Trial Outcomes & Findings for Naproxen Sodium/Acetaminophen Proof of Concept Dosing Study (NCT NCT03879408)

NCT ID: NCT03879408

Last Updated: 2022-12-05

Results Overview

Time-weighted sum of the pain intensity difference (SPID) score was measured using a Pain Intensity-Numerical Rating Scale (PI-NRS) ranging from 0-10 (0 = no pain, 10 = very severe pain). The possible range of SPID for 0-6 hours was from -60 to 60. A higher value of SPID indicated greater pain relief. PID was the difference between baseline pain intensity and pain intensity at assessment. Time-weighted sum of the pain intensity difference scores were derived by first multiplying each PID score by the time from the previous time point and adding these time-weighted PID scores together over the intervals from 0 to 6 hours.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

290 participants

Primary outcome timeframe

Baseline (0 hour) up to 6 hours post-dose

Results posted on

2022-12-05

Participant Flow

Participant milestones

Participant milestones
Measure
Arm 1: Placebo
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Overall Study
STARTED
35
69
61
63
62
Overall Study
COMPLETED
33
65
58
62
61
Overall Study
NOT COMPLETED
2
4
3
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Arm 1: Placebo
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Overall Study
Lost to Follow-up
0
3
2
1
0
Overall Study
Withdrawal by Subject
2
1
1
0
1

Baseline Characteristics

Naproxen Sodium/Acetaminophen Proof of Concept Dosing Study

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Total
n=290 Participants
Total of all reporting groups
Age, Continuous
18.4 years
STANDARD_DEVIATION 1.50 • n=5 Participants
19.0 years
STANDARD_DEVIATION 2.39 • n=7 Participants
18.2 years
STANDARD_DEVIATION 1.33 • n=5 Participants
19.0 years
STANDARD_DEVIATION 2.23 • n=4 Participants
18.3 years
STANDARD_DEVIATION 1.70 • n=21 Participants
18.6 years
STANDARD_DEVIATION 1.95 • n=8 Participants
Sex: Female, Male
Female
19 Participants
n=5 Participants
36 Participants
n=7 Participants
33 Participants
n=5 Participants
35 Participants
n=4 Participants
32 Participants
n=21 Participants
155 Participants
n=8 Participants
Sex: Female, Male
Male
16 Participants
n=5 Participants
33 Participants
n=7 Participants
28 Participants
n=5 Participants
28 Participants
n=4 Participants
30 Participants
n=21 Participants
135 Participants
n=8 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
8 Participants
n=5 Participants
9 Participants
n=7 Participants
5 Participants
n=5 Participants
6 Participants
n=4 Participants
6 Participants
n=21 Participants
34 Participants
n=8 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
27 Participants
n=5 Participants
60 Participants
n=7 Participants
56 Participants
n=5 Participants
57 Participants
n=4 Participants
56 Participants
n=21 Participants
256 Participants
n=8 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=8 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
1 Participants
n=21 Participants
4 Participants
n=8 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
3 Participants
n=7 Participants
2 Participants
n=5 Participants
4 Participants
n=4 Participants
1 Participants
n=21 Participants
10 Participants
n=8 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
2 Participants
n=4 Participants
0 Participants
n=21 Participants
6 Participants
n=8 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
2 Participants
n=8 Participants
Race (NIH/OMB)
White
32 Participants
n=5 Participants
61 Participants
n=7 Participants
57 Participants
n=5 Participants
54 Participants
n=4 Participants
57 Participants
n=21 Participants
261 Participants
n=8 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=8 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
2 Participants
n=4 Participants
3 Participants
n=21 Participants
7 Participants
n=8 Participants

PRIMARY outcome

Timeframe: Baseline (0 hour) up to 6 hours post-dose

Population: Intent-to-Treat (ITT) analysis set included all randomized participants.

Time-weighted sum of the pain intensity difference (SPID) score was measured using a Pain Intensity-Numerical Rating Scale (PI-NRS) ranging from 0-10 (0 = no pain, 10 = very severe pain). The possible range of SPID for 0-6 hours was from -60 to 60. A higher value of SPID indicated greater pain relief. PID was the difference between baseline pain intensity and pain intensity at assessment. Time-weighted sum of the pain intensity difference scores were derived by first multiplying each PID score by the time from the previous time point and adding these time-weighted PID scores together over the intervals from 0 to 6 hours.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Time-Weighted Sum of Pain Intensity Difference Score From Baseline (0 Hour) to 6 Hours (SPID 0-6)
2.36 Units on a scale
Standard Error 2.181
25.59 Units on a scale
Standard Error 1.562
30.28 Units on a scale
Standard Error 1.677
33.77 Units on a scale
Standard Error 1.633
23.60 Units on a scale
Standard Error 1.651

PRIMARY outcome

Timeframe: Baseline (0 hour) up to 12 hours post-dose

Population: ITT analysis set included all randomized participants.

