Duloxetine moderately relieves osteoarthritis, chronic low back pain: meta-analysis

  • Osteoarthritis Cartilage

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Duloxetine shows efficacy and safety for osteoarthritis (OA) and chronic low back pain (CLBP), according to a meta-analysis of 9 randomized controlled trials (RCTs).

Why this matters

  • Results suggest that duloxetine can be considered a first-line drug on par with NSAIDs for OA and CLBP.

Study design

  • 9 RCTs (N=3209) were included.
  • Funding: Jiangsu Provincial Key R&D; others.

Key results

  • Duloxetine was superior to placebo for most outcomes:
    • Brief Pain Inventory 24-hour average pain:
      • Weighted mean difference (WMD): −0.67 (95% CI, −0.80 to −0.53).
    • Weekly mean of the 24-hour average pain:
      • WMD, −0.65 (95% CI, −0.79 to −0.52).
    • Patient's Global Impression of Improvement:
      • WMD, −0.41 (95% CI, −0.49 to −0.32).
    • 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).
    • Response rates for ≥30% (moderate) and ≥50% (substantial) reductions in chronic pain intensity:
      • Moderate: risk ratio, 1.35 (95% CI, 1.26-1.44). 
      • Substantial: risk ratio, 1.49 (95% CI, 1.36-1.63).
    • More treatment-emergent adverse events with duloxetine (risk ratio, 1.25; 95% CI, 1.17-1.33).

Limitations

  • Small number of studies.
  • Heterogeneity across studies.