PainPhase 3NCT00986180
NUCYNTA (Tapentadol Immediate Release) Versus Oxycodone Immediate Release in the Treatment of Acute Low Back Pain
A Phase 3 study testing NUCYNTA and Oxycodone IR in people with Pain and Back Pain, run by Ortho-McNeil Janssen Scientific Affairs, LLC at 74 sites in United States.
Trial summary
Evaluate how NUCYNTA (tapentadol) immediate release (IR) compares with oxycodone IR in the treatment of acute low back pain. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pain, Back Pain, Low Back Pain
- What is being tested?
- NUCYNTA and Oxycodone IR
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 667 participants
- Where
- 74 sitesUnited States
- Study dates
- Sep 2009to Dec 2010
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- At Visit 1 (study entry) patients must have a medical history and physical and neurological examinations that support a clinical diagnosis of acute low back pain that is felt down to the lower leg below the knee with the onset no longer than 30 days before Visit 1
- At Visit 1 patients must report qualifying pain intensity scores
- Patients must be appropriate candidates for treatment with oral opioid pain medication in the investigator's clinical judgment
- Patients must be able to appropriately verbalize pain characteristics and to complete all protocol required measurements/assessments without assistance
- Patients must be medically stable on the basis of physical examination, medical history, vital signs, and clinical laboratory tests performed at screening
Who cannot join
- History of back (cervical, thoracic or lumbosacral) pain =50% of the time in the 1 year prior to the first visit
- History of any low back pain episode, with the exception of the current acute low back pain episode, within 3 months prior to the first visit that was greater than mild in pain intensity, or was associated with disability (e.g., loss of time from work, family, or activities of daily living), or necessitated the use of an opioid (narcotic) analgesic including tramadol
- Medical history or physical examination results that suggest the acute low back pain or any of the neurological symptoms or signs are caused by a serious medical condition (e.g., fever, chills, unexplained weight loss, bowel or urinary bladder dysfunction or incontinence, bilateral leg weakness, progressive weakness, paralysis)
- There is a high probability for surgical intervention for the back pain during the projected time on the study or that there will be an increase in the severity of the leg pain or deficits
- Had either a surgical procedure involving the spine or intervertebral discs in the lower back region within 1 year prior to Visit 1 or had >1 surgical procedure(s) involving the spine or intervertebral discs in the lower back region
- has any painful condition that could interfere with the study assessments or with the patient's ability to differentiate the pain associated with the acute low back pain episode from pain associated with another condition
Show all 16Show fewer
- History of severe lumbar spinal stenosis, fibromyalgia, or ankylosing spondylitis
- history of epilepsy or recurrent seizures
- Unable or unwilling to discontinue all prohibited medications at the time of randomization and during the time of their participation in the study
- Known or suspected history of alcohol or drug abuse based on medical history, physical examination, urine drug screening, or the investigator's clinical judgment
- History of cancer malignancy within 2 years prior to the first visit, with the exception of basal cell skin carcinoma
- Have filed or plan to file a worker's compensation claim for any issue related to the current acute low back pain episode
- Currently involved in litigation or plan to seek legal recourse for any issue related to their acute low back pain
- Known allergies, hypersensitivity, or intolerance to tapentadol or the comparator (oxycodone) or any excipients used in their manufacture
- Had previously been enrolled in a tapentadol clinical study
- is pregnant or are breast-feeding
Trial locations and contacts
74 sites in 1 country.
