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A Study to Assess the Efficacy and Tolerability of Diclofenac Potassium Soft Gelatin Capsules Compared With Ibuprofen Tablets in Patients With Moderate to Severe Postoperative Dental Pain

A Randomized, Double-blind, Double-dummy, Active-controlled Study to Assess the Efficacy and Tolerability of 50 mg Diclofenac Potassium Soft Gelatin Capsules Compared With 400 mg Ibuprofen Tablets in Patients With Moderate to Severe Postoperative Dental Pain

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02476422
Enrollment
328
Registered
2015-06-19
Start date
2015-04-30
Completion date
2015-08-31
Last updated
2016-10-17

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

Conditions

Post Operative Dental Pain

Keywords

Diclofenac potassium, Post-operative dental pain, Moderate to severe pain

Brief summary

The study is designed to assess the efficacy and tolerability of diclofenac potassium soft gelatin capsules compared with ibuprofen tablets in patients with moderate to severe postoperative dental pain.

Interventions

Single dose of diclofenac 50 mg soft gelatin capsule

DRUGIbuprofen

Single dose of ibuprofen 400 mg tablet

Single dose of placebo to ibuprofen 400 mg tablet

DRUGPlacebo to diclofenac potassium

Single dose of placebo to diclofenac potassium 50 mg soft gelatin capsule

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

Key Inclusion Criteria: * Patients requiring surgical removal of 2 ipsilateral third molars, of which the mandibular must be fully or partially impacted. The ipsilateral maxillary third molar may be of any impaction level. * Patients having a moderate to severe Baseline pain intensity as assessed by a score of 2 (moderate) or 3 (severe) on the 4-point categorical pain intensity VRS, confirmed by a VASPI score of ≥ 50 mm within 5 hours of surgical completion, after local anesthetic dissipation. Key

Exclusion criteria

* Patients who require the removal of a single third molar, or 2 ipsilateral third molars where mandibular molar is not fully or partially impacted. * Patients with active peptic ulcer disease or a history of significant gastrointestinal disease or any gastrointestinal bleeding. * Patients with coagulation or bleeding disorders. * Patients with a positive drug or alcohol screen. * Patients who have received an anti-inflammatory agent, analgesic, sedative, hypnotic, muscle relaxant, or tranquilizer within 5 elimination half-lives before administration of study drug (other than surgical anesthetic prior to and during dental surgery).

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at 60 Minutes Post Dose60 minutes postdoseVASPI reduction from baseline is the difference between the Baseline VASPI score and the VASPI score at a specific observation point. Subjects were asked to identify their current level of pain intensity on the 100 mm VASPI, labeled no pain (0 mm) as the left anchor and worst possible pain (100 mm) as the right anchor. A positive change represents a reduction in pain.

