Evidence map›Paper›PMID 35123461›Full record

Trial reportBMC musculoskeletal disorders2022

Duloxetine in OsteoArthritis (DOA) study: effects of duloxetine on pain and function in end-stage hip and knee OA - a pragmatic enriched randomized controlled trial.

T Blikman, W Rienstra, T M van Raaij, A J Ten Hagen, B Dijkstra, W P Zijlstra, S K Bulstra, M Stevens, I van den Akker-Scheek

Open access · goldAbstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
2.0field-weighted citation impact, top 13% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 19 citations in OpenAlex.

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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

9 authors at 3 institutions in 1 country.

T BlikmanDepartment of Orthopedics, University of Groningen, University Medical Center Groningen, P.O. Box 30001, Groningen, RB, 9700, The Netherlands. t.blikman@umcg.nl.
W RienstraDepartment of Orthopedics, University of Groningen, University Medical Center Groningen, P.O. Box 30001, Groningen, RB, 9700, The Netherlands.
T M van RaaijDepartment of Orthopedics, Martini Hospital Groningen, Groningen, The Netherlands.
A J Ten HagenDepartment of Anaesthesiology, Martini Hospital Groningen, Groningen, The Netherlands.
B DijkstraDepartment of Orthopedics, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
W P ZijlstraDepartment of Orthopedics, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
S K BulstraDepartment of Orthopedics, University of Groningen, University Medical Center Groningen, P.O. Box 30001, Groningen, RB, 9700, The Netherlands.
M StevensDepartment of Orthopedics, University of Groningen, University Medical Center Groningen, P.O. Box 30001, Groningen, RB, 9700, The Netherlands.
I van den Akker-ScheekDepartment of Orthopedics, University of Groningen, University Medical Center Groningen, P.O. Box 30001, Groningen, RB, 9700, The Netherlands.
University of Groningen · NLMartini Ziekenhuis · NLMedisch Centrum Leeuwarden · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSome osteoarthritis (OA) patients experience inadequate pain relief from analgesics like acetaminophen and nonsteroidal anti-inflammatory drugs. This could be the result of experienced non-nociceptive centralized pain. Placebo-controlled randomized trials (RCT) have proven the effectiveness of duloxetine for OA and several chronic pain conditions where central sensitization (CS) is one of the key underlying pain mechanisms.

objectivesAssess the efficacy of an 8-week duloxetine treatment compared to usual care in end-stage knee and hip OA patients with a level of centralized pain.

designPragmatic, enriched, open-label RCT.

methodsPatients were randomized to duloxetine or to care-as-usual. Primary outcome was pain in the index joint, measured with the pain domain of the Knee injury and Osteoarthritis Outcome Score (KOOS) or the Hip disability and Osteoarthritis Outcome Score (HOOS). The intention-to-treat principle was used, with mixed-model repeated measures to analyze the effect.

resultsOne hundred eleven patients were randomized. Nearly 44% felt much to very much better after duloxetine usage compared to 0% in the care-as-usual group (p < 0.001). The duloxetine group scored 11.3 points (95%CI: 5.8, 16.8) better on the pain domain of the KOOS/HOOS (p < 0.001). Knee patients improved significantly more than hip patients (18.7 [95%CI: 11.3, 26.1] versus 6.0 [95%CI: - 2.6, 14.5] points better).

conclusionsAdding duloxetine treatment seems to be beneficial for end-stage knee OA patients with neuropathic-like symptoms (at risk of CS). End stage Hip OA patients seem to be nonresponsive to duloxetine.

trial registrationDutch Trial Registry with number NTR 4744 (15/08/2014) and in the EudraCT database with number 2013-004313-41 .

Indexed as

Chronic PainOsteoarthritis, HipOsteoarthritis, KneeDuloxetine HydrochlorideHumansTreatment OutcomeDuloxetine HydrochlorideDuloxetineHipKneeOsteoarthritisPain

Identifiers

PMID35123461
PMCPMC8818142
OpenAlexW4213043172

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.