Efficacy and safety of duloxetine in chronic musculoskeletal pain: a systematic review and meta-analysis

Abstract

Background Chronic musculoskeletal pain (CMP) is a complex condition that is mainly treated with analgesic drugs. However, antidepressant intervention is also an important factor in the treatment of CMP. Duloxetine is an effective treatment option for patients with CMP as its antidepressant effect. The purpose of this article is to evaluate the efficacy and safety of duloxetine in treating CMP. Databases and data treatment We searched PubMed, Web of Science, Embase, Cochrane Library from inception to May, 2022. Randomized controlled trials (RCTs) evaluating the efficacy and safety of duloxetine versus placebo in patients with CMP were included. We identified 13 articles and studied a population of 4201 participants in 4 countries. Results This meta-analysis showed that the duloxetine has statistically significant compared with the placebo control, benefits on 24-hour average pain, living quality, physical function, and global impressions and there was no difference in the incidence of serious adverse event. In general, duloxetine can improve mood and pain level at the same time. Conclusions This review shows a significant contribution of duloxetine to CMP symptom relief. This meta-analysis improved that duloxetine can significantly reduce the pain level of patients, improve depressive symptoms and global impression, and has no obvious serious adverse reactions. However, additional studies are required to confirm the relationship between psychological diseases and chronic pain and explore their internal links.

Nonhormone therapies for vasomotor symptom management

“…10,11,[23][24][25][26][27][28][29][30][31][32][33][34][35] SNRIs, especially duloxetine, which is approved by the US Food and Drug Administration for the treatment of fi bromyalgia and chronic musculoskeletal pain, are frequently used to treat chronic somatic pain conditions. [36][37][38] As such, they could be considered a good option for the treatment of VMS in patients with prominent menopause-related arthralgia. Because nonhormone medications are often used to treat VMS in breast cancer survivors, it is important to note that paroxetine and fl uoxetine are potent cytochrome P450 CYP2D6 (the enzyme that converts tamoxifen to its most active metabolite) inhibitors and should not be used with tamoxifen, as they would reduce tamoxifen's bioavailability and effi cacy.…”

Duloxetine and cognitive behavioral therapy with phone-based support for the treatment of chronic musculoskeletal pain: study protocol of the PRECICE randomized control trial

“…In preclinical and clinical studies of pain, duloxetine, a selective serotonin norepinephrine reuptake inhibitor, reduces central sensitization [ 26 – 29 ]. Based on the strength of efficacy data [ 30 ], duloxetine received a Food and Drug Administration (FDA) indication for CMP. However, when used in real-world clinic practice, duloxetine only led to modest improvements in pain-related outcomes [ 31 , 32 ].…”

Duloxetine and Cognitive Behavioral Therapy with Phone-based Support for the Treatment of Chronic Musculoskeletal Pain: Study Protocol of the PRECICE Randomized Control Trial

“… 25 In preclinical and clinical studies of pain, duloxetine, a selective serotonin norepinephrine reuptake inhibitor, reduces central sensitization. 26 – 29 Based on the strength of efficacy data, 30 duloxetine received a Food and Drug Administration (FDA) indication for CMP. However, when used in real world clinic practice, duloxetine only led to modest improvements in pain-related outcomes.…”