Secondary

MeasureTime frameDescription
Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points15, 30, 45, 60 and 90 minutes, and 2, 4, 5, 6, 7, and 8 hours post doseVASPI reduction from baseline is the difference between the Baseline VASPI score and the VASPI score at a specific observation point. Subjects were asked to identify their pain intensity using the 100 mm VASPI to indicate their current level of pain intensity on the 100 mm VASPI labeled no pain (0 mm) as the left anchor and worst possible pain (100 mm) as the right anchor. A positive change shows reduction in pain. AUC of VASPI reduction from baseline for each time point was calculated using the trapezoidal rule.
Time to Confirmed First Perceptible Pain ReliefWithin 8 hours postdoseTime to onset of first perceptible pain relief (FPR), provided the FPR was subsequently 'confirmed' through the achievement of meaningful pain relief (MPR). Participant started two stopwatches at dosing, and recorded FPR by stopping the first stopwatch when he/she first experienced 'any' pain relief. FPR is 'confirmed' only if the participant also stopped the second stopwatch indicating 'meaningful pain relief'.
Time to Onset of Meaningful Pain Relief (MPR)Within 8 hours postdoseUsing the double stopwatch technique, participant started two stopwatches at dosing, and stopped the second stopwatch as soon as he/she began to experience 'meaningful' relief from pain. Time elapsed is recorded as the MPR.
Time to Onset of First Perceptible Pain Relief (FPR)Within 8 hours postdoseUsing the double stopwatch technique, participant started two stopwatches at dosing, and stopped the first stopwatch as soon as he/she first began to feel 'any' relief from pain. The time elapsed was recorded as the FPR.
Sum of Pain Intensity Difference (SPID)1, 2, 4, 6, and 8 hours postdoseAt baseline and at each defined study time point, the clinical site staff captured pain intensity information from each subject using the 4-point categorical VRS. The subject was asked What is your pain level at this time? and the response was recorded as 0 = none, 1 = mild, 2 = moderate, and 3 = severe. Pain intensity difference (PID) was the difference between the baseline pain intensity score and the pain intensity score at a specific observation point. SPID is the weighted sum of PIDs from the 15-minute to the 8-hour observation point (SPID8). Additionally, SPID evaluations were also be done at 1 (SPID1), 2 (SPID2), 4 (SPID4) and 6 (SPID6) hours post dose. The weights used for these values were 0.25 for the 15-, 30-, 45-, and 60-minute observations, and 0.5 for the 90-minute, 2- and 4-hour observations, and 1 for the remaining observations.
Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points15, 30, 45, and 90 minutes, and 2, 4, 5, 6, 7, and 8 hours post doseVASPI reduction from baseline is the difference between the Baseline VASPI score and the VASPI score at a specific observation point. Subjects were asked to identify their current level of pain intensity on the 100 mm VASPI, labeled no pain (0 mm) as the left anchor and worst possible pain (100 mm) as the right anchor. A positive change represents a reduction in pain.
Peak Analgesic EffectFrom dose administration to 8 hours post dosePeak analgesic relief is represented through highest pain intensity difference (PID), highest VASPI reduction, and highest pain relief scores. Pain intensity was measured on a verbal rating scale (VRS) ranging from 0 to 3 (none to severe, with higher score for higher pain intensity). PID represents difference in this score at baseline and specific time points, larger change indicating larger reduction in pain, with highest PID representing the largest difference. Pain relief was recorded on a scale ranging from 0 to 4 (none to complete, with higher score for higher pain relief), with highest pain relief representing maximum relief obtained. Pain intensity was also measured through a 100 mm visual analogue scale (VASPI), ranging from no pain (0 mm) to worst possible pain (100 mm). A positive change in VASPI indicates reduction in pain, with highest VASPI reduction representing highest change.
Duration of AnalgesiaFrom dose administration to 8 hours post doseDuration of analgesia (time to first use of rescue medication) was evaluated, from dose administration to the time of first use of rescue medication within the 8-hour treatment period. Censored observations were included in calculating this endpoint. Censored subjects include any subject who did not take rescue medication prior to the end of the assessment period of 480 minutes (8 hours).
Number of Patients Needing Rescue MedicationFrom dose administration to 8 hours post doseThe number of patients needing rescue medication within the 8 hour treatment period was evaluated.
Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)At 8 hour postdose prior to use of rescue medicationPGART was measured by asking patients to give a score on a scale from 0 to 4, where 0 = poor; 1 = fair; 2 = good; 3 = very good; 4 = excellent. This measurement was taken at the end of 8 hours, or before the use of rescue medication (for a patient who takes rescue medciation within the 8 hour period).
Number of Patients With Any Adverse Events, Serious Adverse Events and Deathtime of dosage administration up to the follow-up phone call on study Day 3 (maximum 3 days)Treatment emergent adverse events are reported in the below data table.
Summed Total Pain Relief (TOTPAR) at Different Time Points1, 2, 4, 6, and 8 hours postdoseAfter the administration of the single dose of the assigned study treatment, at the defined study time points, the clinical site staff captured pain relief information from each subject. The subject was asked What is the amount of pain relief as compared to the starting pain? and the response was recorded as 0 = none, 1 = a little, 2 = some, 3 = a lot, or 4 = complete. Total pain relief (TOTPAR) was the weighted sum of the pain relief scores from the 15-minute to the 8-hour observation points (TOTPAR8). Additionally, TOTPARs at 1, 2, 4 and 6 hours were calculated. The weights used for these values (evaluation time points) were 0.25 for the 15-, 30-, 45-, and 60-minute observations, 0.5 for the 90-minute, 2- and 4-hour observations, and 1 for the remaining observations.

