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Study Evaluating Dexketoprofen Trometamol/Tramadol Hydrochloride Analgesic Efficacy in Acute Low Back Pain

Randomized, Double-blind, Placebo-controlled, Parallel Arm Group Study Evaluating Analgesic Efficacy and Safety of Dexketoprofen Trometamol and Tramadol Hydrochloride on Moderate to Severe Acute Pain in Patients With Acute Low Back Pain

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05170841
Acronym
Dante
Enrollment
538
Registered
2021-12-28
Start date
2020-09-17
Completion date
2022-05-04
Last updated
2025-01-09

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

Conditions

Low Back Pain

Brief summary

A randomized, double-blind, study to evaluate the analgesic efficacy and safety of Dexketoprofen trometamol and Tramadol hydrochloride combination versus placebo on moderate to severe acute pain in patients with acute low back pain.

Detailed description

This is a multicenter, randomized, double-blind, double-dummy, parallel group, placebo-controlled study encompassing 2 study phases: a single-dose phase (first 8 hours) and a multiple-dose phase starting after the single-dose phase (from 8h until day 5). Study population will be of male or female patients aged 18 years to 65 years with acute low back pain of moderate to severe intensity, whose onset of the current acute low back pain episode is within 48 hours prior to Screening. Patients with or without radiculopathy will be included, excluding those with neurological signs, according to the Quebec Task Force classification. Patients experiencing a new episode of low back pain will be eligible only if preceded by a period of at least 2 months without any low back pain. Patients should be free from analgesic due to previously administered pain killer (immediate or slow release formulations), according to exclusion criteria. Approximately 612 patients will be screened to achieve 510 patients randomly assigned to study treatment. In the single-dose phase patients will receive a single-dose treatment, consisting of 1 film-coated tablet and 2 capsules which have to be orally administered together at the same time (Day 1). The multiple-dose phase will begin 8 hours after the first dose. The patients assigned to Dexketoprofen/Tramadol fixed combination or Tramadol 100 milligram (mg) during the single-dose phase will continue to receive the same treatment during the multiple-dose phase; however, the patients assigned to receive placebo during the single-dose phase will either receive Dexketoprofen/Tramadol fixed combination or Tramadol 100 mg during the multiple-dose phase.

Interventions

DRUGDexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg

Administered as one single tablet to be taken every 8 hours

Administered as two capsules with 50 mg each to be taken every 8 hours

DRUGPlacebo

Administered as one tablet if matching Dexketoprofen Trometamol 25 mg and Tramadol Hydrochloride 75 mg or two capsules if matching Tramadol Hydrochloride 100 mg

Sponsors

Menarini International Operations Luxembourg SA
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Intervention model description

2 study phases: a single-dose phase (first 8 hours) and a multiple-dose phase starting after the single-dose phase (from 8h until Day 5).In the single-dose phase the patients will receive a single dose treatment, consisting of 1 film-coated tablet and 2 capsules which must be orally administered together at the same time (Day 1). The multiple-dose phase will begin 8 hours after the first dose. The patients assigned to Dexketoprofen/Tramadol fixed combination or Tramadol 100 mg during the single-dose phase will continue to receive the same treatment during the multiple-dose phase; however, the patients assigned to receive placebo during the single-dose phase will either receive Dexketoprofen/Tramadol fixed combination or Tramadol 100 mg during the multiple-dose phase.

Eligibility

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

Inclusion criteria

1. Properly executed written informed consent. 2. Male or female patients aged 18 years to 65 years. 3. Patients with acute low back reporting pain of at least moderate intensity at Screening (NRS score ≥ 5). The onset of the current acute low back pain episode is within 48 hours prior to Screening. 4. Patients with or without radiculopathy will be included, excluding those with neurological signs, according to the Quebec Task Force classification. 5. Naïve patients to any low back pain or patients with previous history of low back pain experiencing a new episode, preceded by a period of at least 2 months without any low back pain prior to Screening. 6. Patients free from analgesic (as per exclusion criterion 14) due to previously administered pain killer (immediate or slow release formulations), according to physician's judgment. 7. Females participating in the study must be either: * Females of non childbearing potential, defined as any woman who had undergone surgical sterilization (documented hysterectomy, bilateral salpingectomy, or bilateral oophorectomy) or is more than 2 years post menopausal (defined as no menses for 12 months); * Females of childbearing potential (following menarche until menopause unless permanently sterile) provided that they have a negative pregnancy test at Screening and are routinely using an effective method of birth control resulting in a low failure rate (ie, combined hormonal contraception, intrauterine device, condoms in combination with a spermicidal cream, male partner sterilization (vasectomy), bilateral tubal occlusion or total sexual abstinence) during the study treatment. 8. Mentally competent and able to understand and give written informed consent prior to Screening. 9. Compliant to undergo all visits and procedures scheduled in the Study.

