Trial Outcomes & Findings for Evaluation of Effectiveness and Tolerability of Tapentadol Hydrochloride in Subjects With Severe Pain Due to Osteoarthritis Taking WHO Step III Analgesics But Showing a Lack of Tolerability. (NCT NCT00982280)

NCT ID: NCT00982280

Last Updated: 2019-10-18

Results Overview

Participants were considered responders if they reported the same or less average pain intensity over a 3 day period after 6 weeks of tapentadol PR treatment as with their previous analgesic treatment.

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

82 participants

Primary outcome timeframe

6 weeks

Results posted on

2019-10-18

Participant Flow

The enrollment of the first participant was on the 02 October 2009 and was prematurely terminated, due to slow recruitment, on 12 August 2010 (when the last subject completed the last follow-up examination).

The Trial had a duration of 13 weeks. The one week Observation Period did not involve dosing with Tapentadol. For Tapentadol analyses purposes the first 6 weeks of dosing with Tapentadol are reported as one period, Titration and Optimal Dose Period. The last 6 weeks on Tapentadol are reported as the Maintenance Period.

Participant milestones

Participant milestones
Measure
Tapentadol PR
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Observation Period
STARTED
82
Observation Period
COMPLETED
63
Observation Period
NOT COMPLETED
19
Titration and Optimal Dose Period
STARTED
63
Titration and Optimal Dose Period
COMPLETED
55
Titration and Optimal Dose Period
NOT COMPLETED
8
Maintenance Period
STARTED
55
Maintenance Period
COMPLETED
54
Maintenance Period
NOT COMPLETED
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Tapentadol PR
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Observation Period
Not eligible to be dosed
19
Titration and Optimal Dose Period
Adverse Event
5
Titration and Optimal Dose Period
Lack of Efficacy
2
Titration and Optimal Dose Period
Withdrawal by Subject
1
Maintenance Period
Adverse Event
1

Baseline Characteristics

Evaluation of Effectiveness and Tolerability of Tapentadol Hydrochloride in Subjects With Severe Pain Due to Osteoarthritis Taking WHO Step III Analgesics But Showing a Lack of Tolerability.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Tapentadol PR
n=63 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Age, Continuous
65.4 years
STANDARD_DEVIATION 9.84 • n=99 Participants
Sex: Female, Male
Female
37 Participants
n=99 Participants
Sex: Female, Male
Male
26 Participants
n=99 Participants
Region of Enrollment
Spain
4 participants
n=99 Participants
Region of Enrollment
Poland
16 participants
n=99 Participants
Region of Enrollment
Denmark
6 participants
n=99 Participants
Region of Enrollment
Australia
2 participants
n=99 Participants
Region of Enrollment
Germany
34 participants
n=99 Participants
Region of Enrollment
United Kingdom
1 participants
n=99 Participants

PRIMARY outcome

Timeframe: 6 weeks

Population: Per Protocol Set. Last Observation Carried Forward (LOCF).

Participants were considered responders if they reported the same or less average pain intensity over a 3 day period after 6 weeks of tapentadol PR treatment as with their previous analgesic treatment.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=53 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Responder Rate
50 Participants

SECONDARY outcome

Timeframe: Baseline

Population: Intention to Treat

For this pain assessment, the participant was to indicate the level of average pain experienced over the previous 3 days on an 11-point Numerical Rating Scale(NRS) where a score of 0 indicated "no pain" and a score of 10 indicated "pain as bad as you can imagine".

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=62 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Average Pain Intensity Before the Start of Tapentadol Treatment
4.7 units on a scale
Standard Deviation 0.66

SECONDARY outcome

Timeframe: Baseline; Week 6 (6 weeks)

Population: Intention to treat

For this pain assessment, the participant was to indicate the level of average pain experienced over the previous 3 days on an 11-point Numerical Rating Scale(NRS) where a score of 0 indicated "no pain" and a score of 10 indicated "pain as bad as you can imagine". The value indicates the change from the baseline value on the 0 to 10 scale. A Negative value indicates a reduction in pain intensity from the baseline average pain intensity.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=55 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Change in Average Pain Intensity After 6 Weeks of Tapentadol PR Treatment.
-2.2 Units on a scale
Standard Deviation 1.55

SECONDARY outcome

Timeframe: Baseline; Week 12 (12 weeks)

