Literature DB >> 20843911

Flexible dosed duloxetine in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled trial.

Lesley M Arnold1, Daniel Clauw, Fujun Wang, Jonna Ahl, Paula J Gaynor, Madelaine M Wohlreich.   

Abstract

OBJECTIVE: To investigate the efficacy of flexible dose duloxetine 60-120 mg/day on changes in fibromyalgia (FM) symptoms assessed by the Patient Global Impression of Improvement (PGI-I) scale.
METHODS: Outpatients ≥ 18 years of age who met American College of Rheumatology criteria for FM, and had ≥ 4 score on the Brief Pain Inventory (BPI) average pain item, were randomized to duloxetine (n = 263) or placebo (n = 267) for 24 week double-blind treatment (primary endpoint at Week 12). Key secondary measures included BPI average pain severity, patient-rated scales assessing mood, anxiety, pain, sleep, and stiffness, Clinical Global Impression of Severity (CGI-S), Multidimensional Fatigue Inventory, Cognitive and Physical Functioning Questionnaire, Beck Depression Inventory (BDI), Beck Anxiety Inventory, and Medical Outcome Study Short-Form Health Survey (SF-36).
RESULTS: At Week 12, duloxetine-treated patients reported significantly greater global improvement with mean PGI-I scores of 2.8 compared to 3.4 in the placebo group (p < 0.001). Significantly more duloxetine- versus placebo-treated patients (57% vs 32%; p < 0.001) reported feeling "much" or "very much better" (PGI-I score ≤ 2). There was significantly greater improvement with duloxetine versus placebo treatment in BPI average pain severity, mood (including BDI total), anxiety (patient-rated only), stiffness, CGI-S, fatigue, all SF-36 domains (except role-physical and physical component summary), and being less bothered by pain or sleep difficulties. Treatment-emergent adverse events occurring significantly more frequently with duloxetine included: nausea, headache, constipation, dry mouth, dizziness, diarrhea, and hyperhidrosis.
CONCLUSION: Treatment with duloxetine 60, 90, and 120 mg/day was associated with feeling much better, pain reduction, being less bothered by sleep difficulties, and improvement in mood, stiffness, fatigue and functioning. (Clinical trial registry NCT00673452).

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Year:  2010        PMID: 20843911     DOI: 10.3899/jrheum.100365

Source DB:  PubMed          Journal:  J Rheumatol        ISSN: 0315-162X            Impact factor:   4.666


  16 in total

Review 1.  Fibromyalgia Pathogenesis and Treatment Options Update.

Authors:  Steven Chinn; William Caldwell; Karina Gritsenko
Journal:  Curr Pain Headache Rep       Date:  2016-04

2.  [Psychopharmacological treatment in patients with somatoform disorders and functional body syndromes].

Authors:  H P Kapfhammer
Journal:  Nervenarzt       Date:  2012-09       Impact factor: 1.214

Review 3.  Alternatives to Opioids in the Pharmacologic Management of Chronic Pain Syndromes: A Narrative Review of Randomized, Controlled, and Blinded Clinical Trials.

Authors:  Andrea L Nicol; Robert W Hurley; Honorio T Benzon
Journal:  Anesth Analg       Date:  2017-11       Impact factor: 5.108

Review 4.  [Drug therapy of fibromyalgia syndrome. Systematic review, meta-analysis and guideline].

Authors:  C Sommer; W Häuser; R Alten; F Petzke; M Späth; T Tölle; N Uçeyler; A Winkelmann; E Winter; K J Bär
Journal:  Schmerz       Date:  2012-06       Impact factor: 1.107

Review 5.  Comparative efficacy of amitriptyline, duloxetine and pregabalin for treating fibromyalgia in adults: an overview with network meta-analysis.

Authors:  Fernanda Fávero Alberti; Matheus William Becker; Carine Raquel Blatt; Patricia Klarmann Ziegelmann; Tatiane da Silva Dal Pizzol; Diogo Pilger
Journal:  Clin Rheumatol       Date:  2022-03-26       Impact factor: 2.980

Review 6.  Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A).

Authors:  Laura J Julian
Journal:  Arthritis Care Res (Hoboken)       Date:  2011-11       Impact factor: 4.794

Review 7.  The Role of Vitamin D in the Management of Chronic Pain in Fibromyalgia: A Narrative Review.

Authors:  Hannah W Haddad; Allison C Jumonville; Katarina J Stark; Shavonne N Temple; Chukwudum C Dike; Elyse M Cornett; Alan D Kaye
Journal:  Health Psychol Res       Date:  2021-06-28

8.  Improvement in multiple dimensions of fatigue in patients with fibromyalgia treated with duloxetine: secondary analysis of a randomized, placebo-controlled trial.

Authors:  Lesley M Arnold; Fujun Wang; Jonna Ahl; Paula J Gaynor; Madelaine M Wohlreich
Journal:  Arthritis Res Ther       Date:  2011-06-13       Impact factor: 5.156

9.  Construct validation of patient global impression of severity (PGI-S) and improvement (PGI-I) questionnaires in the treatment of men with lower urinary tract symptoms secondary to benign prostatic hyperplasia.

Authors:  Lars Viktrup; Risa P Hayes; Ping Wang; Wei Shen
Journal:  BMC Urol       Date:  2012-11-07       Impact factor: 2.264

Review 10.  Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia.

Authors:  Patrick Welsch; Nurcan Üçeyler; Petra Klose; Brian Walitt; Winfried Häuser
Journal:  Cochrane Database Syst Rev       Date:  2018-02-28
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