Comparison of the Efficacy and Safety of Duloxetine and Gabapentin in Diabetic Peripheral Neuropathic Pain: A Meta‐Analysis

Abstract

Background. Diabetic peripheral neuropathic pain (DPNP) is a common chronic pain condition affecting diabetic patients and has growing importance because of the increasing prevalence of patients with type 2 diabetes mellitus. Pain is the most troublesome symptom of DPNP, increasingly recognized as an important and independent feature of DPNP. This meta-analysis aims to compare the efficacy and safety of duloxetine and gabapentin in the treatment of diabetic peripheral neuropathic pain (DPNP) and therefore to provide evidence-based medicine for clinical treatment. Methods. Relevant randomized controlled trials on duloxetine versus gabapentin for DPNP were searched from PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and Chinese Biomedical Literature Database from database inception to October 2021. The data were analyzed by RevMan 5.3 software. Results. Seven studies were included. The results showed that, at the end of the study, duloxetine was significantly superior to gabapentin in terms of the incidence of adverse reactions (RR = 0.59, 95% CI: 0.45–0.79, P < 0.01), sleep interference score (SMD = −0.35, 95% CI: −0.63 to −0.08, P < 0.05), but no significant differences in VAS score (SMD = −0.14, 95% CI: −0.31–0.03, P > 0.05), overall response rate (RR = 1.05, 95% CI: 0.92–1.20, P > 0.05), and clinical global impression of change (SMD = 0.07, 95% CI: −0.20–0.35, P > 0.05). Conclusion. Compared with gabapentin, duloxetine has no obvious advantage in the treatment of diabetic peripheral neuralgia, but it has less side effects and significantly higher safety.

Enhanced healing efficacy of an optimized gabapentin-melittin nanoconjugate gel-loaded formulation in excised wounds of diabetic rats

“…It is well established that normal wound healing is a controlled anticipated process, and any alteration in the steps of the healing process may result in “venous ulcer,” ‘intractable ulcers or chronic wounds that sometimes become lethal. Hyperglycemic condition hinders the delivery of nutrients and other immunological factors that automatically reflect impaired wound healing (Jiang et al, 2022 ). In diabetic patients, delayed wound healing is related to impaired growth factor production, inflammatory cell function, angiogenesis and fibroblast production and migration (Rose & Kam, 2002 ).…”

A Prospective Observational Study Comparing the Efficacy and Safety of Duloxetine and Pregabalin in Diabetic Peripheral Neuropathic Pain

“…The pain is debilitating and adversely affects the quality of life. Moreover, other complications are also attributed to it, including diabetic foot ulcers and diabetic foot deformities [ 12 , 13 ]. DLX is an antidepressant that reduces neuropathic pain by increasing nor-epinephrine and 5-hydroxytryptamine (5-HT) levels in the CNS.…”

Effective Single Twymeeg Administration for Elderly Patient with Type 2 Diabetes (T2D), Arthralgia and Depression as Common Medical Problems

“…Duloxetine seems to present proper relief effect on LBP for elder patients, and it can contribute improving pain sensitization. Concerning diabetic peripheral neuropathic pain (DPNP), comparative study was performed for trials on duloxetine versus gabapentin by internet search for related data [31]. From the results of 7 related studies, no significant differences were found for VAS score and overall response rate in both groups.…”