Population: Intention to treat (ITT)

For this pain assessment, the participant was to indicate the level of average pain experienced over the previous 3 days on an 11-point Numerical Rating Scale(NRS) where a score of 0 indicated "no pain" and a score of 10 indicated "pain as bad as you can imagine". The value indicates the change from the baseline value on the 0 to 10 scale. A Negative value indicates a reduction in pain intensity from the baseline average pain intensity.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=32 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Change in Average Pain Intensity After 12 Weeks of Tapentadol PR Treatment.
-2.7 Units on a scale
Standard Deviation 1.26

SECONDARY outcome

Timeframe: Baseline

Population: Intention to treat (ITT).

Western Ontario McMaster Questionnaire (WOMAC) Global Score: WOMAC is measured with a Likert ordinal scale (the participant gives one of 5 possible answers) A higher score indicate that a symptom is bothersome or disabling. The WOMAC is a self-administered questionnaire and has 24 questions: Pain, Stiffness and Physical Function. The possible scores range from 0-20 for pain, 0-8 for stiffness, 0-68 for physical function and these are then summed 0-96 for the global score. A lower score indicates a lower level of symptoms and or disability.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=62 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Baseline Western Ontario McMaster Questionnaire (WOMAC) Global Score Assessing Pain, Disability and Joint Stiffness of the Knee
54.2 Units on a scale
Standard Deviation 13.19

SECONDARY outcome

Timeframe: 6 weeks

Population: Intention to treat (ITT).

The WOMAC is a self-administered questionnaire and has 24 questions: Pain, Stiffness and Physical Function. The possible scores range from 0-20 for pain, 0-8 for stiffness, 0-68 for physical function and these are then summed 0-96 for the global score. The negative value indicates that there has been an improvement since baseline, the higher the value the greater the change since baseline.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=55 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Change From Baseline in the Western Ontario McMaster Questionnaire (WOMAC) Global Score Assessing Pain, Disability and Joint Stiffness of the Knee Over the Last Week at Week 6
-24.5 Units on a scale
Standard Deviation 18.40

SECONDARY outcome

Timeframe: 12 weeks

Population: Intention to treat (ITT).

The WOMAC is a self-administered questionnaire and has 24 questions: Pain, Stiffness and Physical Function. The possible scores range from 0-20 for pain, 0-8 for stiffness, 0-68 for physical function and these are then summed 0-96 for the global score. The negative value indicates that there has been an improvement since baseline, the higher the value the greater the change since baseline.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=32 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Change From Baseline in the Western Ontario McMaster Questionnaire (WOMAC) Global Score Assessing Pain, Disability and Joint Stiffness of the Knee Over the Last Week at Week 12
-25.1 Units on a scale
Standard Deviation 16.10

SECONDARY outcome

Timeframe: 6 weeks

Population: Intention to treat (ITT).

The participant scored the EuroQol-5. This is a five dimensional health state classification. Each dimension is assessed on a 3-point ordinal scale (1=no problems, 2=some problems, 3=extreme problems). The responses to the five EQ-5D dimensions were scored using a utility-weighted algorithm to derive an EQ-5D health status index score between 0 to 1, with 1.00 indicating "full health" and 0 representing dead. The positive values indicate that during the study the health status improved.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=55 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
EuroQol-5 (EQ-5D) Health Status Index Outcome Over Time
0.201 Units on a scale
Standard Deviation 0.288

SECONDARY outcome

Timeframe: 12 weeks

Population: Intention to treat (ITT).

The participant scored the EuroQol-5. This is a five dimensional health state classification. Each dimension is assessed on a 3-point ordinal scale (1=no problems, 2=some problems, 3=extreme problems). The responses to the five EQ-5D dimensions were scored using a utility-weighted algorithm to derive an EQ-5D health status index score between 0 to 1, with 1.00 indicating "full health" and 0 representing dead. The positive values indicate that during the study the health status improved.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=32 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
EuroQol-5 (EQ-5D) Health Status Index Outcome Over Time
0.155 Units on a scale
Standard Deviation 0.291

SECONDARY outcome

Timeframe: 6 Weeks

Population: Intention to treat (ITT)

