PMID- 26176791
OWN - NLM
STAT- MEDLINE
DCOM- 20160502
LR  - 20220317
IS  - 1526-4637 (Electronic)
IS  - 1526-2375 (Linking)
VI  - 16
IP  - 7
DP  - 2015 Jul
TI  - Efficacy and Safety of Duloxetine on Osteoarthritis Knee Pain: A Meta-Analysis of 
      Randomized Controlled Trials.
PG  - 1373-85
LID - 10.1111/pme.12800 [doi]
AB  - OBJECTIVES: The aim of this meta-analysis was to evaluate the efficacy and safety 
      of duloxetine for management of osteoarthritis knee (OAK) pain. METHODS: A 
      systematic literature search of articles for management of OAK using duloxetine 
      were performed in PubMed, EBSCO, EMBASE, ScienceDirect, MEDLINE, 
      ClinicalTrials.gov, Google Scholar, and Cochrane Central Register of Controlled 
      Trials from the available date of inception until the latest issue (October 
      2013). Potentially relevant randomized controlled trials (RCTs) regarding to 
      comparison of efficacy and safety of duloxetine with placebo for managing OAK 
      pain were included. Also, studies with specific data regarding to pain reductions 
      and response rate, Patient Global Impression of Improvement (PGI-I), functional 
      improvement, Western Ontario and McMaster Osteoarthritis Index (WOMAC), adverse 
      events (AEs), treatment-emergent AEs (TEAEs), mortality were included and 
      analyzed, and those with confounding conditions were excluded. Studies were 
      assessed for quality using the Jadad five-point score for RCTs. Finally, a 
      meta-analysis of all RCTs eligible for inclusion criteria was performed using 
      Review Manager 5.1 meta-analysis software. RESULTS: Three RCTs that enrolled 
      1,011 patients were included in our meta-analysis. There were statistically 
      significant differences between patients taking duloxetine and those taking 
      placebo with regard to the reductions in pain intensity (992 patients, mean 
      difference [MD] = -0.88, 95% confidence interval [CI] -1.11--0.65, P < 0.0001), a 
      moderate improvement in pain intensity (>= 30% response rate; 989 patients, risk 
      ratio [RR] = 1.49, 95% CI 1.31-1.70, P < 0.0001), a substantial improvement in 
      pain intensity (>=50% response rate; 989 patients, RR = 1.69, 95% CI 1.27-2.25, 
      P = 0.0004). Statistically significant differences in PGI-I (976 patients, 
      MD = -0.47, 95% CI -0.63 to -0.30, P < 0.0001) and WOMAC-physical function 
      subscale (977 patients, MD = -4.25, 95% CI -5.82 to -2.68, P < 0.0001) were 
      observed. Similarly, more AEs, TEAEs, and discontinuations for any reason were 
      associated with the use of duloxetine than with placebo (1,011 patients, 
      RR = 2.15, 95% CI 1.48-3.11, P < 0.0001; 1,011 patients, RR = 1.32, 95% CI 
      1.16-1.49, P < 0.0001; 1,011 patients, RR = 1.43, 95% CI 1.14-1.78, P = 0.002, 
      respectively). However, differences in serious AEs were not significantly 
      statistically different. Moreover, no deaths occurred during these three studies. 
      CONCLUSION: This analysis suggests duloxetine (60/120 mg quaque die (QD)), 
      compared with placebo control, resulted in a greater reduction in pain, improved 
      function and patient-rated impression of improvement, and acceptable adverse 
      effects for the treatment of OAK pain after approximately 10-13 weeks of 
      treatment.
CI  - (c) 2015 American Academy of Pain Medicine.
FAU - Wang, Zhao Yu
AU  - Wang ZY
AD  - Guangdong Province Key Laboratory for Biotechnology Drug Candidates, School of 
      Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, 
      510006, China.
FAU - Shi, Sheng Ying
AU  - Shi SY
AD  - Department of Pharmacy, Zhujiang Hospital, Southern Medical University, 
      Guangzhou, 510282, China.
FAU - Li, Shu Jie
AU  - Li SJ
AD  - Department of Pharmacy, Zhujiang Hospital, Southern Medical University, 
      Guangzhou, 510282, China.
FAU - Chen, Feng
AU  - Chen F
AD  - Department of Pharmacy, Yue Bei People's Hospital, Shantou University, Shaoguan, 
      512026, China.
FAU - Chen, Huang
AU  - Chen H
AD  - Guangdong Province Key Laboratory for Biotechnology Drug Candidates, School of 
      Biosciences and Biopharmaceutics, Guangdong Pharmaceutical University, Guangzhou, 
      510006, China.
FAU - Lin, Hai Zhen
AU  - Lin HZ
AD  - Department of Pharmacy, Zhujiang Hospital, Southern Medical University, 
      Guangzhou, 510282, China.
FAU - Lin, Jing Ming
AU  - Lin JM
AD  - Pharmaceutical Research & Development, Zhujiang Hospital, Southern Medical 
      University, Guangzhou, 510282, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20150605
PL  - England
TA  - Pain Med
JT  - Pain medicine (Malden, Mass.)
JID - 100894201
RN  - 0 (Analgesics)
RN  - 9044SC542W (Duloxetine Hydrochloride)
SB  - IM
MH  - Analgesics/therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Duloxetine Hydrochloride/administration & dosage/adverse effects/*therapeutic use
MH  - Humans
MH  - Knee Joint/*drug effects/pathology
MH  - Osteoarthritis, Knee/*drug therapy/*physiopathology
MH  - Pain Management/*methods
MH  - Pain Measurement/methods
MH  - Randomized Controlled Trials as Topic
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Duloxetine
OT  - Meta-Analysis
OT  - Osteoarthritis Knee Pain
OT  - Randomized Controlled Trials
EDAT- 2015/07/16 06:00
MHDA- 2016/05/03 06:00
CRDT- 2015/07/16 06:00
PHST- 2014/07/12 00:00 [received]
PHST- 2015/01/06 00:00 [revised]
PHST- 2015/03/29 00:00 [accepted]
PHST- 2015/07/16 06:00 [entrez]
PHST- 2015/07/16 06:00 [pubmed]
PHST- 2016/05/03 06:00 [medline]
AID - 10.1111/pme.12800 [doi]
PST - ppublish
SO  - Pain Med. 2015 Jul;16(7):1373-85. doi: 10.1111/pme.12800. Epub 2015 Jun 5.