Efficacy and safety of twice‐daily tramadol hydrochloride bilayer sustained‐release tablets with an immediate release component for postherpetic neuralgia: Results of a Phase III, randomized, double‐blind, placebo‐controlled, treatment‐withdrawal study

Background: We investigated the efficacy and safety of twice‐daily bilayer sustained‐release tramadol hydrochloride tablets (35% immediate‐release; 65% sustained‐release) in patients with postherpetic neuralgia. Methods: This was a Phase III treatment‐withdrawal study with 1–4‐week dose‐escalation,...

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Publicado en:Pain Practice Vol. 23; no. 3; pp. 277 - 290
Autores principales: Kawai, Shinichi, Hasegawa, Jun, Ito, Hideki, Fukuuchi, Yasuo, Nakano, Hideshi, Ohtani, Hideaki, Sasaki, Kazutaka, Adachi, Takeshi
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Wiley-Blackwell Mar2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2023
      vid: 23
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/papr.13190
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        atl: Efficacy and safety of twice‐daily tramadol hydrochloride bilayer sustained‐release tablets with an immediate release component for postherpetic neuralgia: Results of a Phase III, randomized, double‐blind, placebo‐controlled, treatment‐withdrawal study
      aug:
        au:
          Kawai, Shinichi
          Hasegawa, Jun
          Ito, Hideki
          Fukuuchi, Yasuo
          Nakano, Hideshi
          Ohtani, Hideaki
          Sasaki, Kazutaka
          Adachi, Takeshi
        affil: Department of Inflammation & Pain Control Research, Toho University School of Medicine, Tokyo, Japan
      sug:
        subj:
          Neuralgia, Postherpetic Drug Therapy
          Tramadol Pharmacodynamics
          Patient Safety
          Delayed-Action Preparations Pharmacokinetics
          Drug Efficacy
          Tramadol Administration and Dosage
          Drug Administration Methods
          Human
          Randomized Controlled Trials
          Random Assignment
          Japan
          Scales
          Adult
          Analgesics, Opioid Pharmacodynamics
          Dose-Response Relationship, Drug
          Treatment Withdrawal
          Confidence Intervals
          Substance Dependence Evaluation
          Tramadol Adverse Effects
          Adverse Drug Event Evaluation
          Adult: 19-44 years
      ab: Background: We investigated the efficacy and safety of twice‐daily bilayer sustained‐release tramadol hydrochloride tablets (35% immediate‐release; 65% sustained‐release) in patients with postherpetic neuralgia. Methods: This was a Phase III treatment‐withdrawal study with 1–4‐week dose‐escalation, 1‐week fixed‐dose, and 4‐week randomized, double‐blind, placebo‐controlled withdrawal periods performed at 43 medical institutions in Japan. Patients aged ≥20 years, ≥3 months after the onset of herpes zoster with localized, persistent pain despite fixed‐dose analgesics for ≥2 weeks before enrollment were eligible. Patients started tramadol at 100 mg/day and its dose escalated to a maximum of 400 mg/day to achieve a reduction in their Numeric Rating Scale (NRS) for pain of ≥2 points. Eligible patients were randomized to continue tramadol or switched to placebo for 4 weeks (double‐blind period). Patients were withdrawn due to inadequate analgesia (NRS deteriorated on ≥2 consecutive days) or their request. Results: Overall, 252 patients started tramadol and 173 were randomized (tramadol: 85; placebo: 88). Tramadol was superior to placebo for the primary endpoint (time from randomization to an inadequate analgesic effect) with log‐rank test p = 0.0005. The hazard ratio was 0.353 (95% confidence interval 0.190–0.657) in favor of tramadol and fewer patients in the tramadol group experienced inadequate analgesic effects (16.9% vs. 39.8%). Adverse events in ≥10% of patients in the open‐label period were constipation (43.8%), nausea (34.9%), somnolence (18.5%), and dizziness (11.6%). The frequencies of adverse events in the double‐blind period were similar in both groups. Conclusion: Sustained‐release tramadol tablets with an immediate‐release component are effective and well tolerated for managing postherpetic neuralgia.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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