Exclusion criteria

1. Patients who are judged by the Investigator not to be suitable candidates for the study treatments and the Rescue Medication (RM) based on their medical history, physical examination, Concomitant Medication (CM) and concurrent systemic diseases. 2. Clinically significant abnormalities in the vital signs as per Investigator's judgment. 3. Patients with acute low back pain and radiation to limb with presence of neurologic signs (focal weakness, asymmetry of reflexes, sensory loss in a dermatome, or loss of bowel, bladder, or sexual function) according to Quebec Task Force Classification. 4. History of hypersensitivity to the study treatments, RM or to any other nonsteroidal anti-inflammatory drugs (NSAIDs), or opioids. 5. Known photoallergic or phototoxic reactions during treatment with ketoprofen or fibrates. 6. History of peptic ulcer, gastrointestinal disorders when taking NSAIDs, gastrointestinal bleeding, or other active bleeding. 7. History of allergy (eg, precipitate attacks of asthma, bronchospasm, acute rhinitis, or cause nasal polyps, urticaria or angioneurotic oedema) to the study treatments, RM or to any other NSAIDs, or opioids. 8. Anamnestic mild to severe renal dysfunction, mild to severe hepatic dysfunction, as per Investigator's judgment. 9. Patients with chronic dyspepsia. 10. Patients with severe heart failure \[Class III and Class IV of New York Heart Association (NYHA) Classification\]. 11. History of hemorrhagic diathesis and other coagulation disorders. 12. History of or current epilepsy or convulsions. 13. Patients with Crohn's disease or ulcerative colitis. 14. Patients receiving monoamine oxidase (MAO) inhibitors (a minimum of 14 days of washout must elapse prior to the Screening). 15. Treatment with topical preparations/medications within 4 hours prior to Screening, anesthetics and muscle relaxants within 8 hours prior to Screening, short-acting analgesics (eg, paracetamol) within 4 hours prior to Screening, other analgesics within 5 half-lives prior to Screening or use of an opioid within the 14 days preceding Screening. 16. Treatment with high doses of salicylates (≥3 g/day), anticoagulants, thrombolytic and antiplatelet agents, heparins, corticosteroids (except inhalers and topical agents), lithium methotrexate, used at high doses of 15 mg/week or more, hydantoins (including phenytoin) and sulphonamides, antiepileptics, antipsychotics, serotonin reuptake inhibitors and tricyclic antidepressants, and analgesics within 48 hours or 5 half-lives (whichever is the longer) prior to Screening. 17. Patients using sedatives (eg, benzodiazepines) and hypnotic agents within 8 hours before Screening. 18. Any chronic or acute painful condition other than the study indication that may interfere with the assessment of the efficacy of the study treatment. 19. Any non-pharmacological interventional therapy for low back pain (physical therapy, acupuncture, massage etc.) one month before Screening. 20. Patients with litigation related to work. 21. Patients with severe dehydration (caused by vomiting, diarrhea, or insufficient fluid intake) within one month prior to Screening. 22. Severe respiratory depression according to physician's judgment. 23. Participation in other clinical studies in the previous 4 weeks. 24. History of drug or alcohol abuse. For the purpose of the study, alcohol abuse is defined as regularly intake of more than 4 units of alcohol per day (1 unit corresponds approximately to 125 ml wine, 200 ml beer, 25 ml spirit). 25. History of any illness or condition that, in the opinion of the Investigator might pose a risk to the patient or confound the efficacy and safety results of the study. 26. Pregnant and breastfeeding women: a pregnancy test will be performed on all women of childbearing potential at Screening. 27. Patients presenting any of the contraindications reported for dexketoprofen/tramadol, tramadol or paracetamol (according to the SmPC). 28. Known or suspected serious spinal pathology (eg, metastatic, inflammatory or infective diseases of the spine, cauda equine syndrome, trauma, spinal fracture). 29. Spinal surgery within the preceding 6 months.