Time-weighted sum of the pain intensity difference score was measured using a PI-NRS ranging from 0-10 (0 = no pain, 10 = very severe pain). The possible range of SPID for 0-12 hours was from -120 to 120. A higher value of SPID indicated greater pain relief. PID was the difference between baseline pain intensity and pain intensity at assessment (12 hours). Time-weighted sum of the pain intensity difference scores were derived by first multiplying each PID score by the time from the previous time point and adding these time-weighted PID scores together over the intervals from 0 to 12 hours.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Time-weighted Sum of Pain Intensity Difference Score From Baseline (0 Hour) to 12 Hours (SPID 0-12)
5.80 Units on a scale
Standard Error 4.666
50.07 Units on a scale
Standard Error 3.341
55.47 Units on a scale
Standard Error 3.587
66.43 Units on a scale
Standard Error 3.494
39.94 Units on a scale
Standard Error 3.533

SECONDARY outcome

Timeframe: Baseline (0 hour) up to 6 hours post-dose

Population: ITT analysis set included all randomized participants.

Time-weighted total pain relief (TOTPAR) was measured using a Pain Relief Numerical Rating Scale (PR-NRS) ranging from 0-10 (0 = no relief, 10 = complete relief). Total pain relief scores (TOTPARs) were calculated by multiplying the pain relief score at each postdose time point by the duration (in hours) since the preceding time point and then summing these values. The minimum value was 0, and the maximum value was 60. Higher scores was indicative of more pain relief.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Time-Weighted Sum of Total Pain Relief Score From Baseline (0 Hour) to 6 Hours (TOTPAR 0-6)
7.96 Units on a scale
Standard Error 2.581
35.20 Units on a scale
Standard Error 1.848
40.94 Units on a scale
Standard Error 1.984
45.13 Units on a scale
Standard Error 1.933
32.88 Units on a scale
Standard Error 1.954

SECONDARY outcome

Timeframe: Baseline (0 hour) up to 8 hours post-dose

Population: ITT analysis set included all randomized participants.

TOTPAR was measured using a PR-NRS ranging from 0-10 (0 = no relief, 10 = complete relief). Total pain relief scores (TOTPARs) were calculated by multiplying the pain relief score at each postdose time point by the duration (in hours) since the preceding time point and then summing these values. The minimum value was 0, and the maximum value was 80. Higher scores was indicative of more pain relief.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Time-Weighted Sum of Total Pain Relief Score From Baseline (0 Hour) to 8 Hours (TOTPAR 0-8)
11.12 Units on a scale
Standard Error 3.554
47.19 Units on a scale
Standard Error 2.545
54.37 Units on a scale
Standard Error 2.732
60.78 Units on a scale
Standard Error 2.662
41.61 Units on a scale
Standard Error 2.691

SECONDARY outcome

Timeframe: Baseline (0 hour) up to 12 hours post-dose

Population: ITT analysis set included all randomized participants.

TOTPAR was measured using a PR-NRS ranging from 0-10 (0 = no relief, 10 = complete relief). Total pain relief scores (TOTPARs) were calculated by multiplying the pain relief score at each postdose time point by the duration (in hours) since the preceding time point and then summing these values. The minimum value was 0, and the maximum value was 120. Higher scores was indicative of more pain relief.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Time-Weighted Sum of Total Pain Relief Score From Baseline (0 Hour) to 12 Hours (TOTPAR 0-12)
18.20 Units on a scale
Standard Error 5.595
69.96 Units on a scale
Standard Error 4.006
76.80 Units on a scale
Standard Error 4.301
90.22 Units on a scale
Standard Error 4.190
57.03 Units on a scale
Standard Error 4.237

SECONDARY outcome

Timeframe: Baseline (0 hour) up to 8 hours post-dose

Population: ITT analysis set included all randomized participants.

