Cochrane meta-analysis: duloxetine dramatically diminishes pain in osteoarthritis, chronic low back pain

  • Osteoarthritis and Cartilage

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Duloxetine shows efficacy and safety in meta-analyses of patients with osteoarthriis (OA) and chronic low back pain (CLBP), according to searches of randomized controlled trials (RCTs) in PubMed, Embase, Web of Science, Cochrane cental register, among others.

Why this matters

  • Duloxetine is not inferior to other first-line drugs including NSAIDs.

Study design

  • 9 RCTs (n=3209) underwent meta-analysis.
  • Funding: Jiangsu Provincial Key R&D; other.

Key results

  • Duloxetine was superior to placebo for most of the following outcomes:
    • Brief Pain Inventory 24-h average pain (weighted mean difference [WMD]: -0.67; 95% CI:-0.80, -0.53).
    • Weekly mean of the 
24-h average pain (WMD: -0.65; 95% CI: -0.79, -0.52),
    • Patient's Global 
Impression of improvement (WMD, -.41; 95% CI, -4.9 to -.32).
    • Clinical Global impression of severity (WMD: -0.32; 95% CI: -0.38 to -0.25),
    • European Quality 
of Life Questionnaire-5 Dimension (WMD: 0.04; 95% CI: 0.02, 0.07).
    • Impression of Improvement (WMD: -0.41; 95% CI: -0.49, -0.32),
    • Clinical Global Impression of Severity (WMD: -0.32; 95% CI: -0.38, -0.25),
    • Response rates of approximately 30% and 50% in pain intensity in the treatment of OA or CLBP, respectively.
    • European Quality 
of Life Questionnaire-5 Dimension (WMD: 0.04; 95% CI: 0.02, 0.07).
    • More treatment-emergent adverse events (risk ratio, 1.25; 95% CI, 1.17, 1.33); 


Limitations

  • Small number of studies.
  • Heterogeneity across studies.