抜歯後疼痛に対するJNS013(トラマドール塩酸塩/アセトアミノフェン配合錠)の臨床評価- 各配合成分の単独投与との二重盲検比較試験

We assessed the clinical significance of the combined preparation JNS013 and the analgesic efficacy and safety of a single oral dose of JNS013 (Tramadol hydrochloride/acetaminophen combination tablets) as compared with a single dose of tramadol hydrochloride (TRAM) or acetaminophen (APAP) in patient...

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Published in日本口腔外科学会雑誌 Vol. 58; no. 3; pp. 110 - 122
Main Authors 中嶋, 頼俊, 覚道, 健治, 小村, 健, 金子, 明寛, 山下, 徹郎, 坂田, 秀雄, 平木, 昭光, 新谷, 悟, 久保田, 英朗, 渡貫, 圭, 山本, 英雄, 今井, 裕, 神部, 芳則, 岩永, 賢二郎, 伊能, 智明
Format Journal Article
LanguageJapanese
Published 社団法人 日本口腔外科学会 2012
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ISSN0021-5163
2186-1579
DOI10.5794/jjoms.58.110

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Abstract We assessed the clinical significance of the combined preparation JNS013 and the analgesic efficacy and safety of a single oral dose of JNS013 (Tramadol hydrochloride/acetaminophen combination tablets) as compared with a single dose of tramadol hydrochloride (TRAM) or acetaminophen (APAP) in patients who had pain associated with extraction of a mandibular impacted third molar in a multicenter, double-blind, randomized, active-controlled, parallel-group comparitive study. Efficacy and safety were evaluated in a total of 328 patients who were given the study drugs (JNS013 group: 132 patients, TRAM group: 66 patients, APAP group: 130 patients). As for the primary endpoint of efficacy, the means ± standard deviations of the total pain relief scores from 0 to 8 hours after administration of the study drugs (TOTPAR 0-8h) were 17.7 ± 7.91 in the JNS013 group, 12.4 ± 8.36 in the TRAM group, and 13.3 ± 8.07 in the APAP group, indicating a significantly higher value in the JNS013 group than in the TRAM and APAP groups. On safety analyses, at least 1 adverse event occurred in 62.1% (82/132) of patients in the JNS013 group. Major adverse events occurring in the JNS013 group included somnolence 29.5%, nausea 15.2%, dizziness 9.1%, and blood bilirubin increased 9.1%. The severities of most of these adverse events were mild. The symptoms and incidence of adverse events in the JNS013 group were generally similar to those in the TRAM group, while the incidence in the JNS013 group was higher than that in the APAP group. The present study showed that JNS013 was more effective for the management of post-tooth-extraction pain than either uncombined TRAM or APAP, supporting the clinical significance of combination. In addition, the usefulness of the drug for post-tooth-extraction pain was confirmed. JNS013 is expected to provide a new alternative for pain control in the fields of dentistry and oral surgery.
AbstractList We assessed the clinical significance of the combined preparation JNS013 and the analgesic efficacy and safety of a single oral dose of JNS013 (Tramadol hydrochloride/acetaminophen combination tablets) as compared with a single dose of tramadol hydrochloride (TRAM) or acetaminophen (APAP) in patients who had pain associated with extraction of a mandibular impacted third molar in a multicenter, double-blind, randomized, active-controlled, parallel-group comparitive study. Efficacy and safety were evaluated in a total of 328 patients who were given the study drugs (JNS013 group: 132 patients, TRAM group: 66 patients, APAP group: 130 patients). As for the primary endpoint of efficacy, the means ± standard deviations of the total pain relief scores from 0 to 8 hours after administration of the study drugs (TOTPAR 0-8h) were 17.7 ± 7.91 in the JNS013 group, 12.4 ± 8.36 in the TRAM group, and 13.3 ± 8.07 in the APAP group, indicating a significantly higher value in the JNS013 group than in the TRAM and APAP groups. On safety analyses, at least 1 adverse event occurred in 62.1% (82/132) of patients in the JNS013 group. Major adverse events occurring in the JNS013 group included somnolence 29.5%, nausea 15.2%, dizziness 9.1%, and blood bilirubin increased 9.1%. The severities of most of these adverse events were mild. The symptoms and incidence of adverse events in the JNS013 group were generally similar to those in the TRAM group, while the incidence in the JNS013 group was higher than that in the APAP group. The present study showed that JNS013 was more effective for the management of post-tooth-extraction pain than either uncombined TRAM or APAP, supporting the clinical significance of combination. In addition, the usefulness of the drug for post-tooth-extraction pain was confirmed. JNS013 is expected to provide a new alternative for pain control in the fields of dentistry and oral surgery.
