The short-term effect and safety of duloxetine in osteoarthritis

Abstract

Background: Previous clinical trials indicated that duloxetine may be effective in the treatment of osteoarthritis (OA) pain. This meta-analysis is conducted to evaluate short term analgesic effect and safety of duloxetine in the treatment of OA. Methods: Electronic databases were searched in February 2019, including PUBMED, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science. All eligible studies should be randomized controlled trials (RCTs) comparing duloxetine treatment group to placebo about OA pain relief and safety outcomes. Results: Five RCTs with 2059 patients were involved in this systematic review and meta-analysis. Compared to placebo, duloxetine treatment showed significant better result, with higher reduction pain intensity (mean difference [MD] = –0.77, P < .00001), higher rates of both 30% and 50% reduction in pain severity (risk ratio [RR] = 1.42, P < .00001; RR = 1.62, P < .00001), lower mean Patient Global Improvement-Inventory (PGI-I) score (MD = –0.48, P < .00001). The results of the Western Ontario and McMaster Universities (WOMAC) score change from baseline to endpoint also favored duloxetine treatment group in all four categories, including total (MD = –5.43, P < .00001), pain (MD = –1.63, P = .001), physical function (MD = –4.22, P < .00001), and stiffness score (MD = –0.58, P < .00001). There were higher rates of treatment-emergent adverse events (TEAEs) (RR = 1.32, P < .00001) and discontinuation (RR = 1.88, P < .00001) in duloxetine group. However, there was no significant difference in the incidence of severe adverse events (SAEs) between these 2 groups (RR = 0.84, P = .68). Conclusion: Duloxetine was an effective and safe choice to improve pain and functional outcome in OA patients. However, further studies are still needed to find out the optimal dosage for OA and examine its long-term efficacy and safety. Trial registration number: CRD42019128862

The Effectiveness of Duloxetine for Knee Osteoarthritis: An Overview of Systematic Reviews

“…After the duplicates were screened out, eight articles were left. After referring to the full text, six papers were finally included ( Wang et al, 2015 ; Chen et al, 2019 ; Gao et al, 2019 ; Osani and Bannuru, 2019 ; Qu et al, 2020 ; Chen et al, 2021 ). The literature screening process is detailed in Figure 1 .…”

“…The number of RCTs in the SRs ranged from 3 to 6. Among them, five were published in English ( Wang et al, 2015 ; Chen et al, 2019 ; Gao et al, 2019 ; Osani and Bannuru, 2019 ; Chen et al, 2021 ) and one in Chinese ( Qu et al, 2020 ). Among the risk of bias assessment tools for RCTs, one paper chose the Jadad score ( Wang et al, 2015 ) and five papers selected the Cochrane Handbook recommended risk of bias assessment tools ( Chen et al, 2019 ; Gao et al, 2019 ; Osani and Bannuru, 2019 ; Qu et al, 2020 ; Chen et al, 2021 ).…”

“…Among them, five were published in English ( Wang et al, 2015 ; Chen et al, 2019 ; Gao et al, 2019 ; Osani and Bannuru, 2019 ; Chen et al, 2021 ) and one in Chinese ( Qu et al, 2020 ). Among the risk of bias assessment tools for RCTs, one paper chose the Jadad score ( Wang et al, 2015 ) and five papers selected the Cochrane Handbook recommended risk of bias assessment tools ( Chen et al, 2019 ; Gao et al, 2019 ; Osani and Bannuru, 2019 ; Qu et al, 2020 ; Chen et al, 2021 ). In addition, six papers decided on duloxetine 60/120 mg, with Qd as the intervention group and placebo as the control group, finding that duloxetine improved pain and function in KOA patients while attention is required to be paid to the occurrence of adverse events.…”

“…In terms of Domain 2, by evaluating the identification and selection of studies, 6 (100%) SRs were rated to be low-risk. 1 SR ( Wang et al, 2015 ) was rated as high risk in Domain 3 (data collection and study appraisal) with 3 SRs ( Chen et al, 2019 ; Gao et al, 2019 ; Qu et al, 2020 ) being rated as high risk in Domain 4 (synthesis and findings). Finally, 2 SRs ( Chen et al, 2019 ; Gao et al, 2019 ) were rated to be low-risk in Phase 3 (risk of bias in the review).…”

Estudo longitudinal sobre o impacto do exercício físico aeróbico adjuvante ao antidepressivo nos marcadores inflamatórios periféricos de pacientes com transtorno depressivo maior

“…Halvorsen; Tanum, 2017). Outros efeitos relatados foram: alívio em distúrbios gastrointestinais, como doença inflamatória intestinal (Spiller, 2002;Macer et al, 2017), dispepsia funcional e azia funcional, bem como dor torácica funcional (Xiong et al, 2018), artrite reumatoide (Richards et al, 2012), síndrome de fibromialgia (Häuser et al, 2012) e osteoartrite (Gao et al, 2019).…”