Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials
2008

Duloxetine for Painful Diabetic Neuropathy and Fibromyalgia Pain

Sample size: 1696 publication Evidence: high

Author Information

Author(s): Sultan Asquad, Gaskell Helen, Derry Sheena, Moore R Andrew

Primary Institution: Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK

Hypothesis

We investigated the efficacy of duloxetine in painful diabetic neuropathy and fibromyalgia to allow comparison with other antidepressants.

Conclusion

Duloxetine is equally effective for the treatment of PDN and fibromyalgia, judged by the outcome of at least 50% pain relief over 12 weeks, and is well tolerated.

Supporting Evidence

  • 41% of patients achieved 50% pain relief with duloxetine compared to 24% with placebo.
  • The number needed to treat (NNT) for at least 50% pain relief with duloxetine was 5.9.
  • Duloxetine was well tolerated with fewer withdrawals due to lack of efficacy compared to placebo.

Takeaway

Duloxetine helps reduce pain for people with diabetic nerve pain and fibromyalgia, making it a good option for these tough conditions.

Methodology

We searched PubMed, EMBASE, and Cochrane CENTRAL for randomised controlled trials using duloxetine to treat neuropathic pain.

Potential Biases

The trials were of good methodological quality, indicating a low chance of bias.

Limitations

The trials were only 12 to 13 weeks long, providing no information for longer-term efficacy or safety.

Participant Demographics

The mean age in the trials ranged between 49 and 61 years, and the majority of patients were Caucasian.

Statistical Information

P-Value

p=0.89

Confidence Interval

95% CI 4.5 to 8.4

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1471-2377-8-29

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