74 sites in 1 country
United States74 sites
Study site
Akron, Ohio
Study site
Altoona, Pennsylvania
Study site
Andover, Ohio
Study site
Atco, New Jersey
Study site
Atlanta, Georgia
Study site
Austin, Texas
Study site
Avon, Indiana
Study site
Beavercreek, Ohio
Study site
Blackwood, New Jersey
Study site
Boynton Beach, Florida
Study site
Bryan, Texas
Study site
Bulverde, Texas
Study site
Centerville, Ohio
Study site
Charlotte, North Carolina
Study site
Cherry Hill, New Jersey
Study site
Cincinnati, Ohio
Study site
Clearwater, Florida
Study site
Clinton, Utah
Study site
Covington, Louisiana
Study site
Danville, Virginia
Study site
Denver, Colorado
Study site
Edgewater, Florida
Study site
Evansville, Indiana
Study site
Fairfield, Connecticut
Study site
Fall River, Massachusetts
Study site
Florissant, Missouri
Study site
Fresno, California
Study site
Garden Grove, California
Study site
Glendale, California
Study site
Henderson, Nevada
Study site
Hickory, North Carolina
Study site
Houston, Texas
Study site
Jacksonville, Florida
Study site
Jonesboro, Arkansas
Study site
Kalamazoo, Michigan
Study site
Laguna Hills, California
Study site
Lake Jackson, Texas
Study site
Lake Worth, Florida
Study site
Lexington, Kentucky
Study site
Mandeville, Louisiana
Study site
Marion, Ohio
Study site
Metairie, Louisiana
Study site
Miami, Florida
Study site
Mobile, Alabama
Study site
Mooresville, North Carolina
Study site
Murrells Inlet, South Carolina
Study site
Nashville, Tennessee
Study site
New Orleans, Louisiana
Study site
Newport Richey, Florida
Study site
North Dartmouth, Massachusetts
Study site
North Massapequa, New York
Study site
Oklahoma City, Oklahoma
Study site
Oldsmar, Florida
Study site
Orem, Utah
Study site
Overland Park, Kansas
Study site
Pahrump, Nevada
Study site
Palm Springs, California
Study site
Pembroke Pines, Florida
Study site
Phoenix, Arizona
Study site
Pismo Beach, California
Study site
Plano, Texas
Study site
Saint Cloud, Florida
Study site
San Antonio, Texas
Study site
Savannah, Georgia
Study site
Springfield, Missouri
Study site
Sugar Land, Texas
Study site
Sunset, Louisiana
Study site
Tampa, Florida
Study site
Tyrone, Pennsylvania
Study site
Washington, Missouri
Study site
West Palm Beach, Florida
Study site
Wildomar, California
Study site
Williamsville, New York
Study site
Winston-Salem, North Carolina
About this study
Official title: A Randomized, Double-Blind, Parallel-Group Study of NUCYNTA (Tapentadol) Immediate Release vs. Oxycodone Immediate Release for the Treatment of Acute Low Back Pain
Evaluate how NUCYNTA (tapentadol) immediate release (IR) compares with oxycodone IR in the treatment of acute low back pain.
Read the detailed description
This is a randomized, outpatient, multicenter, double-blind study (blinded to patient and to study doctor) comparing NUCYNTA to oxycodone IR in the treatment of patients with acute (new onset) low back pain who also have associated leg pain that radiates (travels down) below the knee. Patients will be screened for study eligibility at Visit 1. The study will be explained and informed consent will be obtained. Potential patients must satisfy all eligibility criteria to be enrolled in the study. Eligible candidates will proceed to the Double-Blind Treatment Phase. At the time of study entry, all prohibited medications will be discontinued and will be disallowed throughout the study. All patients will call into an interactive voice response system (IVRS) to complete a pain assessments twice daily throughout the study. Patients who discontinue early for any reason will be instructed to contact the study site to complete final assessments, prior to taking supplemental pain medication if applicable, and to schedule a final study visit. All patients will return to the study site on Day 5 (Visit 2) where they will be evaluated by study personnel and, as appropriate, continue with study treatment for an additional 5 days. Patients will return to the study site for the final visit on Day 10/End of Study (Visit 3) when they will have all final study assessments. The treatment duration will be up to 10 days. The sponsor will collect adverse events starting with the signing of the informed consent form. Adverse events will be reported by the subject for the duration of the study. Any clinically significant abnormalities persisting at the end of the study will be followed by the investigator until resolution or until a clinically stable endpoint is reached. Blood samples for serum chemistry and hematology and a urine sample for urinalysis will be collected. The investigator will review the laboratory report, document this review, and record any clinically relevant changes occurring during the study. The following tests will be performed by the central laboratory: Urine Pregnancy Testing for women of childbearing potential only, Urine Drug Screen, Vital Signs (pulse rate and blood pressure), Physical Examination, Neurological Examination, and Vomiting Assessment. The study will be conducted at approximately 80 sites in the United States (US). Patients will be randomized to one of the two following treatment groups: NUCYNTA 50, 75 or 100 mg every 4 to 6 hours up to 10 days as needed for pain. Oxycodone IR 5, 10 or 15 mg every 4 to 6 hours as needed for pain. Patients will begin treatment on Day 1 with one "lower dose" capsule of study drug (NUCYNTA 50 mg or oxycodone IR 5 mg). Subsequent dose adjustments will be made by study patients, as needed, to achieve a dose that provides a meaningful improvement in their pain intensity
