Duloxetine diminishes fibromyalgia pain in meta-analysis

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.