Utility of CYP2D6 Genotyping to Improve the Efficacy and Safety of Tramadol

NCT ID: NCT05657704

Last Updated: 2022-12-20

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-05

Study Completion Date

2023-12-31

Brief Summary

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Randomized clinical trial to evaluate the utility of CYP2D6 genotyping to improve the efficacy and safety of tramadol in the treatment of acute postoperative pain.

Phase IV and low-intervention trial To evaluate if the implementation of pharmacogenetics in clinical practice can help to improve the treatment of acute pain, increasing efficacy and reducing adverse reactions.

The main evaluation variable: This is a simple study, which does not differ from standard clinical practice and therefore we do not expect early ending of the study.

Detailed Description

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Randomized clinical trial to evaluate the utility of CYP2D6 genotyping to improve the efficacy and safety of tramadol in the treatment of acute postoperative pain.

Phase IV and low-intervention trial The main objective is evaluate if the implementation of pharmacogenetics in clinical practice can help to improve the treatment of acute pain, increasing efficacy and reducing adverse reactions. Secondary objectives: 1. To evaluate whether treatment adjusted according to CYP2D6 phenotype can reduce adverse reactions to tramadol in acute postoperative pain. 2. To compare the efficacy and safety of dexketoprofen and tramadol in the treatment of acute postoperative pain. 3. To investigate the influence on analgesic response and the incidence of adverse reactions of polymorphisms of other genes involved in the pharmacokinetics and mechanism of action of dexketoprofen and tramadol, such as: CYP2C9, CYP2C8, CYP2C19, CYP3A4, CYP3A5, CYP2B6, CYP2E1, COMT, ABCB1, SLC22A1, OPRM1 and PTGS2. 4. To evaluate the relationship of tramadol, M1 and dexketoprofen plasma concentrations with response to treatment and the occurrence of adverse reactions.

Inclusion criteria: 1. Men or women over 18 years of age. 2. Patients scheduled for outpatient surgical extraction, under local anesthesia, of at least two impacted third molars, at least one of which will require bone removal. 3. Patients who agree to participate in the study and give written consent.

Exclusion criteria: 1. Patients under treatment with other drugs that can inhibit CYP2D6, or are contraindicated in combination with tramadol or dexketoprofen. 2. Patients on treatment with bisphosphonates. 3. Patients who are receiving analgesic treatment before the operation, 24 hours prior to the operation. This criterion will be evaluated at the intervention visit. 4. Patients suffering from other uncontrolled diseases. 5. Pregnant or breastfeeding women. 6. Patients with contraindications for treatment with tramadol or dexketoprofen.

Conditions

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Post-surgical Pain Pain, Acute Postoperative Pain

Keywords

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Pharmacogenetics Therapeutic techniques in treatment of acute postoperative pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Phase IV trial and low intervention, multicenter study. Group 1: Tramadol, 100 mg according to clinical practice for the treatment of postoperative pain. Group 2: Dexketoprofen 25 mg according to clinical practice for the treatment of postoperative pain. Experimental group 3: patients in this group will be genotyped before surgery and treatment will be prescribed according to the CYP2D6 phenotype. Normal Metabolizers (NM): Tramadol 100 mg every 8 hour; Ultrarapid Metabolizers (UM): Tramadol 50 mg every 8 hours and Intermediate and poor metabolizers (IM/PM): dexketoprofen 25 mg every 8 hours
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Open label study

Study Groups

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Tramadol

Patients treated with Tramadol, 100 mg every 8 hours according to clinical practice for the treatment of postoperative pain.

Group Type NO_INTERVENTION

No interventions assigned to this group

Dexketoprofen

Patients treated with Dexketoprofen 25 mg every 8 hours according to clinical practice for the treatment of postoperative pain.

Group Type NO_INTERVENTION

No interventions assigned to this group

Experimental Group

The patients in this group will be genotyped before surgery and treatment will be prescribed according to the CYP2D6 phenotype.

