Evidence map›Paper›PMID 23733529›Full record

Trial reportEuropean journal of pain (London, England)2014

Duloxetine use in chronic painful conditions--individual patient data responder analysis.

R A Moore, N Cai, V Skljarevski, T R Tölle

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of pain (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02652988 (Home-based Transcranial Direct Current Stimulation in Fibromyalgia Patients. Phase II, Randomized, Double-blind, Single-center Clinical Trial), which is not on this map. Cited by 72 papers, 45 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 45 pooled it
18.3field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02652988 nacompletednot on this mapstarted 2016, after this paper: background citation

Home-based Transcranial Direct Current Stimulation in Fibromyalgia Patients. Phase II, Randomized, Double-blind, Single-center Clinical Trial

TypeinterventionalSponsorWolnei CaumoRan2016 to 2018Enrolled20ConditionsFibromyalgiaArmsActive-tDCS, Sham-tDCS
3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 45 syntheses or guidelines pooled it, 171 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Antidepressants for hip and knee osteoarthritis.The Cochrane database of systematic reviews · 2022
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pregabalin for neuropathic pain in adults.The Cochrane database of systematic reviews · 2019
    Pooled it
  7. Mirtazapine for fibromyalgia in adults.The Cochrane database of systematic reviews · 2018
    Pooled it
  8. Cannabis-based medicines for chronic neuropathic pain in adults.The Cochrane database of systematic reviews · 2018
    Pooled it
  9. Acupuncture for neuropathic pain in adults.The Cochrane database of systematic reviews · 2017
    Pooled it
  10. Pooled it
  11. Antiepileptic drugs for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017
    Pooled it
  12. Antidepressants for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017
    Pooled it
  13. Pooled it
  14. Pooled it
  15. Opioids for chronic non-cancer pain in children and adolescents.The Cochrane database of systematic reviews · 2017
    Pooled it
  16. Pooled it
  17. Opioids for cancer-related pain in children and adolescents.The Cochrane database of systematic reviews · 2017
    Pooled it
  18. Tramadol for neuropathic pain in adults.The Cochrane database of systematic reviews · 2017
    Pooled it
  19. Gabapentin for chronic neuropathic pain in adults.The Cochrane database of systematic reviews · 2017
    Pooled it
  20. Pooled it

12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

R A MoorePain Research and Nuffield Division of Anaesthetics, University of Oxford, UK.
N Cai
V Skljarevski
T R Tölle
Eli Lilly (United States) · USTechnical University of Munich · DEUniversity of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuloxetine has been studied in four distinct chronic pain conditions - osteoarthritis (OA), fibromyalgia, chronic low back pain (CLBP) and diabetic peripheral neuropathic pain (DPNP). These trials have involved large numbers of patients with at least moderate pain, and have used similar methods for recording pain intensity, over about 12 weeks.

methodsData from the trials were pooled according to painful condition, and reanalysed at the level of the individual patient and using increasing levels of pain intensity reduction (<15%, 15-29%, 30-49%, ≥ 50%), with different imputation methods on withdrawal.

resultsThe proportion of patients recording at least 50% pain intensity reduction plateaued after 2-6 weeks in fibromyalgia, and 8-12 weeks in other conditions. The duloxetine-specific benefit [number needed to treat (NNT) for at least 50% pain intensity reduction] was fairly constant after about 2 weeks for DPNP and fibromyalgia and after about 4 or 5 weeks for OA and CLBP. In all conditions, responses were bimodal, with patients generally experiencing either very good or very poor pain relief. Last-observation-carried-forward imputation produced numerically and occasionally statistically better (lower) NNTs than use of baseline-observation-carried-forward (true response).

conclusionsBaseline-observation-carried-forward (true response), which combines the success of high levels of pain relief with the failure to experience pain relief on withdrawal of the drug is conservative and probably reflective of clinical practice experience. The distribution of effect was not normal; few patients had the average response and averages are not an appropriate descriptor for these data.

Indexed as

Antidepressive AgentsChronic PainDiabetic NeuropathiesDouble-Blind MethodDuloxetine HydrochlorideFibromyalgiaHumansIndividualityLow Back PainOsteoarthritisPain MeasurementThiophenesTreatment OutcomeAntidepressive AgentsDuloxetine HydrochlorideThiophenes

Identifiers

PMID23733529
PMCPMC4302330
OpenAlexW1517417769

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.