Low Back Pain, Neck Pain, Shoulder Pain
Conditions
Keywords
Low back pain, Shoulder pain, Neck pain, Tramadol hydrochloride, Paracetamol
Brief summary
The purpose of this study is to evaluate the efficacy and safety of tramadol hydrochloride-paracetamol tablets in treatment of moderate (medium level of seriousness) to severe (very serious) acute neck, shoulder and low back pain in orthopedics (pertaining to the bones) outpatient or emergency setting.
Detailed description
This is an open-label (all people know the identity of the intervention), non-randomized, multi-center (when more than one hospital or medical school team work on a medical research study) and prospective (study following participants forward in time) study of tramadol hydrochloride-paracetamol tablets. Participants will receive 1 to 2 tablets of tramadol hydrochloride-paracetamol orally once daily (each tablet containing tramadol 37.5 milligram \[mg\] and paracetamol 325mg). Participants may be given the additional dose according to the clinical requirement. The total treatment duration will be 6 hours. The total study duration will be 4 months. Efficacy will be evaluated primarily by pain intensity and pain relief. Participants will evaluate the pain severity and pain relief at 0.5, 1, 2, 3, 4 and 6 hours respectively after the first dose; and the drug efficacy and overall satisfaction level at the end of 6 hours after the first dose. Participants' safety will be monitored throughout the study.
Interventions
Participants will receive 1 to 2 tablets of tramadol HCl-paracetamol orally once daily (each tablet containing tramadol 37.5 milligram \[mg\] and paracetamol 325mg) for up to a total duration of 6 hours. Additional dose may be given based upon the clinical requirement.
Sponsors
Study design
Eligibility
Inclusion criteria
* Intermittent or persistent pain for less than 3 months, required analgesic therapy, orthopedic surgery and emergency call participants suffering with severe neck, shoulder, low back pain or chronic neck, shoulder, lower back pain, acute (a quick and severe form of illness in its early stage) exacerbation pain * Pain intensity to be assessed using Numerical Rating Scale (NRS), NRS score more than or equal to 4 (from 0 to 10, 0 = no pain, 10 = extreme pain) * During normal pain and stable feeling, can study pain assessment methods and can fill in pain control diary * Be willing to participate in the study and must give written informed consent
Exclusion criteria
* Have used strong opium kind of medication 7 days prior to the enrolment * Have severe mental disease or using antipsychotic (agent that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect) medication for medical treatment * Drug abuse/dependence, or chronic alcohol abuse/depend on history * Pregnant or lactating women * Unable to tolerate tramadol or any failed treatment in past by using tramadol * Comparatively more severe pain in other parts of the body than that of the pain mentioned in the research
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Pain Relief Score at Hour 6 | Hour 6 | Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier). |
| Number of Participants With Pain Relief Score at Hour 2 | Hour 2 | Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier). |
| Number of Participants With Pain Relief Score at Hour 3 | Hour 3 | Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier). |
| Number of Participants With Pain Relief Score at Hour 4 | Hour 4 | Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier). |
| Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 0.5 | Hour 0.5 | Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain. |
| Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 1 | Hour 1 | Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain. |
| Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 2 | Hour 2 | Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain. |
| Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 3 | Hour 3 | Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain. |
| Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 4 | Hour 4 | Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain. |
| Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 6 | Hour 6 | Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain. |
| Number of Participants With Pain Relief Score at Hour 0.5 | Hour 0.5 | Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier). |
| Number of Participants With Pain Relief Score at Hour 1 | Hour 1 | Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Analgesic Satisfaction Score | Hour 6 | Participants evaluated their satisfaction with the analgesic effect of the study drug using a 4-point scale (4=very good, 3=good, 2=average, 1=poor). Number of participants in each category was reported. |
| Number of Participants With Overall Analgesic Satisfaction Score | Hour 6 | Participants and physicians separately evaluated their satisfaction with the analgesic effect of the study drug using a 5-point scale (1=very unsatisfied, 2 =unsatisfied, 3=average, 4= satisfied and 5=very satisfied). Number of participants in each category was reported. |
| Number of Participants Who Required Additional Dosage Administration | Baseline up to Hour 2 | Number of participants who additionally required a second tablet within 2 hours after the first administration of the investigational drug was reported. |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol Participants received 1 to 2 tablets of tramadol HCl-paracetamol orally once daily (each tablet containing tramadol 37.5 milligram \[mg\] and paracetamol 325 mg) for up to a total duration of 6 hours. | 1,035 |
| Total | 1,035 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Other | 30 |
Baseline characteristics
| Characteristic | Tramadol Hydrochloride (HCl)-Paracetamol |
|---|---|
| Age Continuous | 42.43 Years STANDARD_DEVIATION 12.34 |
| Sex: Female, Male Female | 493 Participants |
| Sex: Female, Male Male | 542 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 86 / 1,059 |
| serious Total, serious adverse events | 0 / 1,059 |
Outcome results
Number of Participants With Pain Relief Score at Hour 0.5
Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier).