Design outcomes

Primary

MeasureTime frameDescription
Time to First Achieve a Numeric Rating Scale-Pain Intensity Score <4 or a Pain Intensity Reduction of ≥30% From Drug Intake Till 8 Hours After the First Dose8 hours from first intake (referring to first 8 hours of Single Dose Phase)Time to first achieve a Numeric Rating Scale-Pain Intensity (NRS-PI) score of \<4 or a pain intensity reduction ≥30% from drug intake till 8 hours after the first dose. Numeric Rate Scale-Pain Intensity is a Patients rated Pain Intensity scale using an 11-point Numeric Rate Scale (0 no pain; 10 worst pain).

Secondary

MeasureTime frameDescription
Total Pain Relief (TOTPAR) at 6h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs TramadolT=0 to T=6hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 24 for Dexketoprofen/Tramadol group and 0 to 19 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.
Total Pain Relief (TOTPAR) at 8h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs TramadolFrom T=0 to T=8hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 31 for Dexketoprofen/Tramadol group and 0 to 26 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.
Total Pain Relief (TOTPAR) at 6h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs PlaceboFrom T=0 to T=6hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 24 for Dexketoprofen/Tramadol group and 0 to 23 for Placebo group. TOTPAR scale ranges from 0 with no upper limit.
Total Pain Relief (TOTPAR) at 8h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs PlaceboForm T=0 to T=8hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 31 for Dexketoprofen/Tramadol group and 0 to 27 for Placebo group. TOTPAR scale ranges from 0 with no upper limit.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 4 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=4hMax TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR), were calculated at prespecified time points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 97 and 0 to 84 respectively for Dexketoprofen/Tramadol and Tramadol group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 6 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=6hMax TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 98 for Dexketoprofen/Tramadol group and 0 to 77 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 8 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=8hThe max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 98 for Dexketoprofen/Tramadol group and 0 to 83 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 6 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs PlaceboForm T=0 to T=6hThe max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 98 for Dexketoprofen/Tramadol group and 0 to 94 for Placebo group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 8 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs PlaceboForm T=0 to T=8hThe max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 98 for Dexketoprofen/Tramadol group and 0 to 83 for Placebo group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 4 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=4h
Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 6 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=6h
Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 8 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=8h
Total Pain Relief (TOTPAR) at 4h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs TramadolFrom t=o to T=4 hoursTOTPAR was calculated as the time-weighted sum of the PAR- (VRS) scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 16 for Dexketoprofen/Tramadol group and 0 to 14 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.
Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 6 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs PlaceboForm T=0 to T=6hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre specified time point points in the single and the multiple-dose phases of the study.
Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 8 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs PlaceboForm T=0 to T=8hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre specified time point points in the single and the multiple-dose phases of the study.
Total Pain Relief (TOTPAR) at 24h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=24hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 96 for Dexketoprofen/Tramadol group and 0 to 90 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.
Total Pain Relief (TOTPAR) at 48h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=48hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 192 for Dexketoprofen/Tramadol group and 0 to 184 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.
Total Pain Relief (TOTPAR) at 72h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=72hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 288 for Dexketoprofen/Tramadol group and 0 to 280 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 24 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=24hThe max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 100 for Dexketoprofen/Tramadol group and 0 to 94 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 48 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=48hThe max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 100 for Dexketoprofen/Tramadol group and 0 to 96 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 72 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=72hThe max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 100 for Dexketoprofen/Tramadol group and 0 to 97 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Maximum TOTPAR (%Max TOTPAR) at 96 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=96hThe max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 100 for Dexketoprofen/Tramadol group and 0 to 98 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.
Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 48 Hours After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=48hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre-specified time point points in the single and the multiple-dose phases of the study.
Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 72 Hours After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs TramadolForm T=0 to T=72hThe max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some(meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR),percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre specified time point points in the single and the multiple-dose phases of the study.
Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 4 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs PlaceboForm T=0 to T=4hTOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre-specified time point points in the single and the multiple-dose phases of the study.

