SynthesisBMC neurology2008
Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials.
Synthesis in BMC neurology, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 60 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
120 citing papers in PubMed, 60 syntheses or guidelines pooled it, 288 citations in OpenAlex.
- Peripheral magnetic stimulation for the treatment of fibromyalgia: a systematic review and meta-analysis.Pain management · 2025Pooled it
- Topical clonidine for neuropathic pain in adults.The Cochrane database of systematic reviews · 2022Pooled it
- A Systematic Review of Efficacy, Safety, and Tolerability of Duloxetine.Frontiers in psychiatry · 2020Pooled it
- Pregabalin for neuropathic pain in adults.The Cochrane database of systematic reviews · 2019Pooled it
- Cannabis-based medicines for chronic neuropathic pain in adults.The Cochrane database of systematic reviews · 2018Pooled it
- Combination pharmacotherapy for the treatment of fibromyalgia in adults.The Cochrane database of systematic reviews · 2018Pooled it
- Acupuncture for neuropathic pain in adults.The Cochrane database of systematic reviews · 2017Pooled it
- Transcutaneous electrical nerve stimulation (TENS) for fibromyalgia in adults.The Cochrane database of systematic reviews · 2017Pooled it
- Antiepileptic drugs for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017Pooled it
- Antidepressants for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017Pooled it
- Paracetamol (acetaminophen) for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017Pooled it
- Non-steroidal anti-inflammatory drugs (NSAIDs) for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017Pooled it
- Opioids for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017Pooled it
- Non-steroidal anti-inflammatory drugs (NSAIDs) for cancer-related pain in children and adolescents.The Cochrane database of systematic reviews · 2017Pooled it
- Opioids for cancer-related pain in children and adolescents.The Cochrane database of systematic reviews · 2017Pooled it
- Tramadol for neuropathic pain in adults.The Cochrane database of systematic reviews · 2017Pooled it
- Gabapentin for chronic neuropathic pain in adults.The Cochrane database of systematic reviews · 2017Pooled it
- Morphine for chronic neuropathic pain in adults.The Cochrane database of systematic reviews · 2017Pooled it
- Methadone for neuropathic pain in adults.The Cochrane database of systematic reviews · 2017Pooled it
- Oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults.The Cochrane database of systematic reviews · 2017Pooled it
60 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuloxetine hydrochloride is a reuptake inhibitor of 5-hydroxytryptamine and norepinephrine used to treat depression, generalized anxiety disorder, neuropathic pain, and stress incontinence in women. We investigated the efficacy of duloxetine in painful diabetic neuropathy and fibromyalgia to allow comparison with other antidepressants.
methodsWe searched PubMed, EMBASE (via Ovid), and Cochrane CENTRAL up to June 2008 for randomised controlled trials using duloxetine to treat neuropathic pain.
resultsWe identified six trials with 1,696 patients: 1,510 were treated with duloxetine and 706 with placebo. All patients had established baseline pain of at least moderate severity. Trial duration was 12 to 13 weeks. Three trials enrolled patients with painful diabetic neuropathy (PDN) and three enrolled patients with fibromyalgia. The number needed to treat (NNT) for at least 50% pain relief at 12 to 13 weeks with duloxetine 60 mg versus placebo (1,211 patients in the total comparison) was 5.8 (95% CI 4.5 to 8.4), and for duloxetine 120 mg (1,410 patients) was 5.7 (4.5 to 5.7). There was no difference in NNTs between PDN and fibromyalgia. With all doses of duloxetine combined (20/60/120 mg) there were fewer withdrawals for lack of efficacy than with placebo (number needed to treat to prevent one withdrawal 20 (13 to 42)), but more withdrawals due to adverse events (number needed to harm (NNH) 15 (11 to 25)). Nausea, somnolence, constipation, and reduced appetite were all more common with duloxetine than placebo (NNH values 6.3, 11, 11, and 18 respectively). The results for duloxetine are compared with published data for other antidepressants in neuropathic pain.
conclusionDuloxetine 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. The NNT of 6 for 50% pain relief suggests that this is likely to be a useful drug in these difficult-to-treat conditions, where typically only a minority of patients respond. Comparing duloxetine with antidepressants for pain relief in DPN shows inadequacies in the evidence for efficacy of antidepressants, which are currently recommended in PDN care pathways.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.