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CompletedNCT05575700PERISAFEUpdated Dec 19, 2025

Safety of Ibuprofen After Major Orthopaedic Surgeries

A Phase 4 interventional study of Ibuprofen and Placebo in Pain, Acute, Hip Arthropathy and Knee Arthropathy, sponsored by Naestved Hospital. Completed at 11 sites in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-12-19.

Sponsored by Naestved Hospital · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
2,904
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Safety of an eight-day treatment with ibuprofen after primary hip and knee arthroplasties.

Read the detailed description

Hip and knee arthroplasty surgeries are some of the most frequently performed planned procedures in the western world. Multimodal analgesic treatment is the leading analgesic treatment principle, with NSAIDs as an essential part. Ibuprofen, the most frequently prescribed NSAID, is effective in reducing acute postoperative pain. However, ibuprofen may be associated with various serious adverse events, including death, cardiovascular morbidity, gastrointestinal ulcer, and renal impairment. The balance between beneficial and harmful effects of a short-term postoperative treatment with ibuprofen after elective hip and knee arthroplasty is unknown.

Objectives: to assess the adverse events of an eight-day treatment of postoperative pain with ibuprofen in patients undergoing elective primary hip or knee arthroplasty.

Intervention: the participants will be randomized in two groups: a) oral ibuprofen 400 mg 3 times daily for eight days. b) identical oral placebo 3 times daily for eight days.

Design and trial size: PERISAFE is a randomized, placebo-controlled multicentre trial with centralized computer-generated allocation sequence and allocation concealment with unknown block size. Patients, investigators, assessors, caregivers, data-managers, writers of the manuscript, and statisticians will be blinded. A total of 2904 eligible patients are needed to detect or discard an effect corresponding to a relative risk reduction of 1/3 with an acceptable risk of type I error of 5 % and of type II error of 20 %, and a proportion of the composite outcome of serious adverse events of 8% in the experimental group.

Sub-studies:

  • Serious adverse events relating to the renal system
  • Serious adverse events relating to the cardiovascular system
  • Serious adverse events relating to the gastrointestinal system, including major bleeding
  • Persistent pain and opioid consumption at 90 days and one year postoperatively. Predictive co-factors include preoperative analgesic treatment, type of anesthesia, gender, age, ASA-classification, diabetes, and type of surgery
  • Bayesian re-analysis of the primary and secondary outcomes up to 90 days postoperatively. Further details will appear in the statistical analysis plan
  • Health-related quality of life via EQ-5D-5L questionnaire 90-days and one year postoperatively
02

Conditions studied

  • Pain, Acute
  • Hip Arthropathy
  • Knee Arthropathy
  • Safety Issues
  • Analgesia
  • Analgesic Adverse Reaction
  • Postoperative Pain
  • Postoperative Complications

Keywords

  • PERISAFE
  • Hip Arthroplasty
  • Knee Arthroplasty
  • Postoperative pain
  • Analgesia
  • Safety
  • Non-steroidal Anti-inflammatory drugs
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients scheduled for elective primary hip and knee arthroplasty.
  • Age ≥ 18 years.
  • Planned postoperative treatment with NSAID.
  • Negative pregnancy test for women in the fertile age.
  • Informed consent.

Exclusion criteria

Exclusion Criteria:

  • Unable to understand or speak Danish.
  • Allergy to or contraindications against ibuprofen.
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
2,904 participants (actual)

Study arms

  • Experimental
    Ibuprofen

    Participants received ibuprofen 400 mg tablet administered orally three times daily, with eight hour intervals, for eight days after surgery.

    Drug: Ibuprofen

  • Placebo comparator
    Placebo

    Participants received identical placebo tablet administered orally three times daily, with eight hour intervals, for eight days after surgery.

    Drug: Placebo

Interventions

  • DrugIbuprofen

    400 mg tablet three times daily

  • DrugPlacebo

    tablet three times daily

05

What researchers measure

Primary outcomes

  1. A composite outcome of either death, acute myocardial infarction, stroke, pulmonary embolism, deep venous thrombosis, renal failure, major bleeding, re-operation, gastrointestinal ulcer, or readmission within 90 days postoperatively.

    Proportion of patients with one or more severe adverse events defined in the composite outcome of either death, acute myocardial infarction, stroke, pulmonary embolism, deep venous thrombosis, renal failure, major bleeding, re-operation, gastrointestinal ulcer, or readmission within 90 days postoperatively.

    Time frame: Postoperative day 0 to 90.

Secondary outcomes

  1. Hospital free days within 90 days postoperatively.

    Days outside the hospital within 90 days postoperatively.

    Time frame: Postoperative day 0 to 90.

  2. A composite outcome of ibuprofen related adverse events based on an eight-day postoperative diary: dyspepsia, diarrhoea.

    Proportion of patients with one or more adverse events of ibuprofen during intervention period, defined as dyspepsia or diarrhoea.

    Time frame: Postoperative day 0 to 8.

  3. A composite outcome of opioid related adverse events based on an eight-day postoperative diary: nausea, vomiting, constipation, dizziness, confusion, sedation, headache.

    Proportion of patients with one or more adverse events of opioid during intervention period, defined as nausea, vomiting, constipation, dizziness, confusion, sedation, or headache.

    Time frame: Postoperative day 0 to 8.

  4. Health related quality of life questionnaire (EQ-5D-5L) after 90 days

    Evaluation of health related quality of life via EuroQol five-dimensions 5 point Likert-type scale (EQ-5D-5L) questionnaire, incl. the Euro Visual analogue scales (VAS) from 0-100. 100=the best health you can imagine, 0= the worst health you can imagine. The questionnaire of health related quality of life includes: mobility, self-care, usual activities, pain or discomfort, anxiety or depression from a scale of no problems, to slight, moderate, severe problems or unable condition.

    Time frame: Postoperative day 90.

Other outcomes

  1. Postoperative pain levels, analgesic treatment, and opioid consumption based on an eight-day postoperative diary.

    Pain levels will be measured by Numeric Rating Scale (NRS) from 0-10 (no pain = 0, worst pain = 10). Analgesic treatment including opioid consumption will be indicated in total daily doses in mg.

    Time frame: Postoperative day 0 to 8.

06

Study locations

11 sites
  • Private Hospital Gildhøj
    Brøndby, 2605, Denmark
  • Bispebjerg Hospital
    Copenhagen NV, 2400, Denmark
  • Aalborg University Hospital
    Farsø, 9640, Denmark
  • Gentofte Hospital
    Hellerup, 2900, Denmark
  • Nordsjællands Hospital Hillerød
    Hillerød, 3400, Denmark
  • Zealand University Hospital
    Køge, 4600, Denmark
  • Næstved Hospital
    Næstved, 4700, Denmark
  • Odense University Hospital
    Odense, 3900, Denmark
  • Silkeborg Regional Hospital
    Silkeborg, 8600, Denmark
  • Svendborg Hospital
    Svendborg, 5700, Denmark
  • Vejle Sygehus
    Vejle, 7100, Denmark
07

References and documents

Individual participant data

Plan to share: Yes — Data will be published anonymised according to ICMJEs (International Committee of Medical Journal Editors) guidelines

Supporting information: Study protocol, Sap

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT05575700
Lead sponsor
Naestved Hospital
Responsible party
Sponsor
First posted
Oct 12, 2022
Start date
Apr 17, 2023
Primary completion
Aug 19, 2025
Completion
Aug 19, 2025
Last update
Dec 19, 2025

Study contacts

Ole Mathiesen, Professor
study chair · Zealand University Hospital

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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