Time-weighted sum of the pain intensity difference score was measured using a PI-NRS ranging from 0-10 (0 = no pain, 10 = very severe pain). The possible range of SPID for 0-8 hours was from -80 to 80. A higher value of SPID indicated greater pain relief. PID was the difference between baseline pain intensity and pain intensity at assessment (8 hours). Time-weighted sum of the pain intensity difference scores were derived by first multiplying each PID score by the time from the previous time point and adding these time-weighted PID scores together over the intervals from 0 to 8 hours.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Time-Weighted Sum of Pain Intensity Difference Score From Baseline (0 Hour) to 8 Hours (SPID 0-8)
3.24 Units on a scale
Standard Error 2.981
34.11 Units on a scale
Standard Error 2.134
39.98 Units on a scale
Standard Error 2.291
45.27 Units on a scale
Standard Error 2.232
29.58 Units on a scale
Standard Error 2.257

SECONDARY outcome

Timeframe: 0.25 hours, 0.5 hours, 0.75 hours, 1 hours, 1.25 hours, 1.5 hours, 2 hours, 3 hours, 4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, 10 hours, 11 hours, and 12 hours

Population: ITT analysis set included all randomized participants.

Participants answered a question at individual time points: "how much relief do you have from your starting pain?" on a 11-point PR-NRS. Scale ranged from 0=no relief to 10=complete relief. Higher score indicated improvement in pain.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Pain Relief (PAR) Scores at Individual Timepoints
0.5 Hours
0.51 Units on a scale
Standard Error 0.44
2.27 Units on a scale
Standard Error 0.31
3.46 Units on a scale
Standard Error 0.33
4.03 Units on a scale
Standard Error 0.33
3.23 Units on a scale
Standard Error 0.36
Pain Relief (PAR) Scores at Individual Timepoints
0.75 Hours
0.77 Units on a scale
Standard Error 0.48
4.11 Units on a scale
Standard Error 0.35
5.10 Units on a scale
Standard Error 0.37
5.71 Units on a scale
Standard Error 0.36
5.08 Units on a scale
Standard Error 0.36
Pain Relief (PAR) Scores at Individual Timepoints
1 Hours
1.06 Units on a scale
Standard Error 0.49
5.29 Units on a scale
Standard Error 0.35
5.91 Units on a scale
Standard Error 0.38
6.60 Units on a scale
Standard Error 0.37
6.03 Units on a scale
Standard Error 0.37
Pain Relief (PAR) Scores at Individual Timepoints
1.25 Hours
1.13 Units on a scale
Standard Error 0.49
5.99 Units on a scale
Standard Error 0.35
6.46 Units on a scale
Standard Error 0.38
7.17 Units on a scale
Standard Error 0.37
6.40 Units on a scale
Standard Error 0.37
Pain Relief (PAR) Scores at Individual Timepoints
8 Hours
1.65 Units on a scale
Standard Error 0.54
5.95 Units on a scale
Standard Error 0.39
6.63 Units on a scale
Standard Error 0.42
7.71 Units on a scale
Standard Error 0.41
4.23 Units on a scale
Standard Error 0.41
Pain Relief (PAR) Scores at Individual Timepoints
10 Hours
1.73 Units on a scale
Standard Error 0.58
5.71 Units on a scale
Standard Error 0.42
5.66 Units on a scale
Standard Error 0.45