EuroQoL-5D Health State Visual Analog Scale (VAS) is a participant rated questionnaire to assess health-related quality of life in terms of a single index value. The VAS component rates current health state on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state); higher scores indicate a better health state. The values indicated represent the change from the baseline, a positive value indicates an improvement.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=55 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Change in Health Related Quality of Life: EuroQol-5D Health State Visual Analog Scale (VAS)
29.6 Units on a scale
Standard Deviation 15.3

SECONDARY outcome

Timeframe: 12 Weeks

Population: Intention to treat (ITT)

EuroQoL-5D Health State Visual Analog Scale (VAS) is a participant rated questionnaire to assess health-related quality of life in terms of a single index value. The VAS component rates current health state on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state); higher scores indicate a better health state. The values indicated represent the change from the baseline, a positive value indicates an improvement.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=32 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Change in Health Related Quality of Life: EuroQol-5D Health State Visual Analog Scale (VAS)
34.6 Units on a scale
Standard Deviation 17.9

SECONDARY outcome

Timeframe: Baseline; End of Week 6 (6 Weeks)

Population: Intention to treat (ITT).

In the Clinical Global Impression of Change (CGIC) the clinician indicates the perceived change over the treatment period. The clinician is requested to choose one of seven categories. Scores range from very much improved to very much worse.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=55 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Clinical Global Impression of Change
Very much improved
6 participants
Clinical Global Impression of Change
Much improved
28 participants
Clinical Global Impression of Change
Minimally improved
18 participants
Clinical Global Impression of Change
No change
1 participants
Clinical Global Impression of Change
Minimally worse
2 participants
Clinical Global Impression of Change
Much worse
0 participants
Clinical Global Impression of Change
Very much worse
0 participants

SECONDARY outcome

Timeframe: Baseline; End of Week 12 (12 Weeks)

Population: Intention to treat (ITT).

In the Clinical Global Impression of Change (CGIC) the clinician indicates the perceived change over the treatment period. The clinician is requested to choose one of seven categories. Scores range from very much improved to very much worse.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=32 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Clinical Global Impression of Change
Very much improved
3 participants
Clinical Global Impression of Change
Much improved
17 participants
Clinical Global Impression of Change
Minimally improved
11 participants
Clinical Global Impression of Change
No change
1 participants
Clinical Global Impression of Change
Minimally worse
0 participants
Clinical Global Impression of Change
Much worse
0 participants
Clinical Global Impression of Change
Very much worse
0 participants

SECONDARY outcome

Timeframe: Baseline; End of Week 6 (6 Weeks)

Population: Intention to treat (ITT).

In the Patient Global Impression of Change (PGIC) the participant indicates the perceived change over the treatment period. The participant is requested to choose one of seven categories. Scores range from very much improved to very much worse.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=55 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Patient Global Impression of Change
Very much worse
0 participants
Patient Global Impression of Change
Very much improved
6 participants
Patient Global Impression of Change
Much improved
28 participants
Patient Global Impression of Change
Minimally improved
18 participants
Patient Global Impression of Change
No change
1 participants
Patient Global Impression of Change
Minimally worse
2 participants
Patient Global Impression of Change
Much worse
0 participants

SECONDARY outcome

Timeframe: Baseline; End of Week 12 (12 Weeks)

Population: Intention to treat (ITT).

In the Patient Global Impression of Change (PGIC) the participant indicates the perceived change over the treatment period. The participant is requested to choose one of seven categories. Scores range from very much improved to very much worse.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=32 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Patient Global Impression of Change
Very much improved
3 participants
Patient Global Impression of Change
Much improved
17 participants
Patient Global Impression of Change
Minimally improved
11 participants
Patient Global Impression of Change
No change
1 participants
Patient Global Impression of Change
Minimally worse
0 participants
Patient Global Impression of Change
Much worse
0 participants
Patient Global Impression of Change
Very much worse
0 participants

SECONDARY outcome

Timeframe: Baseline

Population: Intention to treat (ITT).

Participants were requested to rate their previous analgesic medication on a 5-point scale. Previous medication was rated as excellent, very good, good, fair and poor.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=62 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Participant's Satisfaction With Previous Analgesic Treatment.
Excellent
0 participants
Participant's Satisfaction With Previous Analgesic Treatment.
Very Good
0 participants
Participant's Satisfaction With Previous Analgesic Treatment.
Good
1 participants
Participant's Satisfaction With Previous Analgesic Treatment.
Fair
46 participants
Participant's Satisfaction With Previous Analgesic Treatment.
Poor
15 participants

SECONDARY outcome

Timeframe: After 6 weeks

Population: Intention to treat (ITT).

