Cochrane · systematic review · CD007115
Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia
Lunn, MPT, Hughes, RAC, Wiffen, PJ · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
12
No studies
3
Included studies
NR
No studies 3 · 20%Ungraded 0 · 0%Very low 0 · 0%Low 6 · 40%Moderate 6 · 40%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyDuloxetine for the treatment of painful diabetic neuropathy
Population: patients with painful neuropathy or chronic pain from diabetic peripheral neuropathy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number of patients with ≥ 50% improvement of pain at 12 weeks or less Duloxetine 60 mg daily 11‐point Likert score | RR 1.73 [1.44, 2.08] | 4 studies · 908 participants | Moderate Downgraded: publication bias |
Mean improvement in pain at 12 weeks or less Duloxetine 60 mg daily 11‐point Likert score Scale from: 0 to 10 | no estimate extracted | 4 studies · 722 participants | Moderate Downgraded: inconsistency |
Number of patients with ≥ 30% improvement in pain at 12 weeks or less Duloxetine 60 mg daily 11‐point Likert scale | RR 1.53 [1.33, 1.75] | 4 studies · 799 participants | Moderate Downgraded: publication bias |
Mean improvement in Patient Reported Global Impression of Change at 12 weeks or less Duloxetine 60 mg daily VAS Scale from: 0 to 10 | no estimate extracted | 5 studies · 1018 participants | Moderate Downgraded: imprecision |
Adverse event leading to cessation All neuropathic pain indications Duloxetine 60 mg daily | RR 1.95 [1.6, 2.37] | 14 studies · 4837 participants | Low |
Duloxetine for the treatment of the chronic pain of fibromyalgia
Population: patients with the chronic pain of fibromyalgia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number with ≥ 50% improvement of pain at 12 weeks or less Duloxetine 60 mg daily 11‐point Likert scale | RR 1.57 [1.2, 2.06] | 2 studies · 528 participants | Low |
Number with ≥ 30% improvement of pain at 12 weeks or less Duloxetine 60 mg daily | RR 1.52 [1.24, 1.85] | 2 studies · 528 participants | Low |
Mean improvement in the Patient Reported Global Impression of Change at completion of trial Duloxetine 60 mg daily VAS Scale from: 0 to 10 | no estimate extracted | 2 studies · 519 participants | Low |
Mean improvement in pain at 12 weeks or less Duloxetine 120 mg daily LikertScale from: 0 to 10 | no estimate extracted | 1 study · 507 participants | Moderate |
Adverse events | no estimate extracted | NR | No studies |
Duloxetine for the treatment of pain in major depressive disorder
Population: patients with pain in major depressive disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Number with ≥ 50% pain relief at 12 weeks or less | RR 1.37 [1.19, 1.59] | 2 studies · 1023 participants | Moderate |
Number with ≥ 30% pain relief at 12 weeks or less | RR 1.27 [1.15, 1.4] | 3 studies · 1359 participants | Low |
Mean improvement in pain at 12 weeks or less Visual analogue scale. Scale from: 0 to 10. | no estimate extracted | 3 studies · 1359 participants | Low |
Mean improvement in Patient Reported Global Impression of Change at 12 weeks or less | no estimate extracted | NR | No studies |
Adverse events | no estimate extracted | NR | No studies |
Comparison
Population: patients with treating painful neuropathy or chronic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Greater than 50% improvement of diabetic peripheral neuropathic pain‐ Duloxetine 60 mg daily 11 point Likert score1 ( | RR 1.65 [1.34, 2.03] | 3 studies · 655 participants | Moderate Downgraded: risk of bias, publication bias |
Improvement in diabetic peripheral neuropathic pain ‐ Duloxetine 60 mg daily 11‐point Likert Scale. Scale from: 0 to 10. ( | no estimate extracted | 3 studies · 618 participants | Moderate Downgraded: risk of bias, publication bias |
Greater than 30% improvement in diabetic peripheral neuropathic pain ‐ Duloxetine 60 mg daily 11‐point Likert Scale6 ( | RR 1.53 [1.27, 1.83] | 2 studies · 442 participants | Moderate Downgraded: risk of bias, publication bias |
Greater than 50% improvement of fibromyalgia pain ‐ Duloxetine 60 mg daily 11‐point Likert scale ( | RR 1.57 [1.2, 2.06] | 2 studies · 528 participants | Moderate Downgraded: risk of bias, publication bias |
Adverse event leading to cessation ‐ Duloxetine 60 mg daily | RR 1.67 [1.2, 2.32] | 5 studies · 1215 participants | Moderate Downgraded: risk of bias, publication bias |