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Efficacy and Safety of Duloxetine Compared with Placebo for Diabetic Neuropathy Pain:Meta-Analysis


Affiliations
1 Dept of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China
2 Zhongnan Hospital of Wuhan University, Wuhan, China
3 Dept of internal medicine, Wuhan, China
 

Background: Duloxetine is relatively considered as a treatment for diabetic neuropathy pain due it is balanced and potent reuptake inhibitor of both serotonin and nor epinephrine where these neurotransmitters play a great in pain inhibition.

Materials and Methods: We searched DLX related articles in Pubmed, Cochrane and Embase from 2005 to 2010. 158 articles were found after through search out of which 68 articles were case reports, reviews and meta-analysis, 40 studies were clinical trials but not efficient data was available, 45 studies were RCTs but not related to our topic. Only 5 RCTs included after exclusion. We then performed the meta-analysis of the studies which met our eligibility criteria we performed fixed effect model network meta-analysis to analyze the efficacy of DLX compare to placebo. We chose diabetic neuropathy duration, diabetes mellitus duration, types of diabetes and DLX with regard to MNSI scale.

Results: 5 published RCTs were included in this meta-analysis no significant difference observed for DLX and DND [(SD mean difference 0.22 (95%CI -0.16 to 0.60); P=0.25)], on diabetes mellitus duration for HbA1c and fasting blood glucose (FBG) [(SD mean difference -0.00 (95%CI-0.087 to 0.87); P=1.00)] and on types of diabetes [(COR 1.00 (95% CI 0.73 to 1.38; P=0.98)] and [(OR 1.00 (95% CI 0.72 to 1.37); P=0.98)]. DLX shown to have significant efficacious compared to placebo for MNSI (95% CI -0.37 to - 0.03); P=0.02)].

Conclusion: In the fixed effect model analyses of DLX, showed similar efficacy to placebo for efficacy parameters, except on MNSI scale but not clinically relevant.


Keywords

Duloxetine, Serotonin (5-HT), Nor-Epinephrine, Diabetic Neuropathy, Diabetes Mellitus, MNSI, Meta-Analysis.
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  • Efficacy and Safety of Duloxetine Compared with Placebo for Diabetic Neuropathy Pain:Meta-Analysis

Abstract Views: 173  |  PDF Views: 139

Authors

M. A. Hassan
Dept of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China
X. Y. Cheng
Dept of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China
Z. Dai
Dept of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China
M. N. Rahmathullah
Zhongnan Hospital of Wuhan University, Wuhan, China
Shahnawaz
Zhongnan Hospital of Wuhan University, Wuhan, China
H. Shamsa
Dept of internal medicine, Wuhan, China
H. Fathuma
Dept of internal medicine, Wuhan, China
A. H. Hussein
Dept of internal medicine, Wuhan, China

Abstract


Background: Duloxetine is relatively considered as a treatment for diabetic neuropathy pain due it is balanced and potent reuptake inhibitor of both serotonin and nor epinephrine where these neurotransmitters play a great in pain inhibition.

Materials and Methods: We searched DLX related articles in Pubmed, Cochrane and Embase from 2005 to 2010. 158 articles were found after through search out of which 68 articles were case reports, reviews and meta-analysis, 40 studies were clinical trials but not efficient data was available, 45 studies were RCTs but not related to our topic. Only 5 RCTs included after exclusion. We then performed the meta-analysis of the studies which met our eligibility criteria we performed fixed effect model network meta-analysis to analyze the efficacy of DLX compare to placebo. We chose diabetic neuropathy duration, diabetes mellitus duration, types of diabetes and DLX with regard to MNSI scale.

Results: 5 published RCTs were included in this meta-analysis no significant difference observed for DLX and DND [(SD mean difference 0.22 (95%CI -0.16 to 0.60); P=0.25)], on diabetes mellitus duration for HbA1c and fasting blood glucose (FBG) [(SD mean difference -0.00 (95%CI-0.087 to 0.87); P=1.00)] and on types of diabetes [(COR 1.00 (95% CI 0.73 to 1.38; P=0.98)] and [(OR 1.00 (95% CI 0.72 to 1.37); P=0.98)]. DLX shown to have significant efficacious compared to placebo for MNSI (95% CI -0.37 to - 0.03); P=0.02)].

Conclusion: In the fixed effect model analyses of DLX, showed similar efficacy to placebo for efficacy parameters, except on MNSI scale but not clinically relevant.


Keywords


Duloxetine, Serotonin (5-HT), Nor-Epinephrine, Diabetic Neuropathy, Diabetes Mellitus, MNSI, Meta-Analysis.

References





DOI: https://doi.org/10.18311/ijmds%2F2016%2F100627