title: SoluMatrix® Diclofenac: Sustained Opioid-Sparing Effects in a Phase 3 Study in Patients with Postoperative Pain.
abstract: To evaluate opioid rescue medication usage and the opioid-sparing effect of low-dose SoluMatrix®diclofenac developed using SoluMatrix Fine Particle Technology™ in a phase 3 study in patients experiencing pain following bunionectomy surgery.
  
  
  
  Multicenter, randomized, double-blind, parallel-group study (NCT01462435).
  
  
  
  Four clinical research centers in the United States.
  
  
  
  Four hundred twenty-eight patients aged 18 to 65 years who experienced moderate-to-severe pain following bunionectomy surgery.
  
  
  
  Patients were randomized to receive low-dose SoluMatrix diclofenac 35 mg or 18 mg capsules three times daily (35-mg group or 18-mg group), celecoxib 400 mg loading dose followed by 200-mg capsules twice daily (celecoxib 200-mg group), or placebo capsules postsurgery. Patients were permitted to receive opioid-containing rescue medication as needed.
  
  
  
  Significantly fewer patients who received SoluMatrix diclofenac 35 mg or 18 mg or celecoxib required rescue medication during 0-24 h and >24-48 h postsurgery compared with placebo. Patients in the SoluMatrix diclofenac 35 mg or 18 mg groups or in the celecoxib group used fewer mean rescue medication tablets over 0-24 h and >24-48 h compared with placebo-treated patients. Patients in the SoluMatrix diclofenac 35 mg and 18 mg groups and in the celecoxib group also required rescue medication at later times and at slower rates compared with placebo-treated patients. No serious adverse effects occurred in patients receiving SoluMatrix diclofenac.
  
  
  
  SoluMatrix diclofenac at two dosage strengths demonstrated an opioid-sparing effect postoperatively in this phase 3 study.
  
  
  
  The opioid-sparing effect following low-dose SoluMatrix diclofenac (35 mg or 18 mg three times daily) administration was evaluated in patients experiencing pain following bunionectomy. Significantly fewer patients receiving SoluMatrix diclofenac or celecoxib (400 mg loading, 200 mg twice daily) required rescue medication during 0-24 h and >24-48 h following bunionectomy compared with placebo. No serious adverse events were reported among patients who received SoluMatrix diclofenac. SoluMatrix diclofenac may reduce opioid usage in the postoperative setting in patients with acute pain.
authors.affiliation: *Neurology Group, Albany Medical College, Albany, New York.
authors.forename: Charles
authors.initials: C
authors.lastname: Argoff
authors.affiliation: School of Medicine, University of California San Diego, San Diego, California.
authors.forename: Bill
authors.initials: B
authors.lastname: McCarberg
authors.affiliation: Pain and Palliative Care, Englewood Hospital and Medical Center, Englewood, New Jersey.
authors.forename: Jeff
authors.initials: J
authors.lastname: Gudin
authors.affiliation: Department of Physical Medicine & Rehabilitation, International Clinical Research Institute, Overland Park, Kansas.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Nalamachu
authors.affiliation: Iroko Pharmaceuticals, LLC, Philadelphia, Pennsylvania USA cyoung@iroko.com.
authors.forename: Clarence
authors.initials: C
authors.lastname: Young
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D004008:Diclofenac / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003692:Delayed-Action Preparations; D004008:Diclofenac
keywords: Acute Pain; Diclofenac; Multimodal; Non-Steroidal Anti-Inflammatory Drugs; Opioid; SoluMatrix®; ZORVOLEX®