Paracetamol in Addition to WHO Step III Opioids in Chronic Cancer Pain Control

NCT ID: NCT05088876

Last Updated: 2025-11-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-28

Study Completion Date

2026-07-31

Brief Summary

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Blinded withdrawal of regular co-medication with paracetamol in chronic pain patients under strong opioids on pain control.

Detailed Description

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Chronic pain patients receiving a strong opioid in combination with paracetamol in a minimum dose of 1.5 g/day will be randomized to receive either paracetamol in the dose already prescribed (group "paracetamol") or an identically looking placebo (group "placebo") using the same schedule during the first study phase (days 1-7). In the second study phase (days 8-14) paracetamol or placebo will be stopped in both arms to assess the effect of pill withdrawal on pain control.

Next to baseline the patients will be instructed to use a pain diary to rate their pain during the study and also document the required opioid rescue doses. Further assessments will include adverse events, subjective ratings of quality of sleep, overall feeling of functioning and quality of life. At the screening visit, patients will also be asked to rate their expected changes in pain relief as a result of co-treatment with paracetamol. At the completion of the study, patients will be asked about their preference and whether, overall, they felt their pain was more poorly controlled during the study.

Adherence will be checked by pill count and measurement of paracetamol blood concentrations. Genotyping of OPRM1, COMT and relevant CYP enzymes and opioid blood concentrations will be assessed as co-variates for pain control.

Conditions

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Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Paracetamol

Group Type ACTIVE_COMPARATOR

Paracetamol

Intervention Type DRUG

Paracetamol in the dose already used

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Blinded withdrawal of regular co-medication with paracetamol

Interventions

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Placebo

Blinded withdrawal of regular co-medication with paracetamol

Intervention Type DRUG

Paracetamol

Paracetamol in the dose already used

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Male and female patients receiving a WHO step III opioid (i.e. morphine, oxycodone, methadone, fentanyl, hydromorphone, or buprenorphine) in combination with paracetamol (minimum dose 1.5 g/day)
* Age ≥ 18 at screening
* Ability to understand the study procedures and to provide written informed consent
* Stable analgesia before randomisation, defined as no required changes in the analgesic treatment during the previous 7 days

Exclusion Criteria

* Participation in another interventional trial within 30 days prior to randomisation, with the exception of cancer treatment trials
* Changes of the dosage or start of other (co-)analgesics (e.g. tricyclic antidepressants, neuroleptics, nonsteroidal anti-inflammatory drugs (NSAIDs), dipyrone), within the last 7 days preceding randomisation
* Surgery within the 14 days preceding randomisation or surgery planned within the duration of the study
* Any circumstances, comorbidities or conditions, which, in the opinion of the investigator, may affect full participation in the study or compliance with the study protocol
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Insel Gruppe AG, University Hospital Bern

OTHER

Sponsor Role lead

Swiss National Science Foundation

OTHER

Sponsor Role collaborator

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Evangelia Liakoni

Role: PRINCIPAL_INVESTIGATOR

Inselspital, Bern University Hospital

Locations

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Kantonsspital Baden

Baden, , Switzerland

Site Status RECRUITING

Inselspital, Bern University Hospital

Bern, , Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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Evangelia Liakoni

Role: CONTACT

0041316325461

Facility Contacts

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Maria Wertli, Prof.

Role: primary

Evangelia Liakoni

Role: primary

0041316325461

Other Identifiers

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BASEC-ID: 2021-01518

Identifier Type: -

Identifier Source: org_study_id

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