Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials

Sultan, Asquad; Gaskell, Helen; Derry, Sheena; Moore, R Andrew

doi:10.1186/1471-2377-8-29

Cited by 246 publications

(128 citation statements)

References 45 publications

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“…The drug is approved by the US Food and Drug administration for the treatment of diabetic polyneuropathy and is recommended as a first line treatment for this purpose [2]. Other indications include management of generalized anxiety disorder [3] fibromyalgia [4], and most recently, stress urinary incontinence [5] [6].…”

Section: Introductionmentioning

confidence: 99%

Trace Determination of Duloxetine HCl in Formulation and Spiked Human Serum at a Carbon Paste Electrode

Hassanein¹,

Moharram²,

Oraiby³

et al. 2017

AJAC

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The electrochemical behavior of duloxetine HCl (DXT.HCl) at a carbon paste electrode (CPE) was achieved by cyclic voltammetry and a mechanism of its oxidation was reported and illustrated. A sensitive linear sweep and square-wave adsorptive anodic stripping voltammetry methods were described for trace determination of DXT.HCl. Introduction: DXT.HCl, N-methyl-3-(nap-thalen-1-yloxy)-3-(thiophene-2-yl) propan-1-amine hydrochloride is a selective serotonin-norepinephrine reuptake inhibitor (SNRI) originally developed as an antidepressant and is currently recommended for maintenance treatment of major depressive disorder. Methods: Electrochemical behavior was studied using cyclic voltammetric method, and the analytical application was studied using linear sweep and square wave voltammetric methods. Solution pH has been measured by pH meter. Results: The process on the surface of carbon paste electrode was found to be irreversible and diffusion-controlled. The number of proton and electron transferred were calculated. Possible reaction mechanism taking place on the surface of electrode was proposed. Calibration plot constructed using square wave voltammetric technique was used for quantitative analysis in pharmaceutical and human serum samples. Limit of detection (LOD) and limit of quantification (LOQ) were calculated. Conclusions: In the present work, we described the electrochemical behavior of DXT.HCl drug. Two precise linear sweep and square wave adsorptive anodic stripping voltammetry methods have been described for its trace quantitation in pharmaceutical formulation and human serum. The method shows the development of a sensor for selective and sensitive determination of DXT.HCl.How to cite this paper: Hassanein, A.M.,

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Section: Introductionmentioning

confidence: 99%

Trace Determination of Duloxetine HCl in Formulation and Spiked Human Serum at a Carbon Paste Electrode

Hassanein¹,

Moharram²,

Oraiby³

et al. 2017

AJAC

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“…Natürlich sehen wir bei jeder Therapie auch Versager, die uns meist weniger präsent sind. [2,7,11,12,20,21]. Aber neben jenen Patienten, bei denen die jeweilige Substanz keine relevante Wirkung erzielt (Nonresponder) gibt es auch Responder auf das jeweilige Analgetikum mit einer klinisch relevanten Schmerzlinderung >30% [3,4,5].…”

Section: Wirken Sich Leitlinien Negativ Auf Den Klinischen Alltag Aus?unclassified

“…Selbst bei der Fibromyalgie ist -trotz hoher NNT-Werte -die Gruppe der Responder z. B. bei Gabe von Pregabalin oder Duloxetin signifikant größer als bei Placebogabe [20,21]. Vergleichbares gilt für Arthroseschmerz.…”

Section: Wirken Sich Leitlinien Negativ Auf Den Klinischen Alltag Aus?unclassified

Ärzte behandeln keine Mittelwerte – sondern Therapieresponder!

Maier

Baron

2012

Schmerz

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“…The Number Need to Treat (NNT) compared with the placebo was 6.4 (4.7 to 9.9). 46 A meta-analysis for treatment of fibromyalgia syndrome was published in 2009. 10 For SNRIs, duloxetine and milnacipran are efficacious in reducing pain (standardized mean difference SMD, -0.36; 95% confidence interval CI, -0.46 to -0.25; P  0.001) and sleep disturbances (SMD, -0.31; 95% CI, -0.47 to -0.14; P  0.001).…”

Section: Efficacymentioning

confidence: 99%

“…[30][31][32] A systematic review of randomized trials was undertaken in 2008. 46 Three trials concerning Duloxetine in FMS were involved. 28,29,31 The response rate was defined as a 50% reduction in the average pain score from baseline to endpoint.…”

Section: Efficacymentioning

confidence: 99%

Pharmacotherapy of Fibromyalgia: Focus on Duloxetine

Serra

Andréjak

2009

Clinical Medicine. Therapeutics

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Context: Fibromyalgia syndrome (FMS) is a frequent medical condition characterized by chronic widespread pain and reduced pain threshold. Associated symptoms include fatigue, non restorative sleep, and psychological distress. As usual in medicine, even if the pathogenesis is unclear, some treatments are useful to help patients. Objectives: Tricyclic antidepressants were the first drugs used to treat FMS. More recently, among serotonin-norepinephrine reuptake inhibitors, duloxetine was approved by US Food and Drug Administration to treat FMS. Duloxetine is used for the management of major depressive disorder, neuropathic pain, generalized anxiety disorder, and stress incontinence. In the pharmacotherapy of fibromyalgia, a focus is presented on the drug duloxetine. Results: Mechanism of action, metabolism and pharmacokinetic profile are presented. Clinical studies of Duloxetine showed an acceptable efficacy for this chronic condition: Number Need to Treat (NTT) of 4.7 to 9.9, through two 3-month placebo-controlled trials and two 6-month trials. Evaluation criteria are discussed. Safety of this medication has been found to be satisfactory, with nausea as the most common adverse event, in almost 20% of cases. Conclusion: Treatment algorithm for duloxetine is presented inside FMS treatment strategy. With duloxetine, it is important to start low and increase slowly to prevent or minimize adverse events: 30 mg/day up to 60 mg/day in the second week and if necessary up to 90-120 mg/day. It is possible to treat for 3 to 6 months, possibly up to 12 months. The drug could be decreased 2 to 4 weeks before stopping, with regular assessments during this time. International recommendations insist on multimodal treatments: drug and non drug. Also effective for anxiety and depression, duloxetine ranks among the first place drugs for FMS.

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Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials

Cited by 246 publications

References 45 publications

Trace Determination of Duloxetine HCl in Formulation and Spiked Human Serum at a Carbon Paste Electrode

Trace Determination of Duloxetine HCl in Formulation and Spiked Human Serum at a Carbon Paste Electrode

Ärzte behandeln keine Mittelwerte – sondern Therapieresponder!

Pharmacotherapy of Fibromyalgia: Focus on Duloxetine

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