Participants were requested to rate their tapentadol (new) analgesic medication on a 5-point scale. The medication was rated as excellent, very good, good, fair and poor.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=55 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Excellent
3 participants
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Very Good
27 participants
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Good
21 participants
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Fair
4 participants
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Poor
0 participants

SECONDARY outcome

Timeframe: After 12 weeks

Population: Intention to treat (ITT).

Participants were requested to rate their tapentadol (new) analgesic medication on a 5-point scale. The medication was rated as excellent, very good, good, fair and poor.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=32 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Excellent
3 participants
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Very Good
16 participants
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Good
12 participants
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Fair
1 participants
Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.
Poor
0 participants

SECONDARY outcome

Timeframe: Baseline; End of Week 6 (6 Weeks)

Population: Intention to treat (ITT). 48 participants with previous transdermal buprenorphine treatment.

Tapentadol was compared to Transdermal Buprenorphine with Buprenorphine set to 1. The average total daily dose of Tapentadol at which a pain score equivalent or below to the pain score at the end of observation period under Transdermal Buprenorphine was reached was documented as the equipotent or equianalgesic dose to the total daily dose of the previously used Transdermal Buprenorphine.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=48 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Mean Equipotency Ratio of Tapentadol Compared to Buprenorphine
281.1 Ratio

SECONDARY outcome

Timeframe: Baseline; End of Week 6 (6 Weeks)

Population: Intention to treat (ITT). 6 participants with previous oxycodone treatment.

Tapentadol was compared to Oxycodone with Oxycodone set to 1. The average total daily dose of Tapentadol at which a pain score equivalent or below to the pain score at the end of observation period under Oxycodone was reached was documented as the equipotent or equianalgesic dose to the total daily dose of the previously used Oxycodone.

Outcome measures

Outcome measures
Measure
Tapentadol PR
n=6 Participants
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Mean Equipotency Ratio of Tapentadol Compared to Oxycodone
4.6 Ratio

Adverse Events

Tapentadol PR

Serious events: 2 serious events
Other events: 21 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Tapentadol PR
n=63 participants at risk
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Gastrointestinal disorders
Abdominal pain
1.6%
1/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
Gastrointestinal disorders
Dysphagia
1.6%
1/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
General disorders
Chest pain
1.6%
1/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
Nervous system disorders
Transient ischaemic attack
1.6%
1/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
Renal and urinary disorders
Renal pain
1.6%
1/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.

Other adverse events

Other adverse events
Measure
Tapentadol PR
n=63 participants at risk
All participants started with either 50 mg, 100 mg or 150 mg tapentadol hydrochloride PR (twice daily). The dose of tapentadol hydrochloride PR was adjusted to a level that provided adequate analgesia (upwards or downwards on a weekly basis as needed). After 5 weeks the doses of tapentadol hydrochloride PR was kept stable. Participants were permitted a maximum dose of 250 mg twice a day (500 mg total daily dose). Tapentadol hydrochloride IR 50 mg (no more than twice daily; at least 4 hours apart) was considered as medication for acute pain episodes however, participants were not permitted to dose tapentadol hydrochloride IR once 500 mg tapentadol hydrochloride PR dose was reached.
Gastrointestinal disorders
Constipation
6.3%
4/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
Gastrointestinal disorders
Diarrhoea
12.7%
8/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
General disorders
Drug Withdrawal Syndrome
6.3%
4/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
General disorders
Fatigue
6.3%
4/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
Nervous system disorders
Dizziness
7.9%
5/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
Skin and subcutaneous tissue disorders
Hyperhidrosis
6.3%
4/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.
Gastrointestinal disorders
Nausea
11.1%
7/63 • In total subjects were to be treated for up to 12 weeks with tapentadol.

Additional Information

Dr. Ilona Steigerwald

Grünenthal GmbH

Phone: +49 241 569 0

Results disclosure agreements

  • Principal investigator is a sponsor employee Grünenthal reserves the right to review any publication pertaining to the trial before it is submitted for publication. Neither party has the right to prohibit publication unless publication can be shown to affect possible patent rights.
  • Publication restrictions are in place

Restriction type: OTHER