Evidence map›Paper›PMID 38157081›Full record

Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2023

Phase III study of bilayer sustained-release tramadol tablets in patients with cancer pain: a double-blind parallel-group, non-inferiority study with immediate-release tramadol capsules as an active comparator.

Masaharu Shinkai, Noriyuki Katsumata, Shinichi Kawai, Shoichi Kuyama, Osamu Sasaki, Yasuhiro Yanagita, Minoru Yoshida, Shima Uneda, Yasushi Tsuji, Hidenori Harada and 11 more

Open access · hybridAbstract readClinical Trial, Phase IIIEquivalence TrialRandomized Controlled Trial
In one paragraph

Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.7field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 17 institutions in 1 country.

Masaharu ShinkaiTokyo Shinagawa Hospital, Tokyo, Japan. shinkai050169@gmail.com.
Noriyuki KatsumataNippon Medical School Musashikosugi Hospital, Kanagawa, Japan.
Shinichi KawaiToho University, Tokyo, Japan.
Shoichi KuyamaNational Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan.
Osamu SasakiMiyagi Cancer Center, Miyagi, Japan.
Yasuhiro YanagitaGunma Prefectural Cancer Center, Gunma, Japan.
Minoru YoshidaJapanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Shima UnedaJapanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Yasushi TsujiTonan Hospital, Hokkaido, Japan.
Hidenori HaradaYamaguchi University Hospital, Yamaguchi, Japan.
Yasunori NishidaKeiyukai Sapporo Hospital, Hokkaido, Japan.
Yasuhiro SakamotoOsaki Citizen Hospital, Miyagi, Japan.
Daisuke HimejiMiyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan.
Hitoshi AriokaYokohama Rosai Hospital, Kanagawa, Japan.
Kazuhiro SatoNagaoka Red Cross Hospital, Niigata, Japan.
Ryo KatsukiNational Hospital Organization Ureshino Medical Center, Saga, Japan.
Hiroki ShomuraJapan Community Health Care Organization Hokkaido Hospital, Hokkaido, Japan.
Hideshi NakanoDepartment of Clinical Development, Nippon Zoki Pharmaceutical Co., Ltd., Osaka, Japan.
Hideaki OhtaniDepartment of Clinical Development, Nippon Zoki Pharmaceutical Co., Ltd., Osaka, Japan.
Kazutaka SasakiDepartment of Clinical Development, Nippon Zoki Pharmaceutical Co., Ltd., Osaka, Japan.
Takeshi AdachiDepartment of Clinical Development, Nippon Zoki Pharmaceutical Co., Ltd., Osaka, Japan.
Nippon Zoki (Japan) · JPJapanese Red Cross Kumamoto Hospital · JPGunma Prefectural Cardiovascular Center · JPHokkaido hospital · JPIwakuni Medical Center · JPKeiyukai Sapporo Hospital · JPMiyagi Prefectural Hospital Organization · JPMiyazaki Prefectural Hospital · JPNagaoka Red Cross Hospital · JPNational Hospital Organization · JPNew Tokyo Hospital · JPNippon Medical School · JPOsaki Citizen Hospital · JPToho University · JPTonan Hospital · JPYamaguchi University Hospital · JPYokohama Rosai Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe investigated whether twice-daily administration of a bilayer tablet formulation of tramadol (35% immediate-release [IR] and 65% sustained-release) is as effective as four-times-daily IR tramadol capsules for managing cancer pain.

methodsThis randomized, double-blind, double-dummy, active-comparator, non-inferiority study enrolled opioid-naïve patients using non-steroidal anti-inflammatory drugs or acetaminophen (paracetamol) to manage cancer pain and self-reported pain (mean value over 3 days ≥ 25 mm on a 100-mm visual analog scale [VAS]). Patients were randomized to either bilayer tablets or IR capsules for 14 days. The starting dose was 100 mg/day and could be escalated to 300 mg/day. The primary endpoint was the change in VAS (averaged over 3 days) for pain at rest from baseline to end of treatment/discontinuation.

resultsOverall, 251 patients were randomized. The baseline mean VAS at rest was 47.67 mm (range: 25.6-82.7 mm). In the full analysis set, the adjusted mean change in VAS was - 22.07 and - 19.08 mm in the bilayer tablet (n = 124) and IR capsule (n = 120) groups, respectively. The adjusted mean difference was - 2.99 mm (95% confidence interval [CI] - 7.96 to 1.99 mm). The upper 95% CI was less than the predefined non-inferiority margin of 7.5 mm. Other efficacy outcomes were similar in both groups. Adverse events were reported for 97/126 (77.0%) and 101/125 (80.8%) patients in the bilayer tablet and IR capsule groups, respectively.

conclusionTwice-daily administration of bilayer tramadol tablets was as effective as four-times-daily administration of IR capsules regarding the improvement in pain VAS, with comparable safety outcomes. CLINICAL

trial registrationJapicCTI-184143/jRCT2080224082 (October 5, 2018).

Indexed as

Cancer PainNeoplasmsTramadolAcetaminophenAnalgesics, OpioidDelayed-Action PreparationsDouble-Blind MethodHumansPainTabletsTreatment OutcomeAcetaminophenAnalgesics, OpioidDelayed-Action PreparationsTabletsTramadolBilayer tabletsCancer painNon-inferiority studyRandomized controlled studySustained-releaseTramadol

Identifiers

PMID38157081
PMCPMC10756890
OpenAlexW4390412909

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.