A Randomized, Double-Blind, Placebo-Controlled Trial of Duloxetine for the Treatment of Pain in Patients with Multiple Sclerosis.

Background Patients with multiple sclerosis ( MS) often report neuropathic pain ( NP- MS). The purpose of this study was to assess the efficacy and tolerability of duloxetine as treatment for NP- MS. Methods In this study, 239 adults with NP- MS (duloxetine = 118, placebo = 121) were randomized to d...

Full description

Bibliographic Details
Published in:Pain Practice Vol. 14; no. 8; pp. 732 - 745
Main Authors: Vollmer, Timothy L., Robinson, Michael J., Risser, Richard C., Malcolm, Sandra K.
Format: research tables/charts randomized controlled trial Journal Article
Published: Wiley-Blackwell Nov2014
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103913471&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 103913471
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        15307085
        HYN
      jtl: Pain Practice
      issn: 15307085
      maglogo: Y
    pubinfo:
      dt: Nov2014
      vid: 14
      iid: 8
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        103913471
        99218518
        10.1111/papr.12127
        NLM24152240
        103913471
      ppf: 732
      ppct: 13
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: A Randomized, Double-Blind, Placebo-Controlled Trial of Duloxetine for the Treatment of Pain in Patients with Multiple Sclerosis.
      aug:
        au:
          Vollmer, Timothy L.
          Robinson, Michael J.
          Risser, Richard C.
          Malcolm, Sandra K.
        affil: Department of Neurology, University of Colorado Health Sciences Center
      sug:
        subj:
          Duloxetine Hydrochloride Administration and Dosage
          Multiple Sclerosis Complications
          Pain Etiology
          Pain Drug Therapy
          Human
          Randomized Controlled Trials
          Double-Blind Studies
          Placebos Administration and Dosage
          Descriptive Statistics
          Scales
          Fisher's Exact Test
          Repeated Measures
          Diaries
          Multicenter Studies
          Europe
          North America
          T-Tests
          Analysis of Covariance
          Data Analysis Software
          Analysis of Variance
          Male
          Female
          Wilcoxon Signed Rank Test
          Adult
          Middle Age
          Aged
          Funding Source
          Brief Pain Inventory
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background Patients with multiple sclerosis ( MS) often report neuropathic pain ( NP- MS). The purpose of this study was to assess the efficacy and tolerability of duloxetine as treatment for NP- MS. Methods In this study, 239 adults with NP- MS (duloxetine = 118, placebo = 121) were randomized to duloxetine 60 mg (30 mg for 1 week, then 60 mg for 5 weeks) or placebo once daily for a 6-week acute therapy phase, followed by a 12-week open-label extension phase (duloxetine 30 to 120 mg/day). Eligible patients had MS for ≥ 1 year and a score ≥ 4 on daily average pain intensity ( API) ratings for ≥ 4 of 7 days immediately before randomization. Patients rated API daily on an 11-point numeric scale (0 [no pain] to 10 [worst possible pain]) in an electronic diary. The primary efficacy measure, change in weekly API ratings, was analyzed longitudinally with a mixed-model repeated-measures analysis. Completion, reasons for discontinuation, and treatment-emergent adverse event incidence were compared by Fisher's exact test. Results Duloxetine-treated patients had statistically greater mean improvement in API vs. placebo at Week 6 (−1.83 vs. −1.07, P = 0.001). Treatment completion did not significantly differ between groups. Discontinuation due to adverse events was statistically greater for duloxetine vs. placebo (13.6% vs. 4.1%, P = 0.012). Decreased appetite was reported significantly more often by duloxetine-treated patients (5.9% vs. 0%, P = 0.007). Conclusions This study found analgesic efficacy of duloxetine for NP- MS. Duloxetine is not approved for treatment of this condition. The duloxetine safety profile of this study was consistent with the known profile in other patient populations.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N