NCT03472469

Brief Summary

This is a comparative effectiveness study of current pain management strategies in acutely injured trauma patients. Two different multi-modal, opioid minimizing analgesic strategies will be compared \[original multimodal pain regimen (MMPR) compared to multi-modal analgesic strategies for trauma (MAST) MMPR\].

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,561

participants targeted

Target at P75+ for phase_4

Timeline
Completed

Started Apr 2018

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 13, 2018

Completed
8 days until next milestone

First Posted

Study publicly available on registry

March 21, 2018

Completed
12 days until next milestone

Study Start

First participant enrolled

April 2, 2018

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 3, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 3, 2019

Completed
1.9 years until next milestone

Results Posted

Study results publicly available

June 10, 2021

Completed
Last Updated

June 18, 2021

Status Verified

June 1, 2021

Enrollment Period

1.3 years

First QC Date

March 13, 2018

Results QC Date

May 16, 2021

Last Update Submit

June 15, 2021

Conditions

Outcome Measures

Primary Outcomes (1)

  • Opioid Use Per Day

    Opioid use per day is calculated by tallying the dose equivalency of all opioids received and dividing by the number of days hospitalized. Morphine milligram equivalents (MME) per day are reported.

    until discharge from hospital or 30 days post admission (whichever is sooner)

Secondary Outcomes (11)

  • Pain as Assessed by Score on the Numeric Rating Scale (NRS)

    until discharge from hospital or 30 days post admission (whichever is sooner)

  • Pain as Assessed by Score on the Behavioral Pain Scale (BPS)

    until discharge from hospital or 30 days post admission (whichever is sooner)

  • Number of Participants Discharged From the Hospital With an Opioid Prescription

    Up to 30 days

  • Number of Participants With Any Opioid-related Complications

    until discharge from hospital or 30 days post admission (whichever is sooner)

  • Overall Costs

    until discharge from hospital or 30 days post admission (whichever is sooner)

  • +6 more secondary outcomes

Study Arms (2)

Original MMPR - descending dose arm

ACTIVE COMPARATOR

Drugs are scheduled around the clock as follows: 1. Acetaminophen 1g intravenously (IV)/per oral (PO) q6 hours in the first 48 hours, and Acetaminophen 1g PO q6 hours thereafter; 2. Ketorolac 30mg IV once and Celebrex 200mg PO q12 hours in the first 48 hours, and Naproxen 500mg PO q12 hours thereafter; 3. Tramadol 100mg PO q6 hours in the first 48 hours, and Tramadol 100mg PO q6 hours thereafter; 4. Pregabalin 100mg PO q8 hours in the first 48 hours, and Gabapentin 300mg PO q8 hours thereafter; 5. Lidocaine patch q12 hours in the first 48 hours, and Lidocaine patch q12 hours thereafter; and 6. Opioids (Regional anesthesia) in the first 48 hours, and Opioids and Regional anesthesia thereafter.

Drug: Acetaminophen IV/PODrug: Acetaminophen PODrug: KetorolacDrug: CelebrexDrug: NaproxenDrug: TramadolDrug: PregabalinDrug: GabapentinDrug: LidocaineDrug: OpioidsDrug: Regional anesthesia

MAST MMPR - escalating dose arm

ACTIVE COMPARATOR

Drugs are scheduled around the clock as follows: 1. Acetaminophen 1g PO q6 hours at admission and thereafter; 2. Ketorolac 30mg IV once and Naproxen 500mg PO q12 hours at admission and thereafter; 3. No drug; 4; Gabapentin 300mg PO q8 hours at admission and thereafter; 5. Lidocaine patch q12 hours at admission and thereafter; and 6. Tramadol and Opioids and Regional anesthesia at admission and thereafter.