- Conditions
- Pain, Back Pain, Low Back Pain, Back Pain With Radiation
- Being tested
- NUCYNTA, Oxycodone IR
- Keywords
- Acute Low Back Pain, Low Back Pain With Leg Pain Below The Knee, Radiculopathy, Oxycodone, Tapentadol, NUCYNTA
- Medical subject headings
- Pain, Back Pain, Low Back Pain, Radiculopathy
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
NUCYNTADrug
50, 75, or 100 mg every 4 to 6 hours for up to 10 days as needed for pain
Oxycodone IRDrug
5, 10, or 15 mg every 4 to 6 hours for up to 10 days as needed for pain
| Study group | Role | What they receive |
|---|---|---|
| 001 | Experimental | NUCYNTA 50 75 or 100 mg every 4 to 6 hours for up to 10 days as needed for pain Receives: Drug: NUCYNTA |
| 002 | Active comparator | Oxycodone IR 5 10 or 15 mg every 4 to 6 hours for up to 10 days as needed for pain Receives: Drug: Oxycodone IR |
What is being measured
The primary outcome is the main question the study is designed to answer.
Sum of Pain Intensity Difference (SPID) for Low Back Pain - Summary Statistics at 120 Hours (With Imputation)
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 120 hours.
Measured: 0 hour (prior to first dose) and 120 hours
Secondary outcomes (32)
Sum of Pain Intensity Difference (SPID) for Low Back Pain - Summary Statistics at 2 Days (With Imputation)
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 2 days.
Measured: Day 0 and Day 2
SPID for Low Back Pain - Summary Statistics at 3 Days (With Imputation)
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 3 days.
Measured: Day 0 and Day 3
SPID for Low Back Pain - Summary Statistics at 10 Days (With Imputation)
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 10 days.
Measured: Day 0 and Day 10
SPID for Index Leg Pain - Summary Statistics at 2 Days (With Imputation)
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 2 days.
Measured: Day 0 and Day 2
SPID for Index Leg Pain - Summary Statistics at 3 Days (With Imputation)
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 3 days.
Measured: Day 0 and Day 3
SPID for Index Leg Pain - Summary Statistics at 5 Days (With Imputation)
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 5 days.
Measured: Day 0 and Day 5
SPID for Index Leg Pain - Summary Statistics at 10 Days (With Imputation)
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 10 days.
Measured: Day 0 and Day 10
Total Pain Relief (TOTPAR) for Low Back Pain - Summary Statistics at 5 Days
Pain Relief - 5-Point Numerical Rating Scale, 0=None, 4=Complete. Total Pain Relief (TOTPAR) is a weighted sum of pain relieve over a specified time period, say 5 days.
Measured: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Continuous Pain Day 5
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). Subscale scores are calculated as the mean of the items in that subscale ranged from 0 to 10. Continuous pain subscale descriptors include: throbbing pain, cramping pain, gnawing pain, aching pain, heavy pain, and tender.
Measured: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Continuous Pain Day 10/Last Visit
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). Subscale scores are calculated as the mean of the items in that subscale ranged from 0 to 10. Continuous pain subscale descriptors include: throbbing pain, cramping pain, gnawing pain, aching pain, heavy pain, and tender.
Measured: Day 0 and Day 10
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Intermittent Pain Day 5
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). Subscale scores are calculated as the mean of the items in that subscale ranged from 0 to 10. Intermittent pain subscale descriptors include: shooting pain, stabbing pain, sharp pain, splitting pain, electric-shock pain, and piercing.
Measured: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Intermittent Pain Day 10/Last Visit
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). Subscale scores are calculated as the mean of the items in that subscale ranged from 0 to 10. Intermittent pain subscale descriptors include: shooting pain, stabbing pain, sharp pain, splitting pain, electric-shock pain, and piercing.
