secondary
Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours
Participants rated pain relief on 5-point categorical scale of 0-4 (0=none, 1=A little, 2=Some, 3=A lot, 4=Complete). Total Pain Relief (TOTPAR) was calculated as the time-weighted sum of pain relief scores up to Hour 12, 24, 48, and 72. Total score ranges from 0 (worst) to 48 (best) for TOTPAR12, 0 (worst) to 96 (best) for TOTPAR24, 0 (worst) to 192 (best) for TOTPAR48, and 0 (worst) to 288 (best) for TOTPAR72. A higher value of TOTPAR indicated greater pain relief.
Time frame: 12, 24, 48, and 72 hours
Population: ITT analysis set, which included all randomly assigned participants with at least 1 dose of study medication. Last-observation-carried-forward imputation method was used for missing values.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 48 hours | 68.2 units on a scale | Standard Deviation 62.26 |
| Placebo | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 12 hours | 13.0 units on a scale | Standard Deviation 11.29 |
| Placebo | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 72 hours | 112.6 units on a scale | Standard Deviation 103.19 |
| Placebo | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 24 hours | 28.0 units on a scale | Standard Deviation 24.5 |
| Tapentadol IR 50 mg | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 48 hours | 115.6 units on a scale | Standard Deviation 45.06 |
| Tapentadol IR 50 mg | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 24 hours | 48.2 units on a scale | Standard Deviation 22.07 |
| Tapentadol IR 50 mg | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 12 hours | 22.5 units on a scale | Standard Deviation 10.27 |
| Tapentadol IR 50 mg | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 72 hours | 187.3 units on a scale | Standard Deviation 68.03 |
| Tapentadol IR 75 mg | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 24 hours | 54.1 units on a scale | Standard Deviation 20.47 |
| Tapentadol IR 75 mg | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 12 hours | 24.4 units on a scale | Standard Deviation 10.33 |
| Tapentadol IR 75 mg | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 72 hours | 194.1 units on a scale | Standard Deviation 74.63 |
| Tapentadol IR 75 mg | Total Pain Relief (TOTPAR) Over 12, 24, 48, and 72 Hours | 48 hours | 123.5 units on a scale | Standard Deviation 49.99 |