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Duloxetine showed confirmed effectiveness in chronic low back pain (CLBP) management. This study investigated the predictors of response to Duloxetine for CLBP.
Duloxetine is a potent norepinephrine and serotonin
inhibitor of CNS. It was found to be efficacious in management of chronic low
back pain (CLBP) but the predictors that generate response are not examined in
detail. In this double blind trial, the predictors of response to Duloxetine
for CLBP has been evaluated and it has been determined that early improvement
and pain sites affects the overall response rate of Duloxetine in CLBP.
Duloxetine showed confirmed effectiveness in chronic low
back pain (CLBP) management. This study investigated the predictors of response
to Duloxetine for CLBP.
Patients received 60 mg/day Duloxetine for 12-14
weeks. The proportion of subjects with
≥30% decrease in Brief Pain Inventory (BPI) average pain at 12-14 weeks was
considered as the primary endpoint. The comparison of patients with ≥30% and
≥50% pain decrease in duloxetine and placebo groups were considered as the
secondary outcome. The number of painful
body sites, early improvement, duration of CLBP, sex, age, and baseline BPI
average pain score were the variables for responder analyses that measured
according to the Michigan Body Map.
Duloxetine-treated patients obtained ≥30% and ≥50% pain decrease as compared to the
placebo. An early improvement was
correlated with the elevated likelihood of ≥30% pain reduction in the
Duloxetine-treated patients. Men were slightly less likely than women to obtain
≥30% or ≥50% pain reduction. The average
pain score subgroups: CLBP duration, age, and baseline BPI showed similar
response rates. As compared to patients with isolated CLBP, patients with ≥two
painful sites were more likely to respond to Duloxetine 60 mg relative to
placebo.
Early pain decline was characteristic of overall
response. Duloxetine is known to provide more benefit among patients with
multiple painful sites.
Journal of Pain Research
Duloxetine 60 mg for chronic low back pain: post hoc responder analysis of double-blind, placebo-controlled trials
Alev L et al.
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