Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: Results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial
- PMID: 18395345
- DOI: 10.1016/j.pain.2008.02.024
Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: Results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial
Abstract
The primary objectives of this study were to assess the efficacy and safety of duloxetine for reducing pain severity in fibromyalgia patients with or without current major depressive disorder. This was a 6-month, multicenter, randomized, double-blind, placebo-controlled study. In total, 520 patients meeting American College of Rheumatology criteria for fibromyalgia were randomly assigned to duloxetine (20 mg/day, 60 mg/day, or 120 mg/day) or placebo, administered once daily, for 6 months (after 3 months, the duloxetine 20-mg/day group titrated to 60 mg/day). The co-primary outcome measures were the Brief Pain Inventory (BPI) average pain severity score and Patient Global Impressions of Improvement (PGI-I) score. Safety was assessed via treatment-emergent adverse events, and changes in vital sign, laboratory, and ECG measures. Compared with placebo-treated patients, those patients treated with duloxetine 120 mg/day improved significantly more on the co-primary outcome measures at 3 months (change in BPI score [-2.31 vs -1.39, P<0.001] and PGI-I [2.89 vs 3.39, P=0.004]) and at 6 months (change in BPI [-2.26 vs -1.43, P=0.003] and PGI-I [2.93 vs 3.37, P=0.012]). Compared with placebo, treatment with duloxetine 60 mg/day also significantly improved the co-primary measures at 3 months and BPI at 6 months. Duloxetine was efficacious in patients both with and without major depressive disorder. There were no clinically significant differences between treatment groups in changes in vital signs, laboratory measures, or ECG measures. Study results demonstrated that duloxetine at doses of 60 mg/day and 120 mg/day appears to be safe and efficacious in patients with fibromyalgia.
Trial registration: ClinicalTrials.gov NCT00190866.
Comment in
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Long-term trials of pregabalin and duloxetine for fibromyalgia symptoms: how study designs can affect placebo factors.Pain. 2008 Jun;136(3):232-234. doi: 10.1016/j.pain.2008.03.005. Epub 2008 Apr 1. Pain. 2008. PMID: 18384959 Free PMC article. No abstract available.
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Duloxetine and pregabalin: safe and effective for the long-term treatment of fibromyalgia?Nat Clin Pract Neurol. 2008 Nov;4(11):594-5. doi: 10.1038/ncpneuro0936. Epub 2008 Oct 14. Nat Clin Pract Neurol. 2008. PMID: 18852724
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First pregabalin and now duloxetine for fibromyalgia syndrome: closer to a brave new world?Nat Clin Pract Rheumatol. 2008 Dec;4(12):636-7. doi: 10.1038/ncprheum0938. Epub 2008 Nov 4. Nat Clin Pract Rheumatol. 2008. PMID: 18982001 No abstract available.
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References
-
- Arnold LM, Lu Y, Crofford LJ, Wohlreich M, Detke MJ, Iyengar S, et al., for the Duloxetine Fibromyalgia Trial Group. A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder. Arthritis Rheum. 2004;50:2974-2984.
-
- Arnold LM, Rosen A, Pritchett YL, D’Souza DN, Goldstein DJ, Iyengar S, et al. A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder. Pain. 2005;119:5-15.
-
- Basbaum AI, Fields HL. Endogenous pain control systems: brainstem spinal pathways and endorphin circuitry. Annu Rev Neurosci. 1984;7:309-338.
-
- Bech P, Kajdasz DK, Porsdal V. Dose-response relationship of duloxetine in placebo-controlled clinical trials in patients with major depressive disorder. Psychopharmacology. 2006;188:273-280.
-
- Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol. 1991;18:728-733.
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