Post Operative Dental Pain
Conditions
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
Single dose of ibuprofen 400 mg tablet
Single dose of placebo to ibuprofen 400 mg tablet
Single dose of placebo to diclofenac potassium 50 mg soft gelatin capsule
Sponsors
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at 60 Minutes Post Dose | 60 minutes postdose | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 15, 30, 45, 60 and 90 minutes, and 2, 4, 5, 6, 7, and 8 hours 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 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 Relief | Within 8 hours postdose | 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 to Onset of Meaningful Pain Relief (MPR) | Within 8 hours postdose | 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 to Onset of First Perceptible Pain Relief (FPR) | Within 8 hours postdose | 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. |
| Sum of Pain Intensity Difference (SPID) | 1, 2, 4, 6, and 8 hours postdose | 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. |
| Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 15, 30, 45, and 90 minutes, and 2, 4, 5, 6, 7, and 8 hours 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. |
| Peak Analgesic Effect | From dose administration to 8 hours post dose | 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. |
| Duration of Analgesia | From dose administration to 8 hours post dose | 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). |
| Number of Patients Needing Rescue Medication | From dose administration to 8 hours post dose | The 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 medication | 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). |
| Number of Patients With Any Adverse Events, Serious Adverse Events and Death | time 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 Points | 1, 2, 4, 6, and 8 hours postdose | 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. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| 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 |
| Total | 328 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Subject/guardian decision | 0 | 1 |
Baseline characteristics
| Characteristic | Dilcofenac Potassium + Placebo to Ibuprofen | Ibuprofen + Placebo to Diclofenac Potassium | Total |
|---|---|---|---|
| Age, Continuous | 24.9 Years STANDARD_DEVIATION 5.21 | 24.7 Years STANDARD_DEVIATION 6.11 | 24.8 Years STANDARD_DEVIATION 5.66 |
| Sex: Female, Male Female | 98 Participants | 96 Participants | 194 Participants |
| Sex: Female, Male Male | 68 Participants | 66 Participants | 134 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 47 / 166 | 47 / 162 |
| serious Total, serious adverse events | 0 / 166 | 0 / 162 |
Outcome results
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.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at 60 Minutes Post Dose | 47.3 units on a scale | Standard Error 2.06 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at 60 Minutes Post Dose | 44.1 units on a scale | Standard Error 2.08 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 60 minutes | 45.4321 units on a scale*hours | Standard Error 1.48887 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 4 hours | 96.7669 units on a scale*hours | Standard Error 6.56154 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 45 minutes | 38.8570 units on a scale*hours | Standard Error 1.03408 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 5 hours | 119.0564 units on a scale*hours | Standard Error 8.50377 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 90 minutes | 54.9330 units on a scale*hours | Standard Error 2.34986 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 6 hours | 145.6112 units on a scale*hours | Standard Error 10.58291 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 30 minutes | 29.3759 units on a scale*hours | Standard Error 0.58537 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 7 hours | 177.2751 units on a scale*hours | Standard Error 12.76115 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 2 hours | 62.3674 units on a scale*hours | Standard Error 3.15839 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 8 hours | 212.9300 units on a scale*hours | Standard Error 15.01237 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 15 minutes | 16.1914 units on a scale*hours | Standard Error 0.19369 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 8 hours | 193.4450 units on a scale*hours | Standard Error 15.15905 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 15 minutes | 15.6262 units on a scale*hours | Standard Error 0.19558 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 30 minutes | 27.9216 units on a scale*hours | Standard Error 0.59109 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 45 minutes | 37.3448 units on a scale*hours | Standard Error 1.04418 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 60 minutes | 44.5882 units on a scale*hours | Standard Error 1.50342 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 90 minutes | 55.9885 units on a scale*hours | Standard Error 2.37282 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 2 hours | 65.1654 units on a scale*hours | Standard Error 3.18925 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 4 hours | 98.9982 units on a scale*hours | Standard Error 6.62565 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 5 hours | 117.4797 units on a scale*hours | Standard Error 8.58686 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 6 hours | 138.6947 units on a scale*hours | Standard Error 10.68631 |