7.49 Units on a scale
Standard Error 0.44
3.66 Units on a scale
Standard Error 0.44
Pain Relief (PAR) Scores at Individual Timepoints
12 Hours
1.89 Units on a scale
Standard Error 0.61
5.62 Units on a scale
Standard Error 0.44
5.18 Units on a scale
Standard Error 0.47
7.25 Units on a scale
Standard Error 0.46
3.98 Units on a scale
Standard Error 0.46
Pain Relief (PAR) Scores at Individual Timepoints
0.25 hours
0.45 Units on a scale
Standard Error 0.26
0.80 Units on a scale
Standard Error 0.18
1.36 Units on a scale
Standard Error 0.20
1.07 Units on a scale
Standard Error 0.19
1.04 Units on a scale
Standard Error 0.20
Pain Relief (PAR) Scores at Individual Timepoints
1.5 Hours
1.18 Units on a scale
Standard Error 0.48
6.36 Units on a scale
Standard Error 0.34
6.89 Units on a scale
Standard Error 0.37
7.65 Units on a scale
Standard Error 0.36
6.44 Units on a scale
Standard Error 0.36
Pain Relief (PAR) Scores at Individual Timepoints
2 Hours
1.08 Units on a scale
Standard Error 0.48
6.62 Units on a scale
Standard Error 0.34
7.37 Units on a scale
Standard Error 0.37
7.97 Units on a scale
Standard Error 0.36
6.38 Units on a scale
Standard Error 0.36
Pain Relief (PAR) Scores at Individual Timepoints
3 Hours
1.37 Units on a scale
Standard Error 0.49
6.52 Units on a scale
Standard Error 0.35
7.61 Units on a scale
Standard Error 0.38
8.24 Units on a scale
Standard Error 0.37
6.26 Units on a scale
Standard Error 0.37
Pain Relief (PAR) Scores at Individual Timepoints
4 Hours
1.66 Units on a scale
Standard Error 0.51
1.46 Units on a scale
Standard Error 0.36
7.68 Units on a scale
Standard Error 0.39
8.46 Units on a scale
Standard Error 0.38
5.96 Units on a scale
Standard Error 0.38
Pain Relief (PAR) Scores at Individual Timepoints
5 Hours
1.59 Units on a scale
Standard Error 0.52
6.45 Units on a scale
Standard Error 0.37
7.43 Units on a scale
Standard Error 0.40
8.23 Units on a scale
Standard Error 0.39
5.54 Units on a scale
Standard Error 0.40
Pain Relief (PAR) Scores at Individual Timepoints
6 Hours
1.53 Units on a scale
Standard Error 0.53
6.26 Units on a scale
Standard Error 0.38
7.23 Units on a scale
Standard Error 0.41
8.15 Units on a scale
Standard Error 0.40
4.88 Units on a scale
Standard Error 0.40
Pain Relief (PAR) Scores at Individual Timepoints
7 Hours
1.51 Units on a scale
Standard Error 0.55
6.05 Units on a scale
Standard Error 0.39
6.80 Units on a scale
Standard Error 0.42
7.94 Units on a scale
Standard Error 0.41
4.50 Units on a scale
Standard Error 0.41
Pain Relief (PAR) Scores at Individual Timepoints
9 Hours
1.61 Units on a scale
Standard Error 0.56
5.73 Units on a scale
Standard Error 0.40
6.27 Units on a scale
Standard Error 0.43
7.44 Units on a scale
Standard Error 0.42
3.88 Units on a scale
Standard Error 0.43
Pain Relief (PAR) Scores at Individual Timepoints
11 Hours
1.86 Units on a scale
Standard Error 0.60
5.71 Units on a scale
Standard Error 0.43
5.33 Units on a scale
Standard Error 0.46
7.26 Units on a scale
Standard Error 0.45
3.91 Units on a scale
Standard Error 0.46

