AzTrials
AzTrials

Stomach NeoplasmsPhase 4NCT07687394

A Phase IV Randomized Trial of Maxigesic® Versus Standard Analgesia After Radical Gastrectomy

A Phase 4 study testing Acetaminophen (Newaminophen Premix) and Maxigesic IV (acetaminophen/ibuprofen) in people with Stomach Neoplasms and Pain, run by Yonsei University.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Background: Radical gastrectomy causes moderate-to-severe pain during the first 48 hours after surgery. Opioids are effective but carry adverse effects and risks of prolonged use, so ERAS-based care recommends multimodal analgesia. Read more about this study

Who is it for?
Ages 20 to 80 years
Conditions the study is for
Stomach Neoplasms, Pain, Postoperative
What is being tested?
Acetaminophen (Newaminophen Premix) and Maxigesic IV (acetaminophen/ibuprofen)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
160 participants
Where
No sites listed yet
Study dates
1 Jul 2026to 31 Dec 2028
Phase
Phase 4
Are there results?
Not yet: the study is under way

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 20 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients aged 20 to 80 years diagnosed with gastric cancer by endoscopic biopsy who are scheduled for minimally invasive radical gastrectomy (laparoscopic or robotic)
  • Patients scheduled for distal, proximal, or total gastrectomy among minimally invasive procedures (wedge resection, pylorus-preserving gastrectomy, and segmental gastrectomy are not eligible)
  • Patients with an ECOG performance status of 0 or 1 and an ASA classification of I-III
  • Patients who have voluntarily agreed to participate after receiving a full explanation of the study's purpose and content, and who have signed the written informed consent form approved by the Institutional Review Board
  • Patients residing in Korea who are able to complete follow-up for 3 months after surgery

Who cannot join

  • Patients with a reported history of hypersensitivity, allergy, or adverse reaction to NSAIDs, opioids, or acetaminophen
  • Patients currently taking medications that may affect the study results, such as opioid or non-opioid analgesics, aspirin, warfarin or other anticoagulants, steroids, or high-dose hepatotoxic drugs
  • Pregnant or breastfeeding patients
  • Patients with a contraindication to NSAIDs or acetaminophen identified from medical history or preoperative evaluation-for example, active liver disease, heart failure, chronic kidney disease, thrombocytopenia, or a history of asthma (peptic ulcer disease is not an exclusion criterion)
  • Patients unable to read or understand the informed consent form
  • Patients weighing less than 45 kg
  • Patients scheduled for transfer to the intensive care unit instead of a general ward after surgery (ICU preparation)
  • Patients scheduled for emergency surgery

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Hyoung-Il Kim, Professor contact

+82-2-2228-2100

cairus@yuhs.ac

About this study

Official title: A Phase IV, Multicenter, Double-blind, Randomized Controlled Trial to Evaluate the Superiority of Maxigesic® Over Standard Analgesia in Patients Undergoing Radical Gastrectomy

Background: Radical gastrectomy causes moderate-to-severe pain during the first 48 hours after surgery. Opioids are effective but carry adverse effects and risks of prolonged use, so ERAS-based care recommends multimodal analgesia. Acetaminophen is the most commonly used non-opioid analgesic in gastrectomy patients; adding ibuprofen as a fixed-dose combination has shown improved analgesia and opioid-sparing effects compared with acetaminophen alone in other surgical populations, but direct evidence in gastrectomy patients is limited.

Objective: To evaluate whether scheduled administration of an acetaminophen-ibuprofen fixed-dose combination (Maxigesic® IV) is superior to acetaminophen alone for pain relief after radical gastrectomy, with exploratory assessment of cost-effectiveness and of differences in analgesic efficacy according to genetic polymorphisms.

Read more

Hypothesis: When given on an identical scheduled regimen, the acetaminophen-ibuprofen fixed-dose combination produces significantly lower pain scores (NRS) over the first 48 postoperative hours than acetaminophen alone (superiority).

