Effectiveness of Duloxetine versus Other Therapeutic Modalities in Patients with Diabetic Neuropathic Pain: A Systematic Review and Meta-Analysis

• Main Authors: Juan José Valenzuela-Fuenzalida (Author), Michelle López-Chaparro (Author), Marisol Barahona-Vásquez (Author), Javiera Campos-Valdes (Author), Javiera Cordero Gonzalez (Author), Pablo Nova-Baeza (Author), Mathias Orellana-Donoso (Author), Alejandra Suazo-Santibañez (Author), Gustavo Oyanedel-Amaro (Author), Héctor Gutiérrez Espinoza (Author)
• Format: Book
• Published: MDPI AG, 2024-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

<b>Objectives:</b> Diabetic peripheral neuropathy (DPN) is a chronic complication of diabetes mellitus (DM) with symptoms like intense pain and impaired quality of life. This condition has no treatment; instead, the pain is managed with various antidepressants, including duloxetine. The aim of this study is to analyze the evidence on the efficacy of duloxetine in the management of DPN. <b>Methods:</b> A systematic search in different databases was conducted using the keywords "diabetic neuropathy", "duloxetine therapy", "neuropathic pain", and "Diabetes Mellitus". Finally, eight studies were included in this meta-analysis. <b>Results:</b> All articles comparing duloxetine at different doses vs. a placebo reported significant differences in favor of duloxetine on pain scales like 24 h Average Pain Severity (standardized mean difference [SMD] = −1.06, confidence interval [CI] = −1.09 to −1.03, and <i>p</i> < 0.00001) and BPI Severity (SMD = −0.70, CI = −0.72 to −0.68, and <i>p</i> < 0.00001), among others. A total of 75% of the meta-analyses of studies comparing duloxetine at different doses showed a tendency in favor of the 120 mg/d dose. There were significant differences in favor of duloxetine when compared to routine care on the Euro Quality of Life (SMD = −0.04, CI = −0.04 to −0.03, and <i>p</i> < 0.00001) and SF-36 Survey (SMD = −5.86, CI = −6.28 to −5.44, and <i>p</i> < 0.00001) scales. There were no significant differences on the visual analog scale (VAS) when comparing duloxetine and gabapentin. <b>Conclusions:</b> Duloxetine appears to be effective in the management of DPN in different pain, symptom improvement, and quality of life scales.

Item Description

10.3390/ph17070856
1424-8247