Normal Metabolizers (NM): Tramadol 100 mg every 8 hour; Ultrarapid Metabolizers (UM): Tramadol 50 mg every 8 hours Intermediate and poor metabolizers (IM/PM): dexketoprofen 25 mg every 8 hours

Group Type EXPERIMENTAL

The patients in experimental group will be genotyped before surgery and treatment will be prescribed according to the CYP2D6 phenotype

Intervention Type DRUG

Treatment will be prescribed according to the CYP2D6 phenotype. Normal Metabolizers (NM): Tramadol 100 mg every 8 hour; Ultrarapid Metabolizers (UM): Tramadol 50 mg every 8 hours Intermediate and poor metabolizers (IM/PM): dexketoprofen 25 mg every 8 hours

Interventions

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The patients in experimental group will be genotyped before surgery and treatment will be prescribed according to the CYP2D6 phenotype

Treatment will be prescribed according to the CYP2D6 phenotype. Normal Metabolizers (NM): Tramadol 100 mg every 8 hour; Ultrarapid Metabolizers (UM): Tramadol 50 mg every 8 hours Intermediate and poor metabolizers (IM/PM): dexketoprofen 25 mg every 8 hours

Intervention Type DRUG

Other Intervention Names

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Tramadol 100 mg Tramadol 50 mg Dexketoprofen 25 mg

Eligibility Criteria

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Inclusion Criteria

* Men or women over 18 years of age.
* Patients scheduled for outpatient surgical extraction, under local anesthesia, of at least two impacted third molars, at least one of which will require bone removal.
* Patients who agree to participate in the study and give written consent.

Exclusion Criteria

* Patients under treatment with other drugs that can inhibit CYP2D6, or are contraindicated in combination with tramadol or dexketoprofen.
* Patients on treatment with bisphosphonates.
* Patients who are receiving analgesic treatment before the operation, 24 hours prior to the operation. This criterion will be evaluated at the intervention visit.
* Patients suffering from other uncontrolled diseases.
* Pregnant or breastfeeding women.
* Patients with contraindications for treatment with tramadol or dexketoprofen.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Hospital Universitario La Paz

OTHER

Sponsor Role collaborator

Hospital Universitario Ramon y Cajal

OTHER

Sponsor Role collaborator

Hospital Universitario Fundación Jiménez Díaz

OTHER

Sponsor Role collaborator

Hospital Universitario San Juan de Alicante

OTHER

Sponsor Role collaborator

Hospital Universitario de Burgos

OTHER

Sponsor Role collaborator

Hospital San Carlos, Madrid

OTHER

Sponsor Role collaborator

Puerta de Hierro University Hospital

OTHER

Sponsor Role collaborator

Fundación de Investigación Biomédica - Hospital Universitario de La Princesa

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hospital Universitario Puerta de Hierro

Majadahonda, Madrid, Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario San Juan de Alicante

Alicante, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital General Universitario de Burgos y Clínica Colina

Burgos, , Spain

Site Status RECRUITING

Fundación para la Investigación Biomédica Hospital La Princesa

Madrid, , Spain

Site Status RECRUITING

Hospital Univesitario Ramón y Cajal

Madrid, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hospital Universitario Clínico San Carlos

Madrid, , Spain

Site Status ACTIVE_NOT_RECRUITING

Hostpital Universitario Fundación Jiménez Díaz

Madrid, , Spain

Site Status NOT_YET_RECRUITING

Hospital Universitaro La Paz

Madrid, , Spain

Site Status ACTIVE_NOT_RECRUITING

Countries

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Spain

Central Contacts

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Francisco Abad Santos, MD

Role: CONTACT

Phone: +34915202593

Email: [email protected]

Jesus Novalbos Reina, PhD

Role: CONTACT

Phone: +34915202540

Email: [email protected]

Facility Contacts

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Cesar Colina Santamaría

Role: primary

Miriam Saiz Rodríguez, PhD

Role: backup

Jesús Novalbos Reina, PhD

Role: primary

Francisco Abad Santos, MD

Role: backup

Dolores Martinez Pérez, MD

Role: primary

Lucía Llanos Jiménez, MD

Role: backup

Other Identifiers

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2022-500377-13-01

Identifier Type: -

Identifier Source: org_study_id