Study plan: This is a phase IV, multicenter, double-blind, randomized controlled trial in which 160 gastric cancer patients scheduled for minimally invasive radical gastrectomy (80 per arm) are randomized 1:1 with stratification by institution. In both arms, the assigned drug is given as a 15-minute intravenous infusion every 6 hours, starting 30 minutes before the end of surgery through 48 hours postoperatively. The primary endpoint is the between-group difference in the time-weighted average (TWA) of repeatedly measured resting and active NRS over 48 hours, analyzed using a mixed model for repeated measures (MMRM); secondary endpoints include opioid consumption (MME), the Quality of Recovery score (QoR-15K), the incidence of chronic postsurgical pain (CPSP), and in-hospital costs.

Read the detailed description

This is a phase IV, multicenter, double-blind, randomized controlled trial conducted at four Yonsei University-affiliated hospitals in the Republic of Korea (Severance, Gangnam Severance, Wonju Severance, and Yongin Severance Hospitals). A total of 160 patients with gastric cancer scheduled for minimally invasive (laparoscopic or robotic) radical gastrectomy are randomized 1:1 to the experimental arm (acetaminophen-ibuprofen fixed-dose combination, Maxigesic IV) or the active comparator arm (acetaminophen alone, Newaminophen Premix). Randomization uses a stratified block design with the participating institution as the stratification factor, and allocation is concealed through a web-based system using a sequence generated by an independent statistician.

To maintain double blinding, study drugs are prepared by an unblinded research pharmacist in a separate area and dispensed in containers masked with opaque labels, so that participants, care providers, and outcome assessors remain unaware of the allocation.

In both arms, the assigned study drug is administered as a 15-minute intravenous infusion every 6 hours, beginning 30 minutes before the end of surgery and continuing through 48 hours after surgery (9 doses in total), with the total daily acetaminophen dose not exceeding 4 g. For breakthrough pain, a standardized stepwise rescue protocol (tramadol followed by pethidine) is applied without altering the scheduled study-drug regimen, and fever requiring an antipyretic is managed with ibuprofen. The two arms are identical except for the addition of ibuprofen in the experimental arm.

Pain intensity is assessed using the 11-point Numerical Rating Scale at rest and on movement at predefined time points over the first 72 hours after surgery. Additional assessments include opioid consumption (morphine milligram equivalents), the Korean Quality of Recovery score (QoR-15K), in-hospital costs, and chronic postsurgical pain at 3 months measured with the Brief Pain Inventory-Korean (BPI-K). Safety is evaluated by postoperative complications (Clavien-Dindo classification), adverse drug reactions, and liver enzyme elevation.

As exploratory analyses, an economic evaluation and a pharmacogenomic analysis are performed. No biospecimen is collected in this study. The pharmacogenomic analysis is conducted only in the subset of participants who are also enrolled in the National Bio Big Data Project, a separate national genomic study; for these participants, whole-genome sequencing data generated by that project are used-under that project's own consent and governance framework-to explore whether genetic polymorphisms are associated with differences in analgesic efficacy.

The primary efficacy analysis is performed in the full analysis set, with the per-protocol set used for sensitivity analysis. The treatment effect on the primary outcome is evaluated as the between-group difference in the time-weighted average of NRS over 0-48 hours, estimated using a mixed model for repeated measures, with a covariate-adjusted linear mixed model as a supportive analysis. A Data Safety Monitoring Board reviews safety and data validity, and an interim analysis for safety and futility is conducted when 50% of the target participants have completed 72-hour follow-up. A two-sided significance level of 0.05 is applied.

Being tested
Acetaminophen (Newaminophen Premix), Maxigesic IV (acetaminophen/ibuprofen)
Keywords
Gastrectomy
Medical subject headings
Stomach Neoplasms, Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Acetaminophen (Newaminophen Premix)Drug

    As an active comparator, Newaminophen Premix 100 mL will be administered by 15-minute intravenous infusion every 6 hours during the first 48 hours after surgery.

