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An Efficacy and Safety Study of Tramadol Hydrochloride-Paracetamol in Treatment of Moderate to Severe Acute Neck-Shoulder Pain and Low Back Pain

The Clinical Efficacy and Safety Study of Tramadol Hydrochloride - Paracetamol Tablets in the Treatment of Moderate to Severe Acute Neck-shoulder Pain and Low Back Pain in Orthopaedics Outpatient or Emergency Setting

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01843660
Enrollment
1059
Registered
2013-04-30
Start date
2007-09-30
Completion date
2008-05-31
Last updated
2013-08-26

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Low Back Pain, Neck Pain, Shoulder Pain

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

DRUGTramadol HCl-Paracetamol

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

Xian-Janssen Pharmaceutical Ltd.
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

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

MeasureTime frameDescription
Number of Participants With Pain Relief Score at Hour 6Hour 6Pain 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 2Hour 2Pain 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 3Hour 3Pain 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 4Hour 4Pain 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 0.5Hour 0.5Pain 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 1Hour 1Pain 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 2Hour 2Pain 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 3Hour 3Pain 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 4Hour 4Pain 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 6Hour 6Pain 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 0.5Hour 0.5Pain 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 1Hour 1Pain 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

MeasureTime frameDescription
Number of Participants With Analgesic Satisfaction ScoreHour 6Participants 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 ScoreHour 6Participants 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 AdministrationBaseline up to Hour 2Number 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

ArmCount
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
Total1,035

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyOther30

Baseline characteristics

CharacteristicTramadol Hydrochloride (HCl)-Paracetamol
Age Continuous42.43 Years
STANDARD_DEVIATION 12.34
Sex: Female, Male
Female
493 Participants
Sex: Female, Male
Male
542 Participants

Adverse events

Event typeEG000
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

Primary

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.

ArmMeasureGroupValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 0.5Complete7 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 0.5Significant92 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 0.5Moderate209 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 0.5Mild326 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 0.5None394 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 0.5Exacerbated1 Participants
Primary

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.

ArmMeasureGroupValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 1Moderate271 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 1Mild332 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 1Complete46 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 1Significant226 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 1None154 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 1Exacerbated0 Participants
Primary

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.

ArmMeasureGroupValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 2Complete104 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 2Significant351 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 2Moderate270 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 2Mild230 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 2None74 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 2Exacerbated0 Participants
Primary

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.

ArmMeasureGroupValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 3Complete179 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 3Significant392 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 3Moderate307 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 3Mild99 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 3None52 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 3Exacerbated0 Participants
Primary

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.

ArmMeasureGroupValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 4Complete222 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 4Significant484 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 4Moderate194 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 4Mild86 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 4None43 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 4Exacerbated0 Participants
Primary

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.

ArmMeasureGroupValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 6Complete304 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 6Significant377 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 6Moderate218 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 6Mild78 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 6None51 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Pain Relief Score at Hour 6Exacerbated1 Participants
Primary

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.

ArmMeasureValue (MEAN)Dispersion
Tramadol Hydrochloride (HCl)-ParacetamolPain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 0.55.29 Units on a scaleStandard Deviation 2.07
Primary

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.

ArmMeasureValue (MEAN)Dispersion
Tramadol Hydrochloride (HCl)-ParacetamolPain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 14.32 Units on a scaleStandard Deviation 2.2
Primary

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.

ArmMeasureValue (MEAN)Dispersion
Tramadol Hydrochloride (HCl)-ParacetamolPain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 23.52 Units on a scaleStandard Deviation 2.14
Primary

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.

ArmMeasureValue (MEAN)Dispersion
Tramadol Hydrochloride (HCl)-ParacetamolPain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 32.93 Units on a scaleStandard Deviation 2
Primary

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.

ArmMeasureValue (MEAN)Dispersion
Tramadol Hydrochloride (HCl)-ParacetamolPain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 42.56 Units on a scaleStandard Deviation 1.92
Primary

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.

ArmMeasureValue (MEAN)Dispersion
Tramadol Hydrochloride (HCl)-ParacetamolPain Intensity Score Based on Numeric Rating Scale (NRS) at Hour 62.39 Units on a scaleStandard Deviation 1.97
Secondary

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.

ArmMeasureValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants Who Required Additional Dosage Administration97 Participants
Secondary

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.

ArmMeasureGroupValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Analgesic Satisfaction ScoreVery good128 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Analgesic Satisfaction ScoreGood659 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Analgesic Satisfaction ScoreAverage212 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Analgesic Satisfaction ScorePoor29 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Analgesic Satisfaction ScoreMissing1 Participants
Secondary

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.

ArmMeasureGroupValue (NUMBER)
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScoreParticipants' evaluation: Very unsatisfied3 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScoreParticipants' evaluation: Unsatisfied39 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScoreParticipants' evaluation: Average207 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScoreParticipants' evaluation: Satisfied669 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScoreParticipants' evaluation: Very satisfied111 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScorePhysicians' evaluation: Very unsatisfied1 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScorePhysicians' evaluation: Unsatisfied33 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScorePhysicians' evaluation: Average159 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScorePhysicians' evaluation: Satisfied710 Participants
Tramadol Hydrochloride (HCl)-ParacetamolNumber of Participants With Overall Analgesic Satisfaction ScorePhysicians' evaluation: Very satisfied126 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026