Controlled phase III clinical trial of diclofenac potassium liquid-filled soft gelatin capsule for treatment of postoperative dental pain.
OBJECTIVE
The purpose of the present study was to assess the safety and efficacy of oral diclofenac potassium liquid-filled soft gelatin capsule (DPSGC) that uses ProSorb dispersion technology (Xanodyne Pharmaceuticals, Inc, licensed from AAIPharma, Wilmington, NC), to treat adult patients with acute pain after third molar extraction.


METHODS
In the present multicenter, randomized, double-blind, placebo-controlled trial, patients experiencing a baseline level of pain (≥ 50 mm on a 100-mm visual analog scale within 4 hours after surgery) were randomized to receive a single dose of DPSGC at 25, 50, or 100 mg or placebo. Pain intensity and relief were assessed for 6 hours after dosing. The efficacy endpoints included the summed pain intensity difference, total pain relief, and the median time to the onset of perceptible and meaningful pain relief (using the 2-stopwatch method).


RESULTS
A total of 249 randomized patients had a significant increase in the summed pain intensity difference and total pain relief values at 3 and 6 hours across all DPSGC-treated groups compared with the placebo group (P < .0001). The onset of perceptible and meaningful pain relief was significantly faster in all DPSGC groups than in the placebo group, including the DPSGC 25-mg group (25 minutes [P = .0002] and 52 minutes [P < .0001] for perceptible and meaningful pain relief, respectively). Significantly fewer patients in the DPSGC groups required rescue medication compared with those in the placebo group (P < .0001). The global evaluation scores were significantly greater for the patients who received DPSGC than for those who received placebo (P < .0001), and more than 65% of DPSGC-treated patients rated the medication as good, very good, or excellent compared with 18% of the placebo-treated patients. DPSGC was generally well tolerated, and no serious adverse events were reported.


CONCLUSIONS
The results from the present single-dose study of postoperative dental pain suggest that DPSGC offers significant pain relief compared with placebo and that the study medication provided was well tolerated by patients who required pain relief after third molar extraction.
Zuniga
John R
JR
University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. john.zuniga@utsouthwestern.edu
Malmström
Hans
H
Noveck
Robert J
RJ
Campbell
John H
JH
Christensen
Steven
S
Glickman
Robert S
RS
Tomasetti
Boyd J
BJ
Boesing
Stephen E
SE
D000042:Absorption; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000493:pharmacokinetics; D002214:Capsules; D004008:Diclofenac / Q000008:administration & dosage* / Q000493:pharmacokinetics; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005780:Gelatin; D006801:Humans; D008297:Male; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D009325:Nausea / Q000209:etiology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D010919:Placebos; D012449:Safety; D013997:Time Factors; D014081:Tooth Extraction / Q000009:adverse effects; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology; D055815:Young Adult
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002214:Capsules; D010919:Placebos; D004008:Diclofenac; D005780:Gelatin