Measured: Day 0 and Day 10
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Neuropathic Pain Day 5
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). Subscale scores are calculated as the mean of the items in that subscale ranged from 0 to 10. Predominantly neuropathic pain subscale descriptors include: hot-burning pain, cold-freezing pain, pain caused by light touch, itching, tingling or "pins and needles" and numbness.
Measured: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Neuropathic Pain Day 10/Last Visit
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). Subscale scores are calculated as the mean of the items in that subscale ranged from 0 to 10. Predominantly neuropathic pain subscale descriptors include: hot-burning pain, cold-freezing pain, pain caused by light touch, itching, tingling or "pins and needles" and numbness.
Measured: Day 0 and Day 10
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Affective Descriptors Day 5
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). Subscale scores are calculated as the mean of the items in that subscale ranged from 0 to 10. Affective subscale descriptors include: tiring-exhausting, sickening, fearful, and punishing-cruel.
Measured: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Affective Descriptors Day 10/Last Visit
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). Subscale scores are calculated as the mean of the items in that subscale ranged from 0 to 10. Affective subscale descriptors include: tiring-exhausting, sickening, fearful, and punishing-cruel.
Measured: Day 0 and Day 10
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Total Score Day 5
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). The total SF-MPQ-2 scale score is calculated as the mean of all 22 items. The range of the total score is 0 to 10.
Measured: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Total Score Day 10/Last Visit
Short-Form McGill Pain Questionnaire - 2 (SF-MPQ-2) is a 22-question instrument. Each item lists different qualities of pain or related symptoms and is scored using an 11-point NRS ranging from (pain or symptom is not present) to 10 (worst possible pain). The total SF-MPQ-2 scale score is calculated as the mean of all 22 items. The range of the total score is 0 to 10.
Measured: Day 0 and Day 10
Patient Global Impression of Change at End of Study
Patient Global Impression of Change (PGIC) assesses the subject's global improvement since starting study treatment using a 7-point NRS (1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, 7=very much worse).
Measured: Day 0 and Day 10/last visit
Patient Global Impression of Change at End of Study
Patient Global Impression of Change (PGIC) assesses the subject's global improvement since starting study treatment using a 7-point NRS (1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, 7=very much worse).
Measured: Day 0 and Day 10/lst visit
Clinician Global Impression of Change at End of Study
Clinician Global Impression of Change (CGIC) assesses the subject's global improvement since starting study treatment using a 7-point NRS (1=very much improved, 2=much improved, 3=minimally improved, 4=no change, 5=minimally worse, 6=much worse, 7=very much worse).
Measured: Day 0 and Day 10/last visit
Satisfaction With Treatment at Day 5
The subject's satisfaction with treatment was assessed using a 7-point scale (1=Very satisfied, 2=Somewhat satisfied, 3=Slightly satisfied, 4=Neither satisfied nor dissatisfied, 5=Slightly dissatisfied, 6=Somewhat dissatisfied, 7=Very dissatisfied).
Measured: Day 0 and Day 5
Satisfaction With Treatment at End of Study
The subject's satisfaction with treatment was assessed using a 7-point scale (1=Very satisfied, 2=Somewhat satisfied, 3=Slightly satisfied, 4=Neither satisfied nor dissatisfied, 5=Slightly dissatisfied, 6=Somewhat dissatisfied, 7=Very dissatisfied).
Measured: Day 0 and Day 10/last visit
Incidence of 30% Responders Without Nausea or Vomiting at Day 5
Number of subjects had ≥ 30% reduction from baseline in low back pain intensity without nausea or vomiting reported.
Measured: Day 0 and Day 5
Incidence of 50% Responders Without Nausea or Vomiting at Day 5
Number of subjects had ≥ 50% reduction from baseline in low back pain intensity without nausea or vomiting reported.
Measured: Day 0 and Day 5
Summary of Treatment-Emergent Adverse Events Leading to Study Drug Discontinuation
Measured: Day 0 and Day 10/last visit
Summary of Subjects Having Nausea as a Treatment-Emergent Adverse Event
Number of subjects that reported nausea as a treatment-emergent adverse event during the study.