SECONDARY outcome

Timeframe: 0.25 hours, 0.5 hours, 0.75 hours, 1 hours, 1.25 hours, 1.5 hours, 2 hours, 3 hours, 4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, 10 hours, 11 hours, and 12 hours

Population: ITT analysis set included all randomized participants.

Pain Intensity was self-reported over 12 hours, using a pain rating of 0-10 on the PI-NRS, with score ranged from 0-10 (0= no pain; 10 = worst imaginable pain). Pain intensity differences were calculated with respect to baseline at each time point after study drug administration.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Pain Intensity Difference (PID) Scores at Individual Time Points
0.25 hours
0.25 Units on a scale
Standard Error 0.21
0.58 Units on a scale
Standard Error 0.15
1.01 Units on a scale
Standard Error 0.16
0.85 Units on a scale
Standard Error 0.15
00.79 Units on a scale
Standard Error 0.16
Pain Intensity Difference (PID) Scores at Individual Time Points
0.5 Hours
0.07 Units on a scale
Standard Error 0.33
1.82 Units on a scale
Standard Error 0.24
2.61 Units on a scale
Standard Error 0.25
3.06 Units on a scale
Standard Error 0.25
2.36 Units on a scale
Standard Error 0.25
Pain Intensity Difference (PID) Scores at Individual Time Points
1.5 Hours
0.31 Units on a scale
Standard Error 0.39
4.72 Units on a scale
Standard Error 0.28
5.18 Units on a scale
Standard Error 0.30
5.76 Units on a scale
Standard Error 0.29
4.74 Units on a scale
Standard Error 0.30
Pain Intensity Difference (PID) Scores at Individual Time Points
2 Hours
0.22 Units on a scale
Standard Error 0.40
4.87 Units on a scale
Standard Error 0.28
5.49 Units on a scale
Standard Error 0.31
6.01 Units on a scale
Standard Error 0.30
4.67 Units on a scale
Standard Error 0.30
Pain Intensity Difference (PID) Scores at Individual Time Points
11 Hours
0.69 Units on a scale
Standard Error 0.50
3.99 Units on a scale
Standard Error 0.35
3.63 Units on a scale
Standard Error 0.38
5.16 Units on a scale
Standard Error 0.37
2.71 Units on a scale
Standard Error 0.37
Pain Intensity Difference (PID) Scores at Individual Time Points
0.75 Hours
0.24 Units on a scale
Standard Error 0.38
3.15 Units on a scale
Standard Error 0.27
3.82 Units on a scale
Standard Error 0.29
4.31 Units on a scale
Standard Error 0.29
3.77 Units on a scale
Standard Error 0.29
Pain Intensity Difference (PID) Scores at Individual Time Points
1 Hours
0.45 Units on a scale
Standard Error 0.39
3.97 Units on a scale
Standard Error 0.28
4.41 Units on a scale
Standard Error 0.30
4.95 Units on a scale
Standard Error 0.29
4.48 Units on a scale
Standard Error 0.30
Pain Intensity Difference (PID) Scores at Individual Time Points
1.25 Hours
0.34 Units on a scale
Standard Error 0.40
4.50 Units on a scale
Standard Error 0.28
4.87 Units on a scale
Standard Error 0.30
5.42 Units on a scale
Standard Error 0.30
4.71 Units on a scale
Standard Error 0.30
Pain Intensity Difference (PID) Scores at Individual Time Points
3 Hours
0.34 Units on a scale
Standard Error 0.41
4.75 Units on a scale
Standard Error 0.30
5.62 Units on a scale
Standard Error 0.32
6.17 Units on a scale
Standard Error 0.31
4.51 Units on a scale
Standard Error 0.31
Pain Intensity Difference (PID) Scores at Individual Time Points
4 Hours
0.53 Units on a scale
Standard Error 0.43
4.63 Units on a scale
Standard Error 0.31
5.64 Units on a scale
Standard Error 0.33
6.31 Units on a scale
Standard Error 0.32
4.26 Units on a scale
Standard Error 0.33
Pain Intensity Difference (PID) Scores at Individual Time Points
5 Hours
0.50 Units on a scale
Standard Error 0.44
4.59 Units on a scale
Standard Error 0.32
5.51 Units on a scale
Standard Error 0.34
6.13 Units on a scale
Standard Error 0.33
3.89 Units on a scale
Standard Error 0.34
Pain Intensity Difference (PID) Scores at Individual Time Points
6 Hours
0.47 Units on a scale
Standard Error 0.44
4.50 Units on a scale
Standard Error 0.32
5.28 Units on a scale
Standard Error 0.34
6.06 Units on a scale
Standard Error 0.33
3.39 Units on a scale
Standard Error 0.34
Pain Intensity Difference (PID) Scores at Individual Time Points
7 Hours
0.40 Units on a scale
Standard Error 0.45
4.36 Units on a scale
Standard Error 0.32
4.96 Units on a scale
Standard Error 0.34
5.82 Units on a scale
Standard Error 0.34
3.08 Units on a scale
Standard Error 0.34
Pain Intensity Difference (PID) Scores at Individual Time Points
8 Hours
0.48 Units on a scale
Standard Error 0.45
4.17 Units on a scale
Standard Error 0.32
4.74 Units on a scale
Standard Error 0.34
5.68 Units on a scale
Standard Error 0.34
2.90 Units on a scale
Standard Error 0.34
Pain Intensity Difference (PID) Scores at Individual Time Points
9 Hours
0.53 Units on a scale
Standard Error 0.46
4.04 Units on a scale
Standard Error 0.33
4.46 Units on a scale
Standard Error 0.35
5.41 Units on a scale
Standard Error 0.34
2.56 Units on a scale
Standard Error 0.35
Pain Intensity Difference (PID) Scores at Individual Time Points
10 Hours
0.64 Units on a scale
Standard Error 0.40
4.01 Units on a scale
Standard Error 0.35
3.87 Units on a scale
Standard Error 0.37
5.43 Units on a scale
Standard Error 0.36
2.42 Units on a scale
Standard Error 0.37
Pain Intensity Difference (PID) Scores at Individual Time Points
12 Hours
0.71 Units on a scale
Standard Error 0.50
3.91 Units on a scale
Standard Error 0.36
3.53 Units on a scale
Standard Error 0.38
5.16 Units on a scale
Standard Error 0.37
2.66 Units on a scale
Standard Error 0.38

SECONDARY outcome

Timeframe: Up to 12 hours

Population: ITT analysis set included all randomized participants. Here, 'N' (number of participants analyzed) signifies number of participants who were evaluable for this outcome measure.