| Ibuprofen + Placebo to Diclofenac Potassium | Area Under the Curve (AUC) of Visual Analog Scale of Pain Intensity (VASPI) Measuring Change From Baseline at Different Time Points | 7 hours | 163.8821 units on a scale*hours | Standard Error 12.88584 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 15 minutes | 9.2 Units on a scale | Standard Error 1.55 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 30 minutes | 24.1 Units on a scale | Standard Error 1.96 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 45 minutes | 38.9 Units on a scale | Standard Error 2.16 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 90 minutes | 53.5 Units on a scale | Standard Error 1.98 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 2 hours | 55.6 Units on a scale | Standard Error 1.96 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 4 hours | 48.8 Units on a scale | Standard Error 2.22 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 5 hours | 45.4 Units on a scale | Standard Error 2.4 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 6 hours | 40.3 Units on a scale | Standard Error 2.58 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 7 hours | 35.2 Units on a scale | Standard Error 2.68 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 8 hours | 32.3 Units on a scale | Standard Error 2.74 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 6 hours | 46.5 Units on a scale | Standard Error 2.61 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 15 minutes | 13.7 Units on a scale | Standard Error 1.56 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 4 hours | 51.9 Units on a scale | Standard Error 2.24 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 30 minutes | 26.6 Units on a scale | Standard Error 1.98 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 8 hours | 37.7 Units on a scale | Standard Error 2.76 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 45 minutes | 36.7 Units on a scale | Standard Error 2.18 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 5 hours | 49.8 Units on a scale | Standard Error 2.42 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 90 minutes | 49.1 Units on a scale | Standard Error 2 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 7 hours | 41.9 Units on a scale | Standard Error 2.71 |
| Ibuprofen + Placebo to Diclofenac Potassium | Change From Baseline in Visual Analog Scale of Pain Intensity (VASPI) at Different Time Points | 2 hours | 53.0 Units on a scale | Standard Error 1.98 |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Duration of Analgesia | 480.0 minutes |
| Ibuprofen + Placebo to Diclofenac Potassium | Duration of Analgesia | 480.0 minutes |
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.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Number of Patients Needing Rescue Medication | 47 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients Needing Rescue Medication | 36 Participants |
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.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Number of Patients With Any Adverse Events, Serious Adverse Events and Death | any adverse events | 47 Participants |
| Dilcofenac Potassium + Placebo to Ibuprofen | Number of Patients With Any Adverse Events, Serious Adverse Events and Death | serious adverse events | 0 Participants |
| Dilcofenac Potassium + Placebo to Ibuprofen | Number of Patients With Any Adverse Events, Serious Adverse Events and Death | Death | 0 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients With Any Adverse Events, Serious Adverse Events and Death | any adverse events | 47 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients With Any Adverse Events, Serious Adverse Events and Death | serious adverse events | 0 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients With Any Adverse Events, Serious Adverse Events and Death | Death | 0 Participants |
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.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Fair (1) | 7 Participants |
| Dilcofenac Potassium + Placebo to Ibuprofen | Number 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 Ibuprofen | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Good (2) | 49 Participants |
| Dilcofenac Potassium + Placebo to Ibuprofen | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Excellent (4) | 49 Participants |