Countries

United States

Participant flow

Participants by arm

ArmCount
Dilcofenac Potassium + Placebo to Ibuprofen
Single dose of diclofenac potassium 50 mg soft gelatin capsule was given once patient developed moderate to severe pain post the extraction of two ipsilateral third molar teeth. Single dose of placebo to ibuprofen 400 mg tablet was also given to patient in order to maintain double dummy method.
166
Ibuprofen + Placebo to Diclofenac Potassium
Single dose of ibuprofen 400 mg tablet was given once patient develops moderate to severe pain post the extraction of two ipsilateral third molar teeth. Single dose of placebo to diclofenac potassium 50 mg soft gelatin capsule was also given to patient in order to maintain double dummy method.
162
Total328

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudySubject/guardian decision01

Baseline characteristics

CharacteristicDilcofenac Potassium + Placebo to IbuprofenIbuprofen + Placebo to Diclofenac PotassiumTotal
Age, Continuous24.9 Years
STANDARD_DEVIATION 5.21
24.7 Years
STANDARD_DEVIATION 6.11
24.8 Years
STANDARD_DEVIATION 5.66
Sex: Female, Male
Female
98 Participants96 Participants194 Participants
Sex: Female, Male
Male
68 Participants66 Participants134 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
47 / 16647 / 162
serious
Total, serious adverse events
0 / 1660 / 162

Outcome results

Primary

Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at 60 Minutes Post Dose

VASPI reduction from baseline is the difference between the Baseline VASPI score and the VASPI score at a specific observation point. Subjects were asked to identify their current level of pain intensity on the 100 mm VASPI, labeled no pain (0 mm) as the left anchor and worst possible pain (100 mm) as the right anchor. A positive change represents a reduction in pain.

Time frame: 60 minutes postdose

Population: The efficacy analyses were performed on the full analysis set (FAS) which consisted of all randomized subjects who were exposed to study drug and provided at least 1 post-dose assessment on any efficacy parameter. Last observation carried forward (LOCF) was used as the imputation technique.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at 60 Minutes Post Dose47.3 units on a scaleStandard Error 2.06
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at 60 Minutes Post Dose44.1 units on a scaleStandard Error 2.08
p-value: 0.21195% CI: [-1.8, 8.3]ANCOVA
Secondary

Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points

VASPI reduction from baseline is the difference between the Baseline VASPI score and the VASPI score at a specific observation point. Subjects were asked to identify their pain intensity using the 100 mm VASPI to indicate their current level of pain intensity on the 100 mm VASPI labeled no pain (0 mm) as the left anchor and worst possible pain (100 mm) as the right anchor. A positive change shows reduction in pain. AUC of VASPI reduction from baseline for each time point was calculated using the trapezoidal rule.