  • Maxigesic IV (acetaminophen/ibuprofen)Drug

    Maxigesic 100 mL will be administered as a 15-minute intravenous infusion every 6 hours for the first 48 hours after surgery

Study groups in NCT07687394
Study groupRoleWhat they receive
AcetaminophenActive comparatorParticipants receive acetaminophen alone (Newaminophen Premix, acetaminophen 1000 mg per 100 mL) as a 15-minute intravenous infusion every 6 hours, starting 30 minutes before the end of surgery and continuing through 48 hours after surgery (9 doses in total). The total daily acetaminophen dose does not exceed 4 g.
Receives: Drug: Acetaminophen (Newaminophen Premix)
MaxigesicExperimentalParticipants receive the acetaminophen-ibuprofen fixed-dose combination (Maxigesic IV, acetaminophen 1000 mg + ibuprofen 300 mg per 100 mL) on the same schedule as the comparator arm: a 15-minute intravenous infusion every 6 hours, starting 30 minutes before the end of surgery and continuing through 48 hours after surgery (9 doses in total). The total daily acetaminophen dose does not exceed 4 g.
Receives: Drug: Maxigesic IV (acetaminophen/ibuprofen)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Postoperative pain intensity (NRS)

    The primary endpoint is the between-group difference in postoperative pain intensity, measured with the 11-point Numerical Rating Scale (NRS; 0 = no pain, 10 = worst pain imaginable). Pain is assessed both at rest and on movement and is measured repeatedly over the first 48 hours after surgery (at rest from 0 to 48 hours; on movement from 6 to 48 hours). The treatment effect is evaluated as the between-group difference in the time-weighted average (TWA) of NRS over 0-48 hours, estimated using a mixed model for repeated measures (MMRM). A linear mixed model adjusting for covariates (e.g., extent of gastric resection) is performed as a supportive analysis to confirm the consistency of the results.

    Measured: At rest - 0 (immediately postoperatively), 2, 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after surgery; on movement - 6, 12, 18, 24, 30, 36, 42, and 48 hours after surgery

Secondary outcomes (5)
  1. Total opioid consumption

    Total opioid consumption through 72 hours after surgery, expressed as morphine milligram equivalents (MME)

    Measured: From the day of operation (day 0) to 72 hours after surgery

  2. Change in Quality of Recovery (QoR-15K)

    Change in the Korean version of the 15-item Quality of Recovery questionnaire (QoR-15K) from baseline.

    Measured: Preoperative, 24 hours aftery surgery, 48 hours after surgery, 72 hours after surgery

  3. Incidence of chronic postsurgical pain (CPSP)

    Proportion of patients with chronic postsurgical pain, assessed using the Brief Pain Inventory-Korean (BPI-K).

    Measured: At 3 months after surgery (±14 days)

  4. (exploratory analysis) In-hospital cost

    Total medical costs incurred during the hospital stay, compared between groups.

    Measured: Through discharge, an average of 5 days

  5. (exploratory analysis) Difference in analgesic efficacy according to genetic polymorphisms

    NRS scores of the experimental group accordnig to CYP gene polymorphism. Exploratory analysis, performed only in participants who are co-enrolled in the National Bio Big Data Project.

    Measured: Genetic polymorphism assessed preoperatively. NRS scores measured through 72 hours after surgery.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Jul 2026
  2. Study start1 Jul 2026 (estimated)
  3. Primary completion1 Oct 2028 (estimated)
  4. Study completion31 Dec 2028 (estimated)

Resources

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 4
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
160 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07687394
Sponsor's protocol ID
4-2026-0528
Status last verified
Jun 2026
First submitted
18 Jun 2026
Last updated
7 Jul 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified individual participant data underlying the published results (primary and secondary clinical outcomes) will be made available to qualified researchers whose proposal is approved by the principal investigator and the Institutional Review Board. Data will be available beginning 12 months after publication of the main results, with no specified end date, under a signed data-use agreement. The study protocol and statistical analysis plan may also be shared on request. Genomic (whole-genome sequencing) data will not be shared owing to re-identification risk and consent and regulatory constraints.

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Acetaminophen (Newaminophen Premix) and Maxigesic IV (acetaminophen/ibuprofen) in people with Stomach Neoplasms and Pain, run by Yonsei University.

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 8 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: opening soon, as of the sponsor's last update on 7 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Hyoung-Il Kim, Professor (+82-2-2228-2100, cairus@yuhs.ac), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Postoperative pain intensity (NRS) (time frame: At rest - 0 (immediately postoperatively), 2, 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after surgery; on movement - 6, 12, 18, 24, 30, 36, 42, and 48 hours after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 7 Jul 2026.

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