Author 中嶋, 頼俊
坂田, 秀雄
覚道, 健治
伊能, 智明
久保田, 英朗
新谷, 悟
山本, 英雄
岩永, 賢二郎
小村, 健
山下, 徹郎
渡貫, 圭
平木, 昭光
今井, 裕
金子, 明寛
神部, 芳則
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References 8) Chandrasekharan, N.V., Dai, H., et al.: COX-3, acyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/ antipyretic drugs: cloning structure, and expression. Proc Natl Acad Sci USA 99: 13926-13931 2002.
7) Warner, T.D., Giuliano, F., et al.: Nonsteroid drug selectivities for cyclo-oxygenase-1 rather than cyclooxygenase-2 are associated with human gastrointestinal toxicity: A full in vitro analysis. Proc. Natl. Acad. Sci. USA 96: 7563-7568 1999.
4) Driessen, B. and Reimann, W.: Interaction of the central analgesic, tramadol, with the uptake and release of 5-hydroxytryptamine in the rat brain in vitro. Br J Pharmacol 105: 147-151 1992.
6) Cossmann, M. and Kohnen, C.: General tolerability and adverse event profile of tramadol hydrochloride. Rev. Contemp. Pharmacother 6: 513-531 1995.
9) カロナール®錠200, カロナール®錠300 添付文書 (2011年4 月改訂).
2) 満島 隆, 川面 博, 他:新鎮痛薬1(- m-methoxyphenyl)-2-dimethylamino methyl cyclohexanol(1)hydrochloride(K-315)の薬理学的研究. 日薬理誌 68: 437-445 1977.
3) Hennies, H.H., Friderichs, E., et al.: Receptor binding, analgesic and antitussive potency of tramadol and other selected opioids. Arzneimittelforschung; 38: 877-880 1988.
1) Ultracet®添付文書(Revised September 2009. 米国)
5) Bamigbade, T.A., Davidson, C., et al.: Actions of tramadol, its enantiomers and principal metabolite, O-desmethyltramadol, on serotonin(5-HT)efflux and uptake in the rat dorsal raphe nucleus. Br J Anaesth 79: 352-356 1977.
10) Fricke, J.R., Hewitt, D.J., et al.: A double-blind placebo-controlled comparison of tramadol/acetaminophen and tramdol in patients with postoperative dental pain. Pain 109: 250-257 2004.
References_xml – reference: 4) Driessen, B. and Reimann, W.: Interaction of the central analgesic, tramadol, with the uptake and release of 5-hydroxytryptamine in the rat brain in vitro. Br J Pharmacol 105: 147-151 1992.
– reference: 10) Fricke, J.R., Hewitt, D.J., et al.: A double-blind placebo-controlled comparison of tramadol/acetaminophen and tramdol in patients with postoperative dental pain. Pain 109: 250-257 2004.
– reference: 5) Bamigbade, T.A., Davidson, C., et al.: Actions of tramadol, its enantiomers and principal metabolite, O-desmethyltramadol, on serotonin(5-HT)efflux and uptake in the rat dorsal raphe nucleus. Br J Anaesth 79: 352-356 1977.
– reference: 9) カロナール®錠200, カロナール®錠300 添付文書 (2011年4 月改訂).
– reference: 7) Warner, T.D., Giuliano, F., et al.: Nonsteroid drug selectivities for cyclo-oxygenase-1 rather than cyclooxygenase-2 are associated with human gastrointestinal toxicity: A full in vitro analysis. Proc. Natl. Acad. Sci. USA 96: 7563-7568 1999.
– reference: 8) Chandrasekharan, N.V., Dai, H., et al.: COX-3, acyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/ antipyretic drugs: cloning structure, and expression. Proc Natl Acad Sci USA 99: 13926-13931 2002.
– reference: 2) 満島 隆, 川面 博, 他:新鎮痛薬1(- m-methoxyphenyl)-2-dimethylamino methyl cyclohexanol(1)hydrochloride(K-315)の薬理学的研究. 日薬理誌 68: 437-445 1977.
– reference: 1) Ultracet®添付文書(Revised September 2009. 米国)
– reference: 3) Hennies, H.H., Friderichs, E., et al.: Receptor binding, analgesic and antitussive potency of tramadol and other selected opioids. Arzneimittelforschung; 38: 877-880 1988.
– reference: 6) Cossmann, M. and Kohnen, C.: General tolerability and adverse event profile of tramadol hydrochloride. Rev. Contemp. Pharmacother 6: 513-531 1995.
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SubjectTerms アセトアミノフェン
トラマドール塩酸塩
トラマドール塩酸塩/アセトアミノフェン配合錠[トラムセット® 配合錠]
抜歯後疼痛
Title 抜歯後疼痛に対するJNS013(トラマドール塩酸塩/アセトアミノフェン配合錠)の臨床評価- 各配合成分の単独投与との二重盲検比較試験
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