Time frame: Hour 0.5
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 0.5 | Complete | 7 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 0.5 | Significant | 92 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 0.5 | Moderate | 209 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 0.5 | Mild | 326 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 0.5 | None | 394 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 0.5 | Exacerbated | 1 Participants |
Number of Participants With Pain Relief Score at Hour 1
Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier).
Time frame: Hour 1
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 1 | Moderate | 271 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 1 | Mild | 332 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 1 | Complete | 46 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 1 | Significant | 226 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 1 | None | 154 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 1 | Exacerbated | 0 Participants |
Number of Participants With Pain Relief Score at Hour 2
Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier).
Time frame: Hour 2
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 2 | Complete | 104 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 2 | Significant | 351 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 2 | Moderate | 270 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 2 | Mild | 230 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 2 | None | 74 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 2 | Exacerbated | 0 Participants |
Number of Participants With Pain Relief Score at Hour 3
Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier).
Time frame: Hour 3
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 3 | Complete | 179 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 3 | Significant | 392 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 3 | Moderate | 307 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 3 | Mild | 99 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 3 | None | 52 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 3 | Exacerbated | 0 Participants |
Number of Participants With Pain Relief Score at Hour 4
Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier).
Time frame: Hour 4
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 4 | Complete | 222 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 4 | Significant | 484 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 4 | Moderate | 194 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 4 | Mild | 86 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 4 | None | 43 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 4 | Exacerbated | 0 Participants |
Number of Participants With Pain Relief Score at Hour 6
Pain relief was measured using 6-point Likert Scale (4=complete, 3=significant/comparatively large, 2=moderate, 1=mild/slight, 0=none, -1=exacerbated/heavier).
Time frame: Hour 6
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 6 | Complete | 304 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 6 | Significant | 377 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 6 | Moderate | 218 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 6 | Mild | 78 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 6 | None | 51 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Pain Relief Score at Hour 6 | Exacerbated | 1 Participants |
Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 0.5
Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain.
Time frame: Hour 0.5
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 0.5 | 5.29 Units on a scale | Standard Deviation 2.07 |
Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 1
Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain.
Time frame: Hour 1
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 1 | 4.32 Units on a scale | Standard Deviation 2.2 |
Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 2
Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain.
Time frame: Hour 2
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 2 | 3.52 Units on a scale | Standard Deviation 2.14 |
Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 3
Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain.
Time frame: Hour 3
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 3 | 2.93 Units on a scale | Standard Deviation 2 |
Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 4
Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain.
Time frame: Hour 4
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 4 | 2.56 Units on a scale | Standard Deviation 1.92 |
Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 6
Pain intensity was measured using NRS (0=painless and 10=most severe pain). Score of 1-3 means mild pain; 4-6 means moderate pain and 7-10 means severe pain.
Time frame: Hour 6
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Pain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 6 | 2.39 Units on a scale | Standard Deviation 1.97 |
Number of Participants Who Required Additional Dosage Administration
Number of participants who additionally required a second tablet within 2 hours after the first administration of the investigational drug was reported.
Time frame: Baseline up to Hour 2
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants Who Required Additional Dosage Administration | 97 Participants |
Number of Participants With Analgesic Satisfaction Score
Participants evaluated their satisfaction with the analgesic effect of the study drug using a 4-point scale (4=very good, 3=good, 2=average, 1=poor). Number of participants in each category was reported.
Time frame: Hour 6
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Analgesic Satisfaction Score | Very good | 128 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Analgesic Satisfaction Score | Good | 659 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Analgesic Satisfaction Score | Average | 212 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Analgesic Satisfaction Score | Poor | 29 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Analgesic Satisfaction Score | Missing | 1 Participants |
Number of Participants With Overall Analgesic Satisfaction Score
Participants and physicians separately evaluated their satisfaction with the analgesic effect of the study drug using a 5-point scale (1=very unsatisfied, 2 =unsatisfied, 3=average, 4= satisfied and 5=very satisfied). Number of participants in each category was reported.
Time frame: Hour 6
Population: Per protocol population included all participants who completed the clinical trial according to the trial protocol.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Participants' evaluation: Very unsatisfied | 3 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Participants' evaluation: Unsatisfied | 39 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Participants' evaluation: Average | 207 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Participants' evaluation: Satisfied | 669 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Participants' evaluation: Very satisfied | 111 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Physicians' evaluation: Very unsatisfied | 1 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Physicians' evaluation: Unsatisfied | 33 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Physicians' evaluation: Average | 159 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Physicians' evaluation: Satisfied | 710 Participants |
| Tramadol Hydrochloride (HCl)-Paracetamol | Number of Participants With Overall Analgesic Satisfaction Score | Physicians' evaluation: Very satisfied | 126 Participants |