Comparing Analgesic Regimen Effectiveness and Safety for Surgery (CARES) Trial

NCT ID: NCT05722002

Last Updated: 2025-10-16

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

900 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-06

Study Completion Date

2026-10-31

Brief Summary

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This trial is being completed to compare two commonly used options to treat pain after surgery. Participants that undergo gallbladder removal, hernia repair, and breast lump removal will be eligible to enroll. Eligible participants will be randomized to 1 of 2 groups of medications (Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) plus acetaminophen or low dose opioids plus acetaminophen).

It is anticipated that the NSAID group will have superior clinical outcomes and fewer side effects when compared to the opioid group.

Detailed Description

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Conditions

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Surgery Pain, Postoperative

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomization of patients will be stratified by site, sex, age (greater or equal to 65 years old), and type of surgery, via permuted block randomization with a variable block size.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Both study staff performing outcome assessment and data analysis will be masked to treatment assignment.

Study Groups

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NSAID regimen

Surgical teams will elect for one of the medications within the treatment arm to which the patient is randomized.

Group Type OTHER

NSAID

Intervention Type DRUG

Once randomized to this group the surgical team will elect for 1 of the following treatment options to be given:

* Ibuprofen 600 milligram (mg) by mouth every six hours as needed for pain (10 doses)
* Celecoxib 400 mg by mouth once then 200 mg every twelve hours as needed for pain (10 doses)
* Naproxen 500 mg by mouth once then 250 mg by mouth every eight hours as needed for pain (10 doses)

Acetaminophen

Intervention Type DRUG

Acetaminophen 1000 mg by mouth every 6 hours around the clock for the first three days after surgery then as needed thereafter (20 doses).

Opioid regimen

Group Type OTHER

Opioid

Intervention Type DRUG

Once randomized to this group the surgical team will elect for 1 of the following treatment options to be given:

* Oxycodone 5 mg by mouth every four to six hours as needed for pain, 10 doses
* Morphine 7.5 mg by mouth every four to six hours as needed for pain, 10 doses
* Hydromorphone 2 mg by mouth every four to six hours as needed for pain, 10 doses

Acetaminophen

Intervention Type DRUG

Acetaminophen 1000 mg by mouth every 6 hours around the clock for the first three days after surgery then as needed thereafter (20 doses).

Interventions

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NSAID

Once randomized to this group the surgical team will elect for 1 of the following treatment options to be given:

* Ibuprofen 600 milligram (mg) by mouth every six hours as needed for pain (10 doses)
* Celecoxib 400 mg by mouth once then 200 mg every twelve hours as needed for pain (10 doses)
* Naproxen 500 mg by mouth once then 250 mg by mouth every eight hours as needed for pain (10 doses)

Intervention Type DRUG

Opioid

Once randomized to this group the surgical team will elect for 1 of the following treatment options to be given:

* Oxycodone 5 mg by mouth every four to six hours as needed for pain, 10 doses
* Morphine 7.5 mg by mouth every four to six hours as needed for pain, 10 doses
* Hydromorphone 2 mg by mouth every four to six hours as needed for pain, 10 doses

Intervention Type DRUG

Acetaminophen

Acetaminophen 1000 mg by mouth every 6 hours around the clock for the first three days after surgery then as needed thereafter (20 doses).

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* No significant analgesic medication use before surgery: For this study, significant analgesic medication use before surgery as use of prescriptions for opioid or NSAID medications in the past 30 days, or over-the-counter NSAID use on greater than 7 of 30 past days, as reported by the patient.
* One of three common low-risk surgical procedures: For this study, the three-common low-risk surgical procedures will include laparoscopic gallbladder removal, inguinal hernia repair, and breast lumpectomy.

Exclusion Criteria

* Anticipated other surgery within 6 months or anticipated life expectancy of less than 6 months
* Patients with contraindications to NSAID drugs in the NSAID arm, opioid drugs in the OPIOID arm, or acetaminophen will be excluded. There are specific contraindications that will be reviewed per protocol.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Mark Bicket, MD, PhD

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mark Bicket, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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University of Michigan

Ann Arbor, Michigan, United States

Site Status RECRUITING

Henry Ford Health System

Detroit, Michigan, United States

Site Status RECRUITING

Washington University in Saint Louis

St Louis, Missouri, United States

Site Status RECRUITING

Cooper University Health Care

Camden, New Jersey, United States

Site Status RECRUITING

University of North Carolina Hospitals

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Temple University - Temple Health

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Women's College Hospital

Toronto, Ontario, Canada

Site Status RECRUITING

Unity Health Toronto

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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United States Canada

Central Contacts

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Sarah Clark, BA

Role: CONTACT

734-232-0324

Facility Contacts

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Sarah Clark

Role: primary

734-232-0324

Kasia Nowak, PhD

Role: primary

313-771-7128

Justin Stout, MS

Role: primary

314-273-2455

Asia Vincent

Role: primary

800-826-6737

Karen Van Manen, PhD

Role: primary

919-843-6572

Anamarys Arroyo-Lloret

Role: primary

215-643-5067

Didem Bozak

Role: primary

416-323-6008

Janneth P Canizares

Role: primary

416-864-6060

References

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Bicket MC, Ladha KS, Haroutounian S, McFarlin K, Neff M, McDuffie RL, Waljee JF, Wijeysundera DN, Brummet C, Li Y; CARES Investigators. Comparing Analgesic Regimen Effectiveness and Safety after Surgery (CARES): protocol for a pragmatic, international multicentre randomised trial. BMJ Open. 2025 Apr 5;15(4):e099925. doi: 10.1136/bmjopen-2025-099925.

Reference Type DERIVED
PMID: 40187774 (View on PubMed)

Other Identifiers

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CER-2021C1-22398

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

HUM00215416

Identifier Type: -

Identifier Source: org_study_id

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