The aim of the present study is to assess the efficacy and safety of paracetamol/ibuprofen Fixed Dose Combination (FDC) compared to ibuprofen in patients with uncomplicated non-specific acute low back pain after a 3-day treatment period.
This is a Phase IV, multicenter, international, open-label, parallel-group study. The study will be conducted at sites located in Italy, Poland and Hungary. The sites will be outpatient facilities and hospitals. A total of 176 patients are planned to be included in the study This trial will be conducted in accordance with the study protocol, GCPs, Declaration of Helsinki (including up-to-date versions) and applicable regulatory requirements. The present clinical trial aims to evaluate the efficacy and safety of the combination of 2 tablets of paracetamol 500 mg/ibuprofen 150 mg administered 3 times daily, in the management of patients with acute non-specific Low Back Pain (LBP) condition.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
176
Università degli Studi della Campania "Luigi Vanvitelli"
Caserta, CE, Italy
Azienda Ospedaliera Universitaria Policlinico G.Rodolico
Catania, Italy
Azienda Ospedaliera Universitaria Integrata di Verona
Verona, Italy
The primary endpoint will be the area under the pain intensity difference-versus-time curve of Low Back Pain scores up to 3 days of treatment
The pain intensity difference will be considered to be the difference in VAS pain intensity between one time-point and the baseline. The sum of the pain intensity differences (SPID) will be the sum of the average of two consecutive pain intensity differences multiplied by the time-interval between two time points.
Time frame: From Day 1 up to Day 3 (±1)
Change in Visual Analogue Scale 0-10 cm (100 mm)
Change in Visual Analogue Scale score at baseline (Visit 0) and at the end of study (Visit 2).The Visual Analogue Scale consists of a continuous horizontal line of 10 cm (100 mm) in length, on a piece of paper, with ends labelled as the extremes of pain, from 0 (left side): "no pain", to 10 (right side): "pain as bad as it could be". Patients will be asked to place a line with a pen perpendicular to the VAS line and intersecting the VAS line at the point that represents their current pain intensity.
Time frame: Day 0 and Day 8 (±1)
Change from baseline up to the end of the study in Visual Analogue Scale 0-10 cm (100 mm) score.
Change from baseline up to the end of the study in VAS score, assessed at baseline (Visit 0) and Visit 2, and daily recorded in the patient diary during the whole home-stay period
Time frame: From Day 0 to Day 8 (±1)
Change from baseline up to the end of the study in the hand-to-floor distance
Change from baseline up to the end of the study in the hand-to-floor distance assessed at Visits 0, 1 and 2, measured by a cm graduated bar. The Hand-to-floor-distance, also called fingertip-to-floor test or mobility assessment, is a test to evaluate the mobility of both the whole spine and the pelvis in the overall motion of bending forward. The Investigator will ask the patient to stay erect on a platform 20-cm high with shoes removed and feet together. The patient will be asked to bend forward as far as possible and try to touch the floor with his/her fingers, while maintaining the knees, arms, and fingers fully extended. The vertical distance between the tip of the middle finger and the platform will be measured through a simple cm graduated bar (0 value at floor). The vertical distance between the platform and tip of the middle finger is positive when the subject does not reach the platform and negative when he/she can go further.
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In-Vivo sp z o. o.
Bydgoszcz, Poland
Przychodnia "Przy Szapitalu"
Bydgoszcz, Poland
Zespół Porani Specjalistycznych Reumed Filia nr 1 Wallenroda
Lublin, Poland
Centrum Medyczne Pratia Poznan
Skorzewo, Poland
Nasz Lekarz Przychodnie Medyczne
Torun, Poland
Centrum Medyczne AstiMed
Warsaw, Poland
Centrum Medyczne PRATIA
Warsaw, Poland
...and 1 more locations
Time frame: Day 0, Day 4 and Day 8 (±1)
Change from baseline up to the end of the study in the in the degree of improvement in the functional disability
Change from baseline up to the end of the study in the in the degree of improvement in the functional disability, assessed at Visits 0, 1 and 2, measured by the Oswestry Disability Index (ODI). The Oswestry Disability Indexcontains 10 sections: (1) pain intensity, (2) personal care (washing/dressing), (3) lifting, (4) walking, (5) sitting, (6) standing, (7) sleeping, (8) sex life (if applicable), (9) social life, (10) travelling. Each section contains six statements that are scored from 0 (minimum degree of difficulty in that activity) to 5 (maximum degree of difficulty): if the first statement is marked, the section score is=0; if the last statement is marked, it is=5. The total score is the Oswestry Disability Index score and is obtained by summing up the scores of all sections, giving a maximum of 50 points. The final score is expressed as a percentage with the following formula: (total score/ (5 × number of questions answered) × 100%.
Time frame: Day 0, Day 4 and Day 8 (±1)
Change in the patients' global impression
Change in the patients' global impression at Visits 1 and 2, measured by the Patients' Global Impression of Change (PGIC) scale.The patient will give the evaluation about his/her rating of overall improvement (if any) relative to a baseline state at the beginning of the treatment, according to the PGIC 7-point scale (Hurst and Bolton, 2004): 1. No change (or condition has got worse) 2. Almost the same, hardly any change at all 3. A little better, but no noticeable change 4. Somewhat better, but the change has not made any real difference 5. Moderately better and a slight but noticeable change 6. Better and a definite improvement that has made a real and worthwhile difference 7. A great deal better and a considerable improvement that has made all the difference
Time frame: Day 4 and Day 8 (±1)
Change in the clinical global impression
Change in the clinical global impression at Visits 1 and 2, measured by the Clinical Global Impression-Improvement (CGI-I) scale. The Clinical Global Impression-Improvement (CGI-I) scale provides an overall clinician-determined summary evaluation of the treatment. the results in the appropriate source documents and on eCRF. The Investigator will assign a score based on how much the patient's illness has improved or worsened relative to a baseline state at the beginning of the treatment, according to the following 7-point scale (Guy, 1976): 1. Very much improved since the initiation of treatment 2. Much improved 3. Minimally improved 4. No change from the initiation of treatment 5. Minimally worse 6. Much worse 7. Very much worse since the initiation of treatment
Time frame: Day 4 and Day 8 (±1)
Monitoring the frequency of adverse events
Safety will be assessed by monitoring the frequency of adverse events in each treatment group. AEs will be summarized using the total number of AEs, the total number and percentage of patients who experienced an AE, and the number and percentage of patients who experienced an AE within each System Organ Class (SOC) and by preferred term.
Time frame: 8 (±1) days