PMID- 38285030
OWN - NLM
STAT- MEDLINE
DCOM- 20240130
LR  - 20240206
IS  - 2150-1149 (Electronic)
IS  - 1533-3159 (Linking)
VI  - 27
IP  - 1
DP  - 2024 Jan
TI  - Co-treatment with Oral Duloxetine and Intraarticular Injection of Corticosteroid 
      plus Hyaluronic Acid Reduces Pain in the Treatment of Knee Osteoarthritis.
PG  - E45-E53
AB  - BACKGROUND: Knee osteoarthritis (OA) is a common form of arthritis in elders 
      which can lead to reduced daily activity and quality of life. It is important to 
      administer a proper treatment with high efficacy and low side effects. In this 
      study, we evaluated the efficacy of co-treatment with oral duloxetine and 
      intraarticular (IA) injection of hyaluronic acid (HA) and corticosteroid (CS) in 
      patients with knee OA. OBJECTIVES: This study aimed to test the hypothesis that 
      an IA injection of CS+HA combined with duloxetine could achieve pain management 
      superior to that of an IA injection of CS+HA alone in patients experiencing knee 
      OA related pain. STUDY DESIGN: This study adopted a prospective, randomized, 
      open-label blind endpoint study design. SETTING: The investigation was performed 
      at Beijing Tiantan Hospital Affiliated with the Capital Medical University from 
      October 2019 to December 2021. The study plan was approved by the Ethics 
      Committee of Beijing Tiantan Hospital (KY 2019-086-02). METHODS: A total of 150 
      patients were randomly allocated to receive either duloxetine combined with an IA 
      injection (n = 75) or a single IA injection alone (n = 75). All patients were 
      followed for 24 weeks. The primary outcome was the change in the weekly 24 hours 
      average mean pain scores, and the secondary outcomes included the proportion of 
      patients with >= 30% or >= 50% pain reduction, Brief Pain Inventory (BPI) items, 
      Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, 
      Patient Global Impression Improvement (PGI-I) ratings, hospital anxiety and 
      depression scale (HADS) scores and adverse events (AEs).. RESULTS: Patients in 
      the experimental group had significantly greater improvement in the change of 
      weekly mean of the 24 hours average pain scores, BPI pain severity ratings (P < 
      0.001) and WOMAC scores (P < 0.001) at the study endpoint. A significantly 
      greater percentage of patients in the experimental group rated PGI-I of <= 2 (P = 
      0.021) and >= 50% pain reduction (P = 0.029) at 24 weeks. There was no difference 
      in the proportion of patients with <= 30% pain reduction, the HADS scores or 
      frequency of AEs between the 2 groups. LIMITATIONS: The effectiveness and safety 
      were examined only up to 24 weeks after treatment, and we did not perform a 
      long-term follow-up as most previous studies have. Optimum dosage of duloxetine, 
      as well as different molecular-weight HA, should be investigated in future 
      studies. CONCLUSION: Patients receiving co-treatment with oral duloxetine and IA 
      (HA+CS) injections experienced considerable improvement in pain and knee function 
      compared to those who received an IA injection alone.
FAU - Li, DuoYi
AU  - Li D
AD  - Department of Pain Management, Beijing Tiantan Hospital, Capital Medical 
      University, Beijing, China; Department of Anesthesiology, Beijing Children's 
      Hospital, Capital Medical University, Beijing, China.
FAU - Hang, Rong
AU  - Hang R
AD  - Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Meng, Lang
AU  - Meng L
AD  - Department of Pain Management, Beijing Tiantan Hospital, Capital Medical 
      University, Beijing, China.
FAU - Zhao, Zhigang
AU  - Zhao Z
AD  - Department of Pharmacy, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Zhao, Chunmei
AU  - Zhao C
AD  - Department of Pain Management, Beijing Tiantan Hospital, Capital Medical 
      University, Beijing, China.
FAU - Luo, Fang
AU  - Luo F
AD  - Department of Pain Management, Beijing Tiantan Hospital, Capital Medical 
      University, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Pain Physician
JT  - Pain physician
JID - 100954394
RN  - 9004-61-9 (Hyaluronic Acid)
RN  - 9044SC542W (Duloxetine Hydrochloride)
RN  - 0 (Adrenal Cortex Hormones)
SB  - IM
MH  - Humans
MH  - Aged
MH  - *Hyaluronic Acid/therapeutic use
MH  - Duloxetine Hydrochloride/therapeutic use
MH  - *Osteoarthritis, Knee/complications/drug therapy
MH  - Prospective Studies
MH  - Quality of Life
MH  - Injections, Intra-Articular
MH  - Pain/drug therapy/etiology
MH  - Adrenal Cortex Hormones
OTO - NOTNLM
OT  - co-treatment
OT  - corticosteroid
OT  - duloxetine
OT  - hyaluronic acid
OT  - intraarticular injection
OT  - knee osteoarthritis
OT  - Pain management
EDAT- 2024/01/29 12:43
MHDA- 2024/01/30 12:42
CRDT- 2024/01/29 10:58
PHST- 2024/01/30 12:42 [medline]
PHST- 2024/01/29 12:43 [pubmed]
PHST- 2024/01/29 10:58 [entrez]
PST - ppublish
SO  - Pain Physician. 2024 Jan;27(1):E45-E53.