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Onset of action of a lozenge containing flurbiprofen 8.75 mg: a randomized, double-blind, placebo-controlled trial with a new method for measuring onset of analgesic activity.

Abstract
A new onset-of-action model was utilized to distinguish the pharmacologic activity of flurbiprofen 8.75mg delivered in a lozenge from the demulcent effect of the lozenge base. In a randomized, double-blind, placebo-controlled trial, patients with sore throat rated pain on a Sore Throat Pain Intensity Scale before taking one flurbiprofen or placebo lozenge and at frequent (2-minute) intervals over the first hour after treatment. Further ratings of the Sore Throat Pain Intensity Scale and other patient-reported outcomes (difficulty swallowing, swollen throat, pain relief) were obtained at varying intervals over 6 hours. Onset of pharmacologic activity was defined as the median time of first perceived pain reduction if a patient reported clinically meaningful (at least moderate) relief. The conventional method of comparing mean treatment responses at each time point was also implemented. Demulcent action was detected at the first 2-minute assessment. By the new method, 102 flurbiprofen-treated patients were identified as first perceiving pain relief at 12 minutes, compared with >120 minutes by 102 patients using placebo (P<0.001). By the conventional method, mean percentage pain reduction for flurbiprofen 8.75 mg was first significantly differentiated from placebo at 26 minutes (P<0.05). Efficacy of flurbiprofen lozenge was demonstrated for 3.5-4hours on the 4 patient-reported outcomes (all P<0.05 compared with placebo). There were no serious adverse events. This patient-centered onset-of-action model identifies the initiation of pain relief in patients who are definite drug responders, here demonstrating that a flurbiprofen 8.75-mg lozenge provides early relief of sore throat.
AuthorsBernard Schachtel, Sue Aspley, Adrian Shephard, Timothy Shea, Gary Smith, Kathleen Sanner, Laurie Savino, Jeanne Rezuke, Emily Schachtel
JournalPain (Pain) Vol. 155 Issue 2 Pg. 422-428 (Feb 2014) ISSN: 1872-6623 [Electronic] United States
PMID24231654 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
Chemical References
  • Analgesics
  • Flurbiprofen
Topics
  • Administration, Oral
  • Adolescent
  • Adult
  • Analgesics (administration & dosage)
  • Double-Blind Method
  • Drug Delivery Systems (methods)
  • Female
  • Flurbiprofen (administration & dosage)
  • Humans
  • Male
  • Pain (diagnosis, drug therapy)
  • Pain Measurement (drug effects, methods)
  • Pharyngitis (diagnosis, drug therapy)
  • Time Factors
  • Treatment Outcome
  • Young Adult

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