Participants were asked to rate their overall impression of the study medication using the following scale: poor (0), fair (1), good (2), very good (3), and excellent (4) where higher score represented better outcome.

Outcome measures

Outcome measures
Measure
Arm 1: Placebo
n=35 Participants
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 Participants
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=60 Participants
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 Participants
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=61 Participants
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Participant's Global Evaluation of Study Medication OR Overall Impression of Study Medication According to Participant's Global Evaluation
0.8 Units on a Scale
Standard Error 0.18
2.7 Units on a Scale
Standard Error 0.13
2.9 Units on a Scale
Standard Error 0.14
3.3 Units on a Scale
Standard Error 0.13
2.7 Units on a Scale
Standard Error 0.14

Adverse Events

Arm 1: Placebo

Serious events: 0 serious events
Other events: 14 other events
Deaths: 0 deaths

Arm 2: Naproxen Sodium 440 mg

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg

Serious events: 0 serious events
Other events: 9 other events
Deaths: 0 deaths

Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg

Serious events: 0 serious events
Other events: 22 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Arm 1: Placebo
n=35 participants at risk
Participants received a single oral dose of four placebo tablets at baseline (Day of surgery-Day 1).
Arm 2: Naproxen Sodium 440 mg
n=69 participants at risk
Participants received a single oral dose of naproxen sodium 440 milligrams (mg)(administered as two naproxen sodium 220 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Arm 3: Naproxen Sodium 220 mg + Acetaminophen 650 mg
n=61 participants at risk
Participants received a single oral dose of naproxen sodium 220 mg tablet (administered as one naproxen sodium 220 mg tablet) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and one placebo tablet at baseline (Day of surgery-Day 1).
Arm 4: Naproxen Sodium 440 mg + Acetaminophen 1000 mg
n=63 participants at risk
Participants received a single oral dose of naproxen sodium 440 mg (administered as two naproxen sodium 220 mg tablets) and acetaminophen 1000 mg (two acetaminophen 500 mg tablets) at baseline (Day of surgery-Day 1).
Arm 5: Hydrocodone 10 mg + Acetaminophen 650 mg
n=62 participants at risk
Participants received a single oral dose of hydrocodone 10 mg (administered as two hydrocodone 5 mg tablets) and acetaminophen 650 mg (two acetaminophen 325 mg tablets) and two placebo tablets at baseline (Day of surgery-Day 1).
Gastrointestinal disorders
Nausea
25.7%
9/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
2.9%
2/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
3.3%
2/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
4.8%
3/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
32.3%
20/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Gastrointestinal disorders
Vomiting
20.0%
7/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
2.9%
2/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
6.6%
4/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
9.5%
6/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
14.5%
9/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Gastrointestinal disorders
Diarrhoea
2.9%
1/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Gastrointestinal disorders
Gastrooesophageal reflux disease
2.9%
1/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Infections and infestations
Alveolar osteitis
0.00%
0/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.4%
1/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
4.9%
3/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.6%
1/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Infections and infestations
Upper respiratory tract infection
2.9%
1/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
3.3%
2/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.6%
1/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Infections and infestations
Postoperative wound infection
0.00%
0/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.6%
1/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.6%
1/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Infections and infestations
Influenza
0.00%
0/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.4%
1/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Nervous system disorders
Dizziness
0.00%
0/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
2.9%
2/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.6%
1/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.6%
1/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
4.8%
3/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Nervous system disorders
Headache
11.4%
4/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.6%
1/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
Investigations
Blood urine present
0.00%
0/35 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
1.4%
1/69 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/61 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/63 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.
0.00%
0/62 • Up to Day 10
The safety analysis set included all participants who were randomized and took investigational product.

Additional Information

ASSOCIATE DIRECTOR CLINICAL RESEARCH

Johnson & Johnson Consumer, Inc.

Phone: 844-434-4210

Results disclosure agreements

  • Principal investigator is a sponsor employee Draft abstracts, manuscripts, and materials for presentation at scientific meetings must be sent to the sponsor at least 60 working days prior to abstract or other relevant submission deadlines. Authorship of publications resulting from this study was based on generally accepted criteria for major medical journals.
  • Publication restrictions are in place

Restriction type: OTHER