Time frame: 15, 30, 45, 60 and 90 minutes, and 2, 4, 5, 6, 7, and 8 hours post dose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 post-dose assessment on any efficacy parameter. Last observation carried forward (LOCF) was used as the imputation technique.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points60 minutes45.4321 units on a scale*hoursStandard Error 1.48887
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points4 hours96.7669 units on a scale*hoursStandard Error 6.56154
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points45 minutes38.8570 units on a scale*hoursStandard Error 1.03408
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points5 hours119.0564 units on a scale*hoursStandard Error 8.50377
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points90 minutes54.9330 units on a scale*hoursStandard Error 2.34986
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points6 hours145.6112 units on a scale*hoursStandard Error 10.58291
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points30 minutes29.3759 units on a scale*hoursStandard Error 0.58537
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points7 hours177.2751 units on a scale*hoursStandard Error 12.76115
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points2 hours62.3674 units on a scale*hoursStandard Error 3.15839
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points8 hours212.9300 units on a scale*hoursStandard Error 15.01237
Dilcofenac Potassium + Placebo to IbuprofenArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points15 minutes16.1914 units on a scale*hoursStandard Error 0.19369
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points8 hours193.4450 units on a scale*hoursStandard Error 15.15905
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points15 minutes15.6262 units on a scale*hoursStandard Error 0.19558
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points30 minutes27.9216 units on a scale*hoursStandard Error 0.59109
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points45 minutes37.3448 units on a scale*hoursStandard Error 1.04418
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points60 minutes44.5882 units on a scale*hoursStandard Error 1.50342
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points90 minutes55.9885 units on a scale*hoursStandard Error 2.37282
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points2 hours65.1654 units on a scale*hoursStandard Error 3.18925
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points4 hours98.9982 units on a scale*hoursStandard Error 6.62565
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points5 hours117.4797 units on a scale*hoursStandard Error 8.58686
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points6 hours138.6947 units on a scale*hoursStandard Error 10.68631
Ibuprofen + Placebo to Diclofenac PotassiumArea Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points7 hours163.8821 units on a scale*hoursStandard Error 12.88584
Secondary

Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points

VASPI reduction from baseline is the difference between the Baseline VASPI score and the VASPI score at a specific observation point. Subjects were asked to identify their current level of pain intensity on the 100 mm VASPI, labeled no pain (0 mm) as the left anchor and worst possible pain (100 mm) as the right anchor. A positive change represents a reduction in pain.

Time frame: 15, 30, 45, and 90 minutes, and 2, 4, 5, 6, 7, and 8 hours post dose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 post-dose assessment on any efficacy parameter. Last observation carried forward (LOCF) was used as the imputation technique.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points15 minutes9.2 Units on a scaleStandard Error 1.55
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points30 minutes24.1 Units on a scaleStandard Error 1.96
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points45 minutes38.9 Units on a scaleStandard Error 2.16
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points90 minutes53.5 Units on a scaleStandard Error 1.98
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points2 hours55.6 Units on a scaleStandard Error 1.96
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points4 hours48.8 Units on a scaleStandard Error 2.22
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points5 hours45.4 Units on a scaleStandard Error 2.4
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points6 hours40.3 Units on a scaleStandard Error 2.58
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points7 hours35.2 Units on a scaleStandard Error 2.68
Dilcofenac Potassium + Placebo to IbuprofenChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points8 hours32.3 Units on a scaleStandard Error 2.74
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points6 hours46.5 Units on a scaleStandard Error 2.61
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points15 minutes13.7 Units on a scaleStandard Error 1.56
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points4 hours51.9 Units on a scaleStandard Error 2.24
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points30 minutes26.6 Units on a scaleStandard Error 1.98
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points8 hours37.7 Units on a scaleStandard Error 2.76
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points45 minutes36.7 Units on a scaleStandard Error 2.18
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points5 hours49.8 Units on a scaleStandard Error 2.42
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points90 minutes49.1 Units on a scaleStandard Error 2
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points7 hours41.9 Units on a scaleStandard Error 2.71
Ibuprofen + Placebo to Diclofenac PotassiumChange From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points2 hours53.0 Units on a scaleStandard Error 1.98
Secondary

Duration of Analgesia

Duration of analgesia (time to first use of rescue medication) was evaluated, from dose administration to the time of first use of rescue medication within the 8-hour treatment period. Censored observations were included in calculating this endpoint. Censored subjects include any subject who did not take rescue medication prior to the end of the assessment period of 480 minutes (8 hours).

