Etanercept (Enbrel) to Treat Pain and Swelling After Third Molar Extraction
Status:
Completed
Trial end date:
2004-05-01
Target enrollment:
Participant gender:
Summary
This study will evaluate the effects of the anti-inflammatory drug etanercept (Enbrel) on
relieving pain and swelling after oral surgery. The Food and Drug Administration has approved
Enbrel for treating symptoms of rheumatoid arthritis, including pain.
Healthy volunteers 16 to 35 years of age who require third molar (wisdom teeth) extractions
may be eligible for this study. Participants must not be allergic to aspirin or to
non-steroidal anti-inflammatory drugs (NSAIDs). Candidates will be screened for eligibility
with a medical history and oral examination, including X-rays if needed.
Participation in the study requires four clinic visits: two for surgery and two for
follow-up:
Visit 1:
Patients will have ultrasound pictures taken to measure cheek size. One hour before surgery,
they will receive a dose of either 25 milligrams (mg) of Enbrel; 15 mg of the standard pain
medicine Toradol; or a placebo (salt-water) through an arm vein. A local injection of an
anesthetic (lidocaine) will be given before surgery to numb the mouth, and a sedative
(Versed) will be infused through a vein to induce sleepiness. When the anesthetic takes
effect, a small piece of tissue will be removed from the inside of the cheek, and then the
upper and lower molars on one side of the mouth will be extracted. After surgery, a small
piece of tubing will be placed in the lower extraction site, from which samples will be
collected to measure chemicals involved in pain and inflammation. Patients will stay in the
clinic for 4 hours after surgery while the anesthetic wears off and will complete pain
questionnaires during that time. If, an hour after surgery, patients have pain that is not
relieved by the treatment given before surgery, they may receive acetaminophen (Tylenol) and
codeine for pain. Another biopsy will be taken (under local anesthetic) from the inside of
the cheek when pain occurs or at the end of the 4-hour observation period. The tubing then
will be removed and the patient discharged with Tylenol and codeine for pain.
Visit 2:
Patients will return to the clinic in the morning 48 hours after the oral surgery for a 1- to
2-hour visit. They will fill out questionnaires, undergo ultrasound imaging of both cheeks
and have another biopsy taken from the inside of the cheek on the operated side.
Visits 3 and 4:
Three weeks after the first surgery patients will schedule extraction of the two wisdom teeth
on the other side of the mouth, and the procedures for visits 1 and 2 will be repeated.
Phase:
Phase 2
Details
Lead Sponsor:
National Institute of Dental and Craniofacial Research (NIDCR)