Countries

Italy

Participant flow

Participants by arm

ArmCount
Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment
Two phase intervention. Single dose phase (time 0 - time 8h) and Multiple dose phase (time 8h - Day 5) In this arm patients will receive during each phase film coated tablets (administered as one tablet) Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg: Administered as one single tablet to be taken every 8 hours
211
Tramadol Hydrochloride 100 mg Treatment
Two phase intervention. Single dose phase (time 0 - time 8h) and Multiple dose phase (time 8h - Day 5) In this arm patients will receive during each phase (administered as 2 capsules of Tramadol 50 mg) Tramadol Hydrochloride 100 mg: Administered as two capsules with 50 mg each to be taken every 8 hours
207
Placebo Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment
Two phase intervention. Single dose phase (time 0 - time 8h) and Multiple dose phase (time 8h - Day 5). SINGLE DOSE PHASE: Placebo film-coated tablets matching Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg MULTIPLE DOSE PHASE: Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg film coated tablets (administered as one tablet) Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg: Administered as one single tablet to be taken every 8 hours Placebo: Administered as one tablet if matching Dexketoprofen Trometamol 25 mg and Tramadol Hydrochloride 75 mg or two capsules if matching Tramadol Hydrochloride 100 mg
59
Placebo Then Tramadol Hydrochloride 100 mg
Two phase intervention. Single dose phase (time 0 - time 8h) and Multiple dose phase (time 8h - Day 5). SINGLE DOSE PHASE: Placebo capsules matching active comparator (administered as 2 capsules of Tramadol 50 mg) MULTIPLE DOSE PHASE: Tramadol Hydrochloride 100 mg (administered as 2 capsules of Tramadol 50 mg) Tramadol Hydrochloride 100 mg: Administered as two capsules with 50 mg each to be taken every 8 hours Placebo: Administered as one tablet if matching Dexketoprofen Trometamol 25 mg and Tramadol Hydrochloride 75 mg or two capsules if matching Tramadol Hydrochloride 100 mg
61
Total538

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Multiple Dose PhaseAdverse Event1214
Multiple Dose PhaseWithdrawal by Subject0100
Single Dose PhaseAdverse Event1202

Baseline characteristics

CharacteristicPlacebo Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg TreatmentPlacebo Then Tramadol Hydrochloride 100 mgTotalDexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg TreatmentTramadol Hydrochloride 100 mg Treatment
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
1 Participants0 Participants4 Participants1 Participants2 Participants
Age, Categorical
Between 18 and 65 years
58 Participants61 Participants534 Participants210 Participants205 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
1 Participants0 Participants1 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
58 Participants61 Participants537 Participants211 Participants207 Participants
Sex: Female, Male
Female
28 Participants28 Participants255 Participants98 Participants101 Participants
Sex: Female, Male
Male
31 Participants33 Participants283 Participants113 Participants106 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
0 / 2700 / 2680 / 2110 / 2070 / 119
other
Total, other adverse events
68 / 27073 / 26828 / 21131 / 20711 / 119
serious
Total, serious adverse events
0 / 2701 / 2681 / 2110 / 2070 / 119

Outcome results

Primary

Time to First Achieve a Numeric Rating Scale-Pain Intensity Score <4 or a Pain Intensity Reduction of ≥30% From Drug Intake Till 8 Hours After the First Dose

Time to first achieve a Numeric Rating Scale-Pain Intensity (NRS-PI) score of \<4 or a pain intensity reduction ≥30% from drug intake till 8 hours after the first dose. Numeric Rate Scale-Pain Intensity is a Patients rated Pain Intensity scale using an 11-point Numeric Rate Scale (0 no pain; 10 worst pain).

Time frame: 8 hours from first intake (referring to first 8 hours of Single Dose Phase)

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio. Tramadol Hydrochloride 100 mg is not applicable for primary outcome measure since the primary objective was To evaluate the analgesic efficacy of Dexketo/Tram fixed combination versus placebo in moderate to severe acute low back pain after the first dose (first 8 hours)

ArmMeasureValue (MEAN)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Time to First Achieve a Numeric Rating Scale-Pain Intensity Score <4 or a Pain Intensity Reduction of ≥30% From Drug Intake Till 8 Hours After the First Dose105 score on a scale
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Time to First Achieve a Numeric Rating Scale-Pain Intensity Score <4 or a Pain Intensity Reduction of ≥30% From Drug Intake Till 8 Hours After the First Dose120 score on a scale
Placebo (Single Dose Phase) Then Tramadol Hydrochloride 100 mg (Multiple Dose Phase)Time to First Achieve a Numeric Rating Scale-Pain Intensity Score <4 or a Pain Intensity Reduction of ≥30% From Drug Intake Till 8 Hours After the First Dose120 score on a scale
p-value: =0.566t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 24 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