Time frame: From dose administration to 8 hours post dose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 post-dose assessment on any efficacy parameter.

ArmMeasureValue (MEDIAN)
Dilcofenac Potassium + Placebo to IbuprofenDuration of Analgesia480.0 minutes
Ibuprofen + Placebo to Diclofenac PotassiumDuration of Analgesia480.0 minutes
Secondary

Number of Patients Needing Rescue Medication

The number of patients needing rescue medication within the 8 hour treatment period was evaluated.

Time frame: From dose administration to 8 hours post dose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 post-dose assessment on any efficacy parameter.

ArmMeasureValue (NUMBER)
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients Needing Rescue Medication47 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients Needing Rescue Medication36 Participants
Secondary

Number of Patients With Any Adverse Events, Serious Adverse Events and Death

Treatment emergent adverse events are reported in the below data table.

Time frame: time of dosage administration up to the follow-up phone call on study Day 3 (maximum 3 days)

Population: Safety analyses were performed on the safety set, which included all randomized subjects who were exposed to study drug.

ArmMeasureGroupValue (NUMBER)
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients With Any Adverse Events, Serious Adverse Events and Deathany adverse events47 Participants
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients With Any Adverse Events, Serious Adverse Events and Deathserious adverse events0 Participants
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients With Any Adverse Events, Serious Adverse Events and DeathDeath0 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients With Any Adverse Events, Serious Adverse Events and Deathany adverse events47 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients With Any Adverse Events, Serious Adverse Events and Deathserious adverse events0 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients With Any Adverse Events, Serious Adverse Events and DeathDeath0 Participants
Secondary

Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)

PGART was measured by asking patients to give a score on a scale from 0 to 4, where 0 = poor; 1 = fair; 2 = good; 3 = very good; 4 = excellent. This measurement was taken at the end of 8 hours, or before the use of rescue medication (for a patient who takes rescue medciation within the 8 hour period).

Time frame: At 8 hour postdose prior to use of rescue medication

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 postdose assessment on any efficacy parameter.

ArmMeasureGroupValue (NUMBER)
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Fair (1)7 Participants
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Very good (3)55 Participants
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Good (2)49 Participants
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Excellent (4)49 Participants
Dilcofenac Potassium + Placebo to IbuprofenNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Poor (0)6 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Excellent (4)47 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Poor (0)10 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Fair (1)7 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Good (2)34 Participants
Ibuprofen + Placebo to Diclofenac PotassiumNumber of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART)Very good (3)64 Participants
Secondary

Peak Analgesic Effect

Peak analgesic relief is represented through highest pain intensity difference (PID), highest VASPI reduction, and highest pain relief scores. Pain intensity was measured on a verbal rating scale (VRS) ranging from 0 to 3 (none to severe, with higher score for higher pain intensity). PID represents difference in this score at baseline and specific time points, larger change indicating larger reduction in pain, with highest PID representing the largest difference. Pain relief was recorded on a scale ranging from 0 to 4 (none to complete, with higher score for higher pain relief), with highest pain relief representing maximum relief obtained. Pain intensity was also measured through a 100 mm visual analogue scale (VASPI), ranging from no pain (0 mm) to worst possible pain (100 mm). A positive change in VASPI indicates reduction in pain, with highest VASPI reduction representing highest change.

Time frame: From dose administration to 8 hours post dose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 post-dose assessment on any efficacy parameter. Last observation carried forward (LOCF) was used as the imputation technique.