Drug: Acetaminophen PODrug: KetorolacDrug: NaproxenDrug: GabapentinDrug: LidocaineDrug: OpioidsDrug: Regional anesthesia

Interventions

Acetaminophen 1g IV/PO every 6 hours

Original MMPR - descending dose arm

Acetaminophen 1g PO every 6 hours

MAST MMPR - escalating dose armOriginal MMPR - descending dose arm

Ketorolac 30mg IV once

MAST MMPR - escalating dose armOriginal MMPR - descending dose arm

Celebrex 200mg PO every 12 hours

Original MMPR - descending dose arm

Naproxen 500mg PO every 12 hours

MAST MMPR - escalating dose armOriginal MMPR - descending dose arm

Tramadol 100mg PO every 6 hours

Original MMPR - descending dose arm

Pregabalin 100mg PO every 8 hours

Original MMPR - descending dose arm

Gabapentin 300mg PO every 8 hours

MAST MMPR - escalating dose armOriginal MMPR - descending dose arm

Lidocaine patch every 12 hours

MAST MMPR - escalating dose armOriginal MMPR - descending dose arm

Opioid options include: Oral Opioids (Codeine, Tramadol, Hydrocodone, Oxycodone, Methadone, Morphine, Hydromorphone); Transdermal Opioid (Fentanyl); Intravenous Opioids (Morphine, Hydromorphone, Fentanyl)

MAST MMPR - escalating dose armOriginal MMPR - descending dose arm

Regional anesthesia

MAST MMPR - escalating dose armOriginal MMPR - descending dose arm

Eligibility Criteria

Age16 Years+
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • All patients admitted to the trauma service who are 16 years and older.

You may not qualify if:

  • pregnant
  • prisoner
  • patients placed in observation (i.e. not admitted to the hospital)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

The University of Texas Health Science Center at Houston

Houston, Texas, 77030, United States

Location

Related Publications (2)

  • Harvin JA, Green CE, Vincent LE, Motley KL, Podbielski J, Miller CC, Tyson JE, Holcomb JB, Wade CE, Kao LS. Multi-modal Analgesic Strategies for Trauma (MAST): protocol for a pragmatic randomized trial. Trauma Surg Acute Care Open. 2018 Aug 19;3(1):e000192. doi: 10.1136/tsaco-2018-000192. eCollection 2018.

    PMID: 30206549BACKGROUND
  • Harvin JA, Albarado R, Truong VTT, Green C, Tyson JE, Pedroza C, Wade CE, Kao LS; MAST Study Group. Multi-Modal Analgesic Strategy for Trauma: A Pragmatic Randomized Clinical Trial. J Am Coll Surg. 2021 Mar;232(3):241-251.e3. doi: 10.1016/j.jamcollsurg.2020.12.014. Epub 2021 Jan 21.

MeSH Terms

Interventions

KetorolacCelecoxibNaproxenTramadolPregabalinGabapentinLidocaineAnalgesics, OpioidAnesthesia, Conduction

Intervention Hierarchy (Ancestors)

IndomethacinIndolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingHeterocyclic CompoundsBenzenesulfonamidesSulfonamidesAmidesOrganic ChemicalsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsSulfonesSulfur CompoundsPyrazolesAzolesHeterocyclic Compounds, 1-RingNaphthaleneacetic AcidsNaphthalenesPolycyclic Aromatic HydrocarbonsPolycyclic CompoundsCyclohexanolsHexanolsFatty AlcoholsAlcoholsDimethylaminesMethylaminesAminesLipidsgamma-Aminobutyric AcidAminobutyratesButyratesAcids, AcyclicCarboxylic AcidsAmino AcidsAmino Acids, Peptides, and ProteinsCyclohexanecarboxylic AcidsAcids, CarbocyclicCyclohexanesCycloparaffinsHydrocarbons, AlicyclicAcetanilidesAnilidesAniline CompoundsNarcoticsCentral Nervous System DepressantsPhysiological Effects of DrugsPharmacologic ActionsChemical Actions and UsesAnalgesicsSensory System AgentsPeripheral Nervous System AgentsCentral Nervous System AgentsTherapeutic UsesAnesthesiaAnesthesia and Analgesia

Results Point of Contact

Title
John A. Harvin, MD
Organization
The University of Texas Health Science Center at Houston

Study Officials

  • John Harvin, MD

    The University of Texas Health Science Center, Houston

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

March 13, 2018

First Posted

March 21, 2018

Study Start

April 2, 2018

Primary Completion

July 3, 2019

Study Completion

July 3, 2019

Last Updated

June 18, 2021

Results First Posted

June 10, 2021

Record last verified: 2021-06

Data Sharing

IPD Sharing
Will not share

Locations