Does Duloxetine help in reducing chronic hip and knee pain?

According to a new study, there was no effect of duloxetine added to usual therapy compared to usual care alone in individuals with persistent osteoarthritis (OA) pain. This study was conducted by Jacoline and team, findings of which were published in the journal of American College of Rheumatology on 6th January, 2022.

The currently recommended analgesics for OA-related pain may not always adequately relieve pain, and they might be linked with adverse effects or be contraindicated. As a result, further therapeutic alternatives are required. Duloxetine, a serotonin and norepinephrine reuptake inhibitor, may be a possibility (SNRI). Duloxetine is thought to alleviate chronic pain by central pain inhibition.

The objective of this study was to determine the efficacy of duloxetine in combination with standard therapy for individuals suffering from chronic OA pain. Secondary goals were to determine cost-effectiveness and if the presence of concentrated pain sensations affects the response to duloxetine.

For this project A cluster randomized open label experiment was carried out. Patients with persistent OA hip or knee pain who had not responded to paracetamol or NSAIDs were included in the study. Duloxetine 60mg/day added to usual care or usual care alone was given to GP practices at random. A modified pain was characterized as the existence of localized pain. DETECT score greater than 12. At 3 months, the primary outcome was WOMAC pain (0-20). The researchers wanted to find a difference in a clinically meaningful impact of 1.9 points between groups (effect size 0.4). The data was analyzed using a linear mixed model with repeated measurements.