Measured: Day 0 and Day 10/last visit
Summary of Subjects Having Vomiting as a Treatment-Emergent Adverse Event
Number of subjects that reported vomiting as a treatment emergent adverse event during the study.
Measured: Day 0 and Day 10/last visit
Summary of Subjects Having Constipation as a Treatment-Emergent Adverse Event
Number of subjects that reported constipation as a treatment emergent adverse event during the study.
Measured: Day 0 and Day 10/last visit
Summary of Subjects Having Pruritus as a Treatment-Emergent Adverse Event
Number of subjects that reported pruritus as a treatment emergent adverse event during the study.
Measured: Day 0 and Day 10/last visit
Kaplan-Meier First Time to 30% Response From Baseline for Low Back Pain
30% response means >= 30% reduction from baseline in low back pain intensity score.
Measured: Day 0 and Day 10/last visit
Kaplan-Meier First Time to 50% Response From Baseline for Low Back Pain
50% response means >= 50% reduction from baseline in low back pain intensity score.
Measured: Day 0 and Day 10/last visit
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Sep 2009 (estimated)
- Study startSep 2009
- Primary completionDec 2010
- Study completionDec 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for PainStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 667 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ortho-McNeil Janssen Scientific Affairs, LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Grünenthal GmbH
- Responsible party
- Sponsor
- Investigators
- Ortho-McNeil Janssen Scientific Affairs, LLC Clinical Trial, Study director, Ortho-McNeil Janssen Scientific Affairs, LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00986180
- Sponsor's protocol ID
- CR015643
- Other IDs
- R331333PAI3025, KF5503/51
- Status last verified
- Dec 2012
- First submitted
- 25 Sep 2009
- Last updated
- 19 Dec 2012
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Publications
Biondi D, Xiang J, Benson C, Etropolski M, Moskovitz B, Rauschkolb C. Tapentadol immediate release versus oxycodone immediate release for treatment of acute low back pain. Pain Physician. 2013 May-Jun;16(3):E237-46.
PubMed 23703422
Study at a glance
From the registry record, last updated by the sponsor on 19 Dec 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-Blind, Parallel-Group Study of NUCYNTA (Tapentadol) Immediate Release vs. Oxycodone Immediate Release for the Treatment of Acute Low Back Pain
- ClinicalTrials.gov ID
- NCT00986180
- Acronym / sponsor ID
- CR015643
- Conditions
- Pain, Back Pain, Low Back Pain, Back Pain With Radiation
- Keywords
- Acute Low Back Pain, Low Back Pain With Leg Pain Below The Knee, Radiculopathy, Oxycodone, Tapentadol, NUCYNTA
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 667 participants (actual)
- Lead sponsor
- Ortho-McNeil Janssen Scientific Affairs, LLCIndustry (pharma, biotech, devices)
- Collaborators
- Grünenthal GmbH
- Study start
- Sep 2009
- Primary completion
- Dec 2010 (actual)
- Study completion
- Dec 2010 (actual)
- First posted
- 29 Sep 2009 (estimated)
- Results
- Posted 29 Feb 2012
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Evaluate how NUCYNTA (tapentadol) immediate release (IR) compares with oxycodone IR in the treatment of acute low back pain.