| Dilcofenac Potassium + Placebo to Ibuprofen | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Poor (0) | 6 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Excellent (4) | 47 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Poor (0) | 10 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Fair (1) | 7 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Good (2) | 34 Participants |
| Ibuprofen + Placebo to Diclofenac Potassium | Number of Patients With Different Responses Based on Patient's Global Assessment of Response to Treatment (PGART) | Very good (3) | 64 Participants |
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.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Peak Analgesic Effect | Highest Mean PID | 1.9 units on a scale | Standard Deviation 0.72 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Peak Analgesic Effect | Highest pain relief | 3.6 units on a scale | Standard Deviation 0.74 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Peak Analgesic Effect | Highest VASPI reduction | 61.3 units on a scale | Standard Deviation 17.99 |
| Ibuprofen + Placebo to Diclofenac Potassium | Peak Analgesic Effect | Highest Mean PID | 1.8 units on a scale | Standard Deviation 0.74 |
| Ibuprofen + Placebo to Diclofenac Potassium | Peak Analgesic Effect | Highest pain relief | 3.5 units on a scale | Standard Deviation 0.86 |
| Ibuprofen + Placebo to Diclofenac Potassium | Peak Analgesic Effect | Highest VASPI reduction | 60.2 units on a scale | Standard Deviation 19.35 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR2 | 5.032 units on a scale | Standard Error 0.1452 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR6 | 15.647 units on a scale | Standard Error 0.5595 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR4 | 10.642 units on a scale | Standard Error 0.3353 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR8 | 19.679 units on a scale | Standard Error 0.7915 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR1 | 1.807 units on a scale | Standard Error 0.068 |
| Ibuprofen + Placebo to Diclofenac Potassium | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR8 | 21.341 units on a scale | Standard Error 0.7992 |
| Ibuprofen + Placebo to Diclofenac Potassium | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR1 | 1.780 units on a scale | Standard Error 0.0687 |
| Ibuprofen + Placebo to Diclofenac Potassium | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR2 | 4.817 units on a scale | Standard Error 0.1466 |
| Ibuprofen + Placebo to Diclofenac Potassium | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR4 | 10.848 units on a scale | Standard Error 0.3385 |
| Ibuprofen + Placebo to Diclofenac Potassium | Summed Total Pain Relief (TOTPAR) at Different Time Points | TOTPAR6 | 16.499 units on a scale | Standard Error 0.565 |
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.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Sum of Pain Intensity Difference (SPID) | SPID1 | 1.077 units on a scale | Standard Error 0.0525 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Sum of Pain Intensity Difference (SPID) | SPID6 | 8.970 units on a scale | Standard Error 0.3703 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Sum of Pain Intensity Difference (SPID) | SPID4 | 6.165 units on a scale | Standard Error 0.2276 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Sum of Pain Intensity Difference (SPID) | SPID8 | 11.099 units on a scale | Standard Error 0.518 |
| Dilcofenac Potassium + Placebo to Ibuprofen | Sum of Pain Intensity Difference (SPID) | SPID2 | 2.955 units on a scale | Standard Error 0.105 |
| Ibuprofen + Placebo to Diclofenac Potassium | Sum of Pain Intensity Difference (SPID) | SPID8 | 11.904 units on a scale | Standard Error 0.523 |
| Ibuprofen + Placebo to Diclofenac Potassium | Sum of Pain Intensity Difference (SPID) | SPID1 | 1.049 units on a scale | Standard Error 0.053 |
| Ibuprofen + Placebo to Diclofenac Potassium | Sum of Pain Intensity Difference (SPID) | SPID2 | 2.772 units on a scale | Standard Error 0.106 |
| Ibuprofen + Placebo to Diclofenac Potassium | Sum of Pain Intensity Difference (SPID) | SPID4 | 6.196 units on a scale | Standard Error 0.2298 |
| Ibuprofen + Placebo to Diclofenac Potassium | Sum of Pain Intensity Difference (SPID) | SPID6 | 9.323 units on a scale | Standard Error 0.3739 |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Time to Confirmed First Perceptible Pain Relief | 15.81665 minutes |
| Ibuprofen + Placebo to Diclofenac Potassium | Time to Confirmed First Perceptible Pain Relief | 14.98335 minutes |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Time to Onset of First Perceptible Pain Relief (FPR) | 15.81665 minutes |
| Ibuprofen + Placebo to Diclofenac Potassium | Time to Onset of First Perceptible Pain Relief (FPR) | 14.85000 minutes |
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.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Dilcofenac Potassium + Placebo to Ibuprofen | Time to Onset of Meaningful Pain Relief (MPR) | 41.67500 minutes |
| Ibuprofen + Placebo to Diclofenac Potassium | Time to Onset of Meaningful Pain Relief (MPR) | 42.02500 minutes |