The max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 100 for Dexketoprofen/Tramadol group and 0 to 94 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=24h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 24 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol46.6 Percentage of score on a scaleStandard Deviation 21.07
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 24 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol42.7 Percentage of score on a scaleStandard Deviation 20.66
Placebo (Single Dose Phase) Then Tramadol Hydrochloride 100 mg (Multiple Dose Phase)Percentage of Maximum TOTPAR (%Max TOTPAR) at 24 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol46.6 Percentage of score on a scaleStandard Deviation 21.07
Placebo and Tramadol Hydrochloride 100 mgPercentage of Maximum TOTPAR (%Max TOTPAR) at 24 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol42.7 Percentage of score on a scaleStandard Deviation 20.66
p-value: =0.045t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 48 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

The max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 100 for Dexketoprofen/Tramadol group and 0 to 96 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=48h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 48 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol51.2 Percentage of score on a scaleStandard Deviation 21.69
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 48 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol46.9 Percentage of score on a scaleStandard Deviation 21.79
Placebo (Single Dose Phase) Then Tramadol Hydrochloride 100 mg (Multiple Dose Phase)Percentage of Maximum TOTPAR (%Max TOTPAR) at 48 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol51.2 Percentage of score on a scaleStandard Deviation 21.69
Placebo and Tramadol Hydrochloride 100 mgPercentage of Maximum TOTPAR (%Max TOTPAR) at 48 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol46.9 Percentage of score on a scaleStandard Deviation 21.79
p-value: =0.029t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 4 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

Max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR), were calculated at prespecified time points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 97 and 0 to 84 respectively for Dexketoprofen/Tramadol and Tramadol group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=4h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio. This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen/ Tramadol fixed combination versus Tramadol 100 mg after the first dose (first 4 h) in the Single Dose Phase. Placebo arms measurement are not applicable since, as per outcome measure title above, this outcome measure was compared only between active arms

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 4 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol29.1 percentage of score on a scaleStandard Deviation 22.57
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 4 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol24.1 percentage of score on a scaleStandard Deviation 17.92
p-value: =0.011t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 6 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Placebo

The max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 98 for Dexketoprofen/Tramadol group and 0 to 94 for Placebo group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=6h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen/ Tramadol fixed combination versus placebo after the first dose (first 6 h) in the Single Dose Phase. Tramadol 100 mg Arm measurement is not applicable since, as per outcome measure title above, this outcome measure was compared only between Dexketoprofen/Tramadol and Placebo

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 6 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Placebo30.9 Percentage of score on a scaleStandard Deviation 23.04
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 6 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Placebo25.5 Percentage of score on a scaleStandard Deviation 18.12
p-value: =0.029t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 6 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

Max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 98 for Dexketoprofen/Tramadol group and 0 to 77 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=6h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 6 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol30.9 Percentage of score on a scaleStandard Deviation 23.04
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 6 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol25.5 Percentage of score on a scaleStandard Deviation 18.56
p-value: =0.007t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 72 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

The max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 100 for Dexketoprofen/Tramadol group and 0 to 97 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=72h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 72 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol54.7 Percentage of score on a scaleStandard Deviation 22.15
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 72 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol50.3 Percentage of score on a scaleStandard Deviation 22.24
Placebo (Single Dose Phase) Then Tramadol Hydrochloride 100 mg (Multiple Dose Phase)Percentage of Maximum TOTPAR (%Max TOTPAR) at 72 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol54.7 Percentage of score on a scaleStandard Deviation 22.15
Placebo and Tramadol Hydrochloride 100 mgPercentage of Maximum TOTPAR (%Max TOTPAR) at 72 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol50.3 Percentage of score on a scaleStandard Deviation 22.24
p-value: =0.027t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 8 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Placebo

The max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 98 for Dexketoprofen/Tramadol group and 0 to 83 for Placebo group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=8h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen/Tramadol fixed combination versus placebo after the first dose (first 8 h) in the Single Dose Phase. Tramadol 100 mg Arm measurement is not applicable since, as per outcome measure title above, this outcome measure was compared only between Dexketoprofen/Tramadol and Placebo