Detailed description
This is a randomized, outpatient, multicenter, double-blind study (blinded to patient and to study doctor) comparing NUCYNTA to oxycodone IR in the treatment of patients with acute (new onset) low back pain who also have associated leg pain that radiates (travels down) below the knee. Patients will be screened for study eligibility at Visit 1. The study will be explained and informed consent will be obtained. Potential patients must satisfy all eligibility criteria to be enrolled in the study. Eligible candidates will proceed to the Double-Blind Treatment Phase. At the time of study entry, all prohibited medications will be discontinued and will be disallowed throughout the study. All patients will call into an interactive voice response system (IVRS) to complete a pain assessments twice daily throughout the study. Patients who discontinue early for any reason will be instructed to contact the study site to complete final assessments, prior to taking supplemental pain medication if applicable, and to schedule a final study visit. All patients will return to the study site on Day 5 (Visit 2) where they will be evaluated by study personnel and, as appropriate, continue with study treatment for an additional 5 days. Patients will return to the study site for the final visit on Day 10/End of Study (Visit 3) when they will have all final study assessments. The treatment duration will be up to 10 days. The sponsor will collect adverse events starting with the signing of the informed consent form. Adverse events will be reported by the subject for the duration of the study. Any clinically significant abnormalities persisting at the end of the study will be followed by the investigator until resolution or until a clinically stable endpoint is reached. Blood samples for serum chemistry and hematology and a urine sample for urinalysis will be collected. The investigator will review the laboratory report, document this review, and record any clinically relevant changes occurring during the study. The following tests will be performed by the central laboratory: Urine Pregnancy Testing for women of childbearing potential only, Urine Drug Screen, Vital Signs (pulse rate and blood pressure), Physical Examination, Neurological Examination, and Vomiting Assessment. The study will be conducted at approximately 80 sites in the United States (US). Patients will be randomized to one of the two following treatment groups: NUCYNTA 50, 75 or 100 mg every 4 to 6 hours up to 10 days as needed for pain. Oxycodone IR 5, 10 or 15 mg every 4 to 6 hours as needed for pain. Patients will begin treatment on Day 1 with one "lower dose" capsule of study drug (NUCYNTA 50 mg or oxycodone IR 5 mg). Subsequent dose adjustments will be made by study patients, as needed, to achieve a dose that provides a meaningful improvement in their pain intensity
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 001 | Experimental | Drug: NUCYNTANUCYNTA 50 75 or 100 mg every 4 to 6 hours for up to 10 days as needed for pain |
| 002 | Active comparator | Drug: Oxycodone IROxycodone IR 5 10 or 15 mg every 4 to 6 hours for up to 10 days as needed for pain |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- At Visit 1 (study entry) patients must have a medical history and physical and neurological examinations that support a clinical diagnosis of acute low back pain that is felt down to the lower leg below the knee with the onset no longer than 30 days before Visit 1
- At Visit 1 patients must report qualifying pain intensity scores
- Patients must be appropriate candidates for treatment with oral opioid pain medication in the investigator's clinical judgment
- Patients must be able to appropriately verbalize pain characteristics and to complete all protocol required measurements/assessments without assistance
- Patients must be medically stable on the basis of physical examination, medical history, vital signs, and clinical laboratory tests performed at screening
Key exclusion criteria (16 listed)
- History of back (cervical, thoracic or lumbosacral) pain =50% of the time in the 1 year prior to the first visit
- History of any low back pain episode, with the exception of the current acute low back pain episode, within 3 months prior to the first visit that was greater than mild in pain intensity, or was associated with disability (e.g., loss of time from work, family, or activities of daily living), or necessitated the use of an opioid (narcotic) analgesic including tramadol
- Medical history or physical examination results that suggest the acute low back pain or any of the neurological symptoms or signs are caused by a serious medical condition (e.g., fever, chills, unexplained weight loss, bowel or urinary bladder dysfunction or incontinence, bilateral leg weakness, progressive weakness, paralysis)
- There is a high probability for surgical intervention for the back pain during the projected time on the study or that there will be an increase in the severity of the leg pain or deficits
- Had either a surgical procedure involving the spine or intervertebral discs in the lower back region within 1 year prior to Visit 1 or had >1 surgical procedure(s) involving the spine or intervertebral discs in the lower back region
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| NUCYNTA50, 75, or 100 mg every 4 to 6 hours for up to 10 days as needed for pain | Drug | 001 |
| Oxycodone IR5, 10, or 15 mg every 4 to 6 hours for up to 10 days as needed for pain | Drug | 002 |
Primary outcome
Sum of Pain Intensity Difference (SPID) for Low Back Pain - Summary Statistics at 120 Hours (With Imputation)
Time frame: 0 hour (prior to first dose) and 120 hours
Pain intensity is an 11-point numerical rating scale (NRS). 0=no pain, 10=Pain as bad as you can imagine. The pain intensity difference (PID) was to be calculated as baseline pain minus current pain at each assessment time point. SPID is a weighted sum of PID over a specified time period, say 120 hours.