ArmMeasureGroupValue (MEAN)Dispersion
Dilcofenac Potassium + Placebo to IbuprofenPeak Analgesic EffectHighest Mean PID1.9 units on a scaleStandard Deviation 0.72
Dilcofenac Potassium + Placebo to IbuprofenPeak Analgesic EffectHighest pain relief3.6 units on a scaleStandard Deviation 0.74
Dilcofenac Potassium + Placebo to IbuprofenPeak Analgesic EffectHighest VASPI reduction61.3 units on a scaleStandard Deviation 17.99
Ibuprofen + Placebo to Diclofenac PotassiumPeak Analgesic EffectHighest Mean PID1.8 units on a scaleStandard Deviation 0.74
Ibuprofen + Placebo to Diclofenac PotassiumPeak Analgesic EffectHighest pain relief3.5 units on a scaleStandard Deviation 0.86
Ibuprofen + Placebo to Diclofenac PotassiumPeak Analgesic EffectHighest VASPI reduction60.2 units on a scaleStandard Deviation 19.35
Secondary

Summed Total Pain Relief (TOTPAR) at Different Time Points

After the administration of the single dose of the assigned study treatment, at the defined study time points, the clinical site staff captured pain relief information from each subject. The subject was asked What is the amount of pain relief as compared to the starting pain? and the response was recorded as 0 = none, 1 = a little, 2 = some, 3 = a lot, or 4 = complete. Total pain relief (TOTPAR) was the weighted sum of the pain relief scores from the 15-minute to the 8-hour observation points (TOTPAR8). Additionally, TOTPARs at 1, 2, 4 and 6 hours were calculated. The weights used for these values (evaluation time points) were 0.25 for the 15-, 30-, 45-, and 60-minute observations, 0.5 for the 90-minute, 2- and 4-hour observations, and 1 for the remaining observations.

Time frame: 1, 2, 4, 6, and 8 hours postdose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 postdose assessment on any efficacy parameter. Last observation carried forward (LOCF) was used as the imputation technique.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Dilcofenac Potassium + Placebo to IbuprofenSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR25.032 units on a scaleStandard Error 0.1452
Dilcofenac Potassium + Placebo to IbuprofenSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR615.647 units on a scaleStandard Error 0.5595
Dilcofenac Potassium + Placebo to IbuprofenSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR410.642 units on a scaleStandard Error 0.3353
Dilcofenac Potassium + Placebo to IbuprofenSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR819.679 units on a scaleStandard Error 0.7915
Dilcofenac Potassium + Placebo to IbuprofenSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR11.807 units on a scaleStandard Error 0.068
Ibuprofen + Placebo to Diclofenac PotassiumSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR821.341 units on a scaleStandard Error 0.7992
Ibuprofen + Placebo to Diclofenac PotassiumSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR11.780 units on a scaleStandard Error 0.0687
Ibuprofen + Placebo to Diclofenac PotassiumSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR24.817 units on a scaleStandard Error 0.1466
Ibuprofen + Placebo to Diclofenac PotassiumSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR410.848 units on a scaleStandard Error 0.3385
Ibuprofen + Placebo to Diclofenac PotassiumSummed Total Pain Relief (TOTPAR) at Different Time PointsTOTPAR616.499 units on a scaleStandard Error 0.565
Secondary

Sum of Pain Intensity Difference (SPID)

At baseline and at each defined study time point, the clinical site staff captured pain intensity information from each subject using the 4-point categorical VRS. The subject was asked What is your pain level at this time? and the response was recorded as 0 = none, 1 = mild, 2 = moderate, and 3 = severe. Pain intensity difference (PID) was the difference between the baseline pain intensity score and the pain intensity score at a specific observation point. SPID is the weighted sum of PIDs from the 15-minute to the 8-hour observation point (SPID8). Additionally, SPID evaluations were also be done at 1 (SPID1), 2 (SPID2), 4 (SPID4) and 6 (SPID6) hours post dose. The weights used for these values were 0.25 for the 15-, 30-, 45-, and 60-minute observations, and 0.5 for the 90-minute, 2- and 4-hour observations, and 1 for the remaining observations.