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 8 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Placebo32.1 Percentage score on a scaleStandard Deviation 22.75
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 8 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Placebo26.4 Percentage score on a scaleStandard Deviation 18.03
p-value: =0.022t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 8 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

The max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 98 for Dexketoprofen/Tramadol group and 0 to 83 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=8h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 8 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol32.1 Percentage of score on a scaleStandard Deviation 22.75
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 8 Hours After the First Dose- Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol27.1 Percentage of score on a scaleStandard Deviation 18.59
p-value: =0.013t-test, 2 sided
Secondary

Percentage of Maximum TOTPAR (%Max TOTPAR) at 96 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

The max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), and percentage of maximum TOTPAR (%max TOTPAR) were calculated at prespecified time point points in the single and the multiple-dose phases of the study. Percentage of maximum TOTPAR minimum and maximum values were 0 to 100 for Dexketoprofen/Tramadol group and 0 to 98 for Tramadol group. %max TOTPAR scale ranges from 0 to 100.

Time frame: Form T=0 to T=96h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Maximum TOTPAR (%Max TOTPAR) at 96 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol57.7 Percentage of score on a scaleStandard Deviation 22.7
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Maximum TOTPAR (%Max TOTPAR) at 96 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol53.3 Percentage of score on a scaleStandard Deviation 22.82
Placebo (Single Dose Phase) Then Tramadol Hydrochloride 100 mg (Multiple Dose Phase)Percentage of Maximum TOTPAR (%Max TOTPAR) at 96 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol57.7 Percentage of score on a scaleStandard Deviation 22.7
Placebo and Tramadol Hydrochloride 100 mgPercentage of Maximum TOTPAR (%Max TOTPAR) at 96 Hours After the First Dose- Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol53.3 Percentage of score on a scaleStandard Deviation 22.82
p-value: =0.035t-test, 2 sided
Secondary

Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 48 Hours After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre-specified time point points in the single and the multiple-dose phases of the study.

Time frame: Form T=0 to T=48h

Population: Per-protocol (PP) population included all patients in the ITT having major protocol violations that could affect the primary efficacy analysis. Protocol violations which had a major distorting influence on the primary endpoints resulted in patients being excluded from the PP population. Protocol Deviations identified during the the study conduct, as authorized in the final Protocol Deviation log, were taken into consideration in the final assignment of patients to the analysis sets.

ArmMeasureValue (NUMBER)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 48 Hours After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol60 Percentage of patients
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 48 Hours After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol46.5 Percentage of patients
p-value: =0.001t-test, 2 sided
Secondary

Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 4 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre-specified time point points in the single and the multiple-dose phases of the study.

Time frame: Form T=0 to T=4h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg fixed combination versus placebo after the first dose (first 6 h) in the Single Dose Phase. Tramadol Hydrochloride 100 mg Arm is not reported since data of patients in that Arm are not analyzed for this Endpoint

ArmMeasureValue (NUMBER)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 4 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo20.6 percentage of patients
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 4 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo8.8 percentage of patients
p-value: =0.01t-test, 2 sided
Secondary

Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 4 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

Time frame: Form T=0 to T=4h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (NUMBER)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 4 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol20.6 percentage of patients
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 4 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol8.8 percentage of patients
p-value: <0.001t-test, 2 sided
Secondary

Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 6 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre specified time point points in the single and the multiple-dose phases of the study.

Time frame: Form T=0 to T=6h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg fixed combination versus placebo after the first dose (first 6 h) in the Single Dose Phase. Tramadol Hydrochloride 100 mg Arm is not reported since data of patients in that Arm are not analyzed for this Endpoint

ArmMeasureValue (NUMBER)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 6 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo22.5 percentage of patients
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 6 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo8.8 percentage of patients
p-value: =0.04t-test, 2 sided
Secondary

Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 6 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

Time frame: Form T=0 to T=6h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (NUMBER)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 6 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol22.5 percentage of patients
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 6 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol9.8 percentage of patients
p-value: <0.001t-test, 2 sided
Secondary

Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 72 Hours After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

The max TOTPAR was calculated as the theoretical maximum time-weighted sum of the PAR values for each patient. The maximum possible TOTPAR was the value of TOTPAR that would have been obtained if the patient had a complete pain relief for that observation period. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some(meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR),percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre specified time point points in the single and the multiple-dose phases of the study.