32 secondary outcomes
Sum of Pain Intensity Difference (SPID) for Low Back Pain - Summary Statistics at 2 Days (With Imputation)
Time frame: Day 0 and Day 2
SPID for Low Back Pain - Summary Statistics at 3 Days (With Imputation)
Time frame: Day 0 and Day 3
SPID for Low Back Pain - Summary Statistics at 10 Days (With Imputation)
Time frame: Day 0 and Day 10
SPID for Index Leg Pain - Summary Statistics at 2 Days (With Imputation)
Time frame: Day 0 and Day 2
SPID for Index Leg Pain - Summary Statistics at 3 Days (With Imputation)
Time frame: Day 0 and Day 3
SPID for Index Leg Pain - Summary Statistics at 5 Days (With Imputation)
Time frame: Day 0 and Day 5
SPID for Index Leg Pain - Summary Statistics at 10 Days (With Imputation)
Time frame: Day 0 and Day 10
Total Pain Relief (TOTPAR) for Low Back Pain - Summary Statistics at 5 Days
Time frame: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Continuous Pain Day 5
Time frame: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Continuous Pain Day 10/Last Visit
Time frame: Day 0 and Day 10
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Intermittent Pain Day 5
Time frame: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Intermittent Pain Day 10/Last Visit
Time frame: Day 0 and Day 10
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Neuropathic Pain Day 5
Time frame: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Neuropathic Pain Day 10/Last Visit
Time frame: Day 0 and Day 10
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Affective Descriptors Day 5
Time frame: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Affective Descriptors Day 10/Last Visit
Time frame: Day 0 and Day 10
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Total Score Day 5
Time frame: Day 0 and Day 5
SF-MPQ-2 - Change From Baseline Values: Subscale and Total Scores - Total Score Day 10/Last Visit
Time frame: Day 0 and Day 10
Patient Global Impression of Change at End of Study
Time frame: Day 0 and Day 10/last visit
Patient Global Impression of Change at End of Study
Time frame: Day 0 and Day 10/lst visit
Clinician Global Impression of Change at End of Study
Time frame: Day 0 and Day 10/last visit
Satisfaction With Treatment at Day 5
Time frame: Day 0 and Day 5
Satisfaction With Treatment at End of Study
Time frame: Day 0 and Day 10/last visit
Incidence of 30% Responders Without Nausea or Vomiting at Day 5
Time frame: Day 0 and Day 5
Incidence of 50% Responders Without Nausea or Vomiting at Day 5
Time frame: Day 0 and Day 5
Summary of Treatment-Emergent Adverse Events Leading to Study Drug Discontinuation
Time frame: Day 0 and Day 10/last visit
Summary of Subjects Having Nausea as a Treatment-Emergent Adverse Event
Time frame: Day 0 and Day 10/last visit
Summary of Subjects Having Vomiting as a Treatment-Emergent Adverse Event
Time frame: Day 0 and Day 10/last visit
Summary of Subjects Having Constipation as a Treatment-Emergent Adverse Event
Time frame: Day 0 and Day 10/last visit
Summary of Subjects Having Pruritus as a Treatment-Emergent Adverse Event
Time frame: Day 0 and Day 10/last visit
Kaplan-Meier First Time to 30% Response From Baseline for Low Back Pain
Time frame: Day 0 and Day 10/last visit
Kaplan-Meier First Time to 50% Response From Baseline for Low Back Pain
Time frame: Day 0 and Day 10/last visit
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Dec 2012.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 23703422Biondi D, Xiang J, Benson C, Etropolski M, Moskovitz B, Rauschkolb C. Tapentadol immediate release versus oxycodone immediate release for treatment of acute low back pain. Pain Physician. 2013 May-Jun;16(3):E237-46.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ortho-McNeil Janssen Scientific Affairs, LLC Clinical Trial study director
Ortho-McNeil Janssen Scientific Affairs, LLC
74 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing NUCYNTA and Oxycodone IR in people with Pain and Back Pain, run by Ortho-McNeil Janssen Scientific Affairs, LLC at 74 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 19 Dec 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 74 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 29 Feb 2012). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Sum of Pain Intensity Difference (SPID) for Low Back Pain - Summary Statistics at 120 Hours (With Imputation) (time frame: 0 hour (prior to first dose) and 120 hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00986180, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Dec 2012.