Duloxetine diminishes fibromyalgia pain in meta-analysis

  • Lian YN & al.
  • Int J Neurosci
  • 5 Sep 2019

  • International Clinical Digest
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Takeaway

  • Duloxetine is superior to placebo for reducing pain in fibromyalgia, according to a meta-analysis.
  • The 60 mg/day dose has fewer study withdrawals than 120 mg/day.

Why this matters

  • This is among the first meta-analyses of duloxetine randomised controlled trials.
  • It is the first to compare doses with regard to study withdrawals.

Study design

  • Meta-analysis of 7 placebo-controlled, parallel group, double-blind randomised trials.
  • Funding: Natural Science Foundation, Heilongjiang, China.

Key results

  • Duloxetine was more effective than placebo for reducing pain (standardised mean difference [SMD], −0.26; 95% CI, −0.37 to −0.16).
  • Duloxetine (vs placebo) yielded a greater proportion of patients with ≥30% pain relief (risk ratio [RR], 1.31; 95% CI, 1.19-1.44) and with at ≥50% pain relief (RR, 1.46; 95% CI, 1.28-1.67).
  • Duloxetine was associated with more adverse events than placebo (RR, 1.17; 95% CI, 1.12-1.23).
  • Subgroup analysis found a greater incidence of all-cause study withdrawals vs placebo with duloxetine 120 mg/day (RR, 0.96; 95% CI, 0.80-1.15) vs 60 mg/day (RR, 0.77; 95% CI, 0.63-0.93).

Limitations

  • Participants not allowed other medications.
  • Findings do not apply to patients with comorbid disorders.

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