Time frame: Form T=0 to T=72h

Population: Per-protocol (PP) population included all patients in the ITT having major protocol violations that could affect the primary efficacy analysis. Protocol violations which had a major distorting influence on the primary endpoints resulted in patients being excluded from the PP population. Protocol Deviations identified during the the study conduct, as authorized in the final Protocol Deviation log, were taken into consideration in the final assignment of patients to the analysis sets.

ArmMeasureValue (NUMBER)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 72 Hours After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol62.6 Percentage of patients
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 72 Hours After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol53.5 Percentage of patients
Secondary

Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 8 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at pre specified time point points in the single and the multiple-dose phases of the study.

Time frame: Form T=0 to T=8h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg fixed combination versus placebo after the first dose (first 6 h) in the Single Dose Phase. Tramadol Hydrochloride 100 mg Arm is not reported since data of patients in that Arm are not analyzed for this Endpoint

ArmMeasureValue (NUMBER)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 8 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo23.5 percentage of patients
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 8 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo11.8 percentage of patients
p-value: =0.016t-test, 2 sided
Secondary

Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 8 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

Time frame: Form T=0 to T=8h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (NUMBER)
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 8 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol23.5 percentage of patients
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Percentage of Patients Achieving at Least 50% of Maximum TOTPAR at 8 Hours After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol11.3 percentage of patients
p-value: =0.001t-test, 2 sided
Secondary

Total Pain Relief (TOTPAR) at 24h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 96 for Dexketoprofen/Tramadol group and 0 to 90 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.

Time frame: Form T=0 to T=24h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Total Pain Relief (TOTPAR) at 24h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol44.6 score on a scaleStandard Deviation 20.2
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Total Pain Relief (TOTPAR) at 24h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol40.9 score on a scaleStandard Deviation 19.85
Placebo (Single Dose Phase) Then Tramadol Hydrochloride 100 mg (Multiple Dose Phase)Total Pain Relief (TOTPAR) at 24h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol44.6 score on a scaleStandard Deviation 20.2
Placebo and Tramadol Hydrochloride 100 mgTotal Pain Relief (TOTPAR) at 24h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol40.9 score on a scaleStandard Deviation 19.85
p-value: =0.045t-test, 2 sided
Secondary

Total Pain Relief (TOTPAR) at 48h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 192 for Dexketoprofen/Tramadol group and 0 to 184 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.

Time frame: Form T=0 to T=48h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Total Pain Relief (TOTPAR) at 48h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol97.8 score on a scaleStandard Deviation 41.69
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Total Pain Relief (TOTPAR) at 48h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol90.0 score on a scaleStandard Deviation 41.88
Placebo (Single Dose Phase) Then Tramadol Hydrochloride 100 mg (Multiple Dose Phase)Total Pain Relief (TOTPAR) at 48h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol97.8 score on a scaleStandard Deviation 41.69
Placebo and Tramadol Hydrochloride 100 mgTotal Pain Relief (TOTPAR) at 48h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol90.0 score on a scaleStandard Deviation 41.88
p-value: =0.042t-test, 2 sided
Secondary

Total Pain Relief (TOTPAR) at 4h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

TOTPAR was calculated as the time-weighted sum of the PAR- (VRS) scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 16 for Dexketoprofen/Tramadol group and 0 to 14 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.

Time frame: From t=o to T=4 hours

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio. This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen/Tramadol fixed combination versus Tramadol 100 mg after the first 4 h intake during Single Dose Phase. Placebo arms measurement are not applicable since, as per outcome measure title above, this outcome measure was compared only between active arms

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Total Pain Relief (TOTPAR) at 4h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol4.6 score on a scaleStandard Deviation 3.6
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Total Pain Relief (TOTPAR) at 4h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol3.8 score on a scaleStandard Deviation 2.84
p-value: =0.013t-test, 2 sided
Secondary

Total Pain Relief (TOTPAR) at 6h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 24 for Dexketoprofen/Tramadol group and 0 to 23 for Placebo group. TOTPAR scale ranges from 0 with no upper limit.

Time frame: From T=0 to T=6h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio. This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen/Tramadol fixed combination versus placebo after the first dose (first 6 h) in the Single Dose Phase. Tramadol 100 mg Arm measurement is not applicable since, as per outcome measure title above, this outcome measure was compared only between Dexketoprofen/Tramadol and Placebo

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Total Pain Relief (TOTPAR) at 6h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo7.4 score on a scaleStandard Deviation 5.52
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Total Pain Relief (TOTPAR) at 6h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo6.1 score on a scaleStandard Deviation 4.37
p-value: =0.031t-test, 2 sided
Secondary

Total Pain Relief (TOTPAR) at 6h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 24 for Dexketoprofen/Tramadol group and 0 to 19 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.