Time frame: 1, 2, 4, 6, and 8 hours postdose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 postdose assessment on any efficacy parameter. Last observation carried forward (LOCF) was used as the imputation technique.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
Dilcofenac Potassium + Placebo to IbuprofenSum of Pain Intensity Difference (SPID)SPID11.077 units on a scaleStandard Error 0.0525
Dilcofenac Potassium + Placebo to IbuprofenSum of Pain Intensity Difference (SPID)SPID68.970 units on a scaleStandard Error 0.3703
Dilcofenac Potassium + Placebo to IbuprofenSum of Pain Intensity Difference (SPID)SPID46.165 units on a scaleStandard Error 0.2276
Dilcofenac Potassium + Placebo to IbuprofenSum of Pain Intensity Difference (SPID)SPID811.099 units on a scaleStandard Error 0.518
Dilcofenac Potassium + Placebo to IbuprofenSum of Pain Intensity Difference (SPID)SPID22.955 units on a scaleStandard Error 0.105
Ibuprofen + Placebo to Diclofenac PotassiumSum of Pain Intensity Difference (SPID)SPID811.904 units on a scaleStandard Error 0.523
Ibuprofen + Placebo to Diclofenac PotassiumSum of Pain Intensity Difference (SPID)SPID11.049 units on a scaleStandard Error 0.053
Ibuprofen + Placebo to Diclofenac PotassiumSum of Pain Intensity Difference (SPID)SPID22.772 units on a scaleStandard Error 0.106
Ibuprofen + Placebo to Diclofenac PotassiumSum of Pain Intensity Difference (SPID)SPID46.196 units on a scaleStandard Error 0.2298
Ibuprofen + Placebo to Diclofenac PotassiumSum of Pain Intensity Difference (SPID)SPID69.323 units on a scaleStandard Error 0.3739
Secondary

Time to Confirmed First Perceptible Pain Relief

Time to onset of first perceptible pain relief (FPR), provided the FPR was subsequently 'confirmed' through the achievement of meaningful pain relief (MPR). Participant started two stopwatches at dosing, and recorded FPR by stopping the first stopwatch when he/she first experienced 'any' pain relief. FPR is 'confirmed' only if the participant also stopped the second stopwatch indicating 'meaningful pain relief'.

Time frame: Within 8 hours postdose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 postdose assessment on any efficacy parameter.

ArmMeasureValue (MEDIAN)
Dilcofenac Potassium + Placebo to IbuprofenTime to Confirmed First Perceptible Pain Relief15.81665 minutes
Ibuprofen + Placebo to Diclofenac PotassiumTime to Confirmed First Perceptible Pain Relief14.98335 minutes
Secondary

Time to Onset of First Perceptible Pain Relief (FPR)

Using the double stopwatch technique, participant started two stopwatches at dosing, and stopped the first stopwatch as soon as he/she first began to feel 'any' relief from pain. The time elapsed was recorded as the FPR.

Time frame: Within 8 hours postdose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 post-dose assessment on any efficacy parameter.

ArmMeasureValue (MEDIAN)
Dilcofenac Potassium + Placebo to IbuprofenTime to Onset of First Perceptible Pain Relief (FPR)15.81665 minutes
Ibuprofen + Placebo to Diclofenac PotassiumTime to Onset of First Perceptible Pain Relief (FPR)14.85000 minutes
Secondary

Time to Onset of Meaningful Pain Relief (MPR)

Using the double stopwatch technique, participant started two stopwatches at dosing, and stopped the second stopwatch as soon as he/she began to experience 'meaningful' relief from pain. Time elapsed is recorded as the MPR.

Time frame: Within 8 hours postdose

Population: The efficacy analyses were performed on the full analysis set (FAS), which consisted of all randomized subjects who were exposed to study drug and provided at least 1 postdose assessment on any efficacy parameter.

ArmMeasureValue (MEDIAN)
Dilcofenac Potassium + Placebo to IbuprofenTime to Onset of Meaningful Pain Relief (MPR)41.67500 minutes
Ibuprofen + Placebo to Diclofenac PotassiumTime to Onset of Meaningful Pain Relief (MPR)42.02500 minutes

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