Time frame: T=0 to T=6h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Total Pain Relief (TOTPAR) at 6h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol7.4 score on a scaleStandard Deviation 5.52
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Total Pain Relief (TOTPAR) at 6h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol6.0 score on a scaleStandard Deviation 4.41
p-value: =0.006t-test, 2 sided
Secondary

Total Pain Relief (TOTPAR) at 72h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 288 for Dexketoprofen/Tramadol group and 0 to 280 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.

Time frame: Form T=0 to T=72h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Total Pain Relief (TOTPAR) at 72h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol156.9 score on a scaleStandard Deviation 63.83
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Total Pain Relief (TOTPAR) at 72h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol144.7 score on a scaleStandard Deviation 64.14
Placebo (Single Dose Phase) Then Tramadol Hydrochloride 100 mg (Multiple Dose Phase)Total Pain Relief (TOTPAR) at 72h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol156.9 score on a scaleStandard Deviation 63.83
Placebo and Tramadol Hydrochloride 100 mgTotal Pain Relief (TOTPAR) at 72h After the First Dose - Multiple Dose Phase - Dexketoprofen/Tramadol vs Tramadol144.7 score on a scaleStandard Deviation 64.14
p-value: =0.037t-test, 2 sided
Secondary

Total Pain Relief (TOTPAR) at 8h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 31 for Dexketoprofen/Tramadol group and 0 to 27 for Placebo group. TOTPAR scale ranges from 0 with no upper limit.

Time frame: Form T=0 to T=8h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.This Secondary Endpoint is to evaluate the analgesic efficacy of Dexketoprofen/Tramadol fixed combination versus placebo after the first dose (first 8 h) in the Single Dose Phase. Tramadol 100 mg Arm measurement is not applicable since, as per outcome measure title above, this outcome measure was compared only between Dexketoprofen/Tramadol and Placebo

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Total Pain Relief (TOTPAR) at 8h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo10.1 score on a scaleStandard Deviation 7.18
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Total Pain Relief (TOTPAR) at 8h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Placebo8.4 score on a scaleStandard Deviation 5.81
p-value: =0.027t-test, 2 sided
Secondary

Total Pain Relief (TOTPAR) at 8h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol

TOTPAR was calculated as the time-weighted sum of the PAR-VRS scores. The Verbal Rating Scale (VRS) is a 5-point scale to assess the pain relief. The patients were asked to answer the question 'How do you rate your pain relief?' where 0 = 'no relief', 1 = 'a little (perceptible) relief', 2 = 'some (meaningful) relief', 3 = 'lot of relief', 4 = 'complete relief'. Based on VRS, pain relief (PAR) scores, total pain relief (TOTPAR), percentage of maximum TOTPAR (%max TOTPAR), and percentage of patients achieving at least 50% of maximum TOTPAR were calculated at prespecified time point points in the single and the multiple-dose phases of the study. TOTPAR minimum and maximum values were 0 to 31 for Dexketoprofen/Tramadol group and 0 to 26 for Tramadol group. TOTPAR scale ranges from 0 with no upper limit.

Time frame: From T=0 to T=8h

Population: The modified intent-to-treat (mITT) population included the first cohort of patients randomized to the 4 treatment arms in a 4:4:1:1 ratio.

ArmMeasureValue (MEAN)Dispersion
Dexketoprofen Trometamol 25 mg/ Tramadol Hydrochloride 75 mg Treatment (Both Phases)Total Pain Relief (TOTPAR) at 8h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol10.1 score on a scaleStandard Deviation 7.18
Placebo (SDP) Then Dexketoprofen Trometamol 25 mg/Tramadol Hydrochloride 75 mg Treatment (MDP)Total Pain Relief (TOTPAR) at 8h After the First Dose - Single Dose Phase - Dexketoprofen/Tramadol vs Tramadol8.5 score on a scaleStandard Deviation 5.92
p-value: =0.013t-test, 2 sided

Source: ClinicalTrials.gov · Data processed: Feb 7, 2026