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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figuras y tablas -
Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

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Duloxetine versus placebo in the treatment of painful neuropathy: Number of patients with >50% improvement of pain at <12 weeks.
Figuras y tablas -
Figure 2

Duloxetine versus placebo in the treatment of painful neuropathy: Number of patients with >50% improvement of pain at <12 weeks.

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Duloxetine versus placebo in the treatment of pain: Mean improvement in pain at 12 weeks.
Figuras y tablas -
Figure 3

Duloxetine versus placebo in the treatment of pain: Mean improvement in pain at 12 weeks.

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Duloxetine versus placebo in the treatment of pain: Number of patients with >30% improvement in pain at <12 weeks.
Figuras y tablas -
Figure 4

Duloxetine versus placebo in the treatment of pain: Number of patients with >30% improvement in pain at <12 weeks.

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Duloxetine versus placebo in the treatment of pain: Patient reported global impression of change.
Figuras y tablas -
Figure 5

Duloxetine versus placebo in the treatment of pain: Patient reported global impression of change.

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Duloxetine versus placebo in the treatment of pain: BPI severity ‐ average pain.
Figuras y tablas -
Figure 6

Duloxetine versus placebo in the treatment of pain: BPI severity ‐ average pain.

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Duloxetine versus placebo in the treatment of fibromyalgia: >30% improvement <12 weeks.
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Figure 7

Duloxetine versus placebo in the treatment of fibromyalgia: >30% improvement <12 weeks.

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Duloxetine versus placebo in the treatment of fibromyalgia: SF36 Bodily Pain.
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Figure 8

Duloxetine versus placebo in the treatment of fibromyalgia: SF36 Bodily Pain.

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Adverse events leading to cessation of treatment.
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Figure 9

Adverse events leading to cessation of treatment.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 1 Number of patients with >50% improvement of pain at 12 weeks or less.
Figuras y tablas -
Analysis 1.1

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 1 Number of patients with >50% improvement of pain at 12 weeks or less.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 2 Mean improvement in pain at 12 weeks or less.
Figuras y tablas -
Analysis 1.2

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 2 Mean improvement in pain at 12 weeks or less.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 3 Number of patients with >30% improvement in pain at 12 weeks or less.
Figuras y tablas -
Analysis 1.3

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 3 Number of patients with >30% improvement in pain at 12 weeks or less.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 4 Mean improvement in SF‐36 Physical subscore at 12 weeks or less.
Figuras y tablas -
Analysis 1.4

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 4 Mean improvement in SF‐36 Physical subscore at 12 weeks or less.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 5 Mean improvement in SF‐36 Mental Subscore at 12 weeks or less.
Figuras y tablas -
Analysis 1.5

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 5 Mean improvement in SF‐36 Mental Subscore at 12 weeks or less.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 6 Mean improvement in SF‐36 Bodily Pain Subscore at 12 weeks or less.
Figuras y tablas -
Analysis 1.6

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 6 Mean improvement in SF‐36 Bodily Pain Subscore at 12 weeks or less.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 7 Mean improvement in Patient Reported Global Impression of Change at 12 weeks or less.
Figuras y tablas -
Analysis 1.7

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 7 Mean improvement in Patient Reported Global Impression of Change at 12 weeks or less.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 8 Mean improvement in BPI severity ‐ average pain at 12 weeks or less.
Figuras y tablas -
Analysis 1.8

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 8 Mean improvement in BPI severity ‐ average pain at 12 weeks or less.

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Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 9 Mean improvement in pain at rest (night pain) at 12 weeks or less.
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Analysis 1.9

Comparison 1 Duloxetine versus placebo in the treatment of painful neuropathy, Outcome 9 Mean improvement in pain at rest (night pain) at 12 weeks or less.

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Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 1 Number of patients with = or >50% improvement of pain at = or <12 weeks.
Figuras y tablas -
Analysis 2.1

Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 1 Number of patients with = or >50% improvement of pain at = or <12 weeks.

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Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 2 Number of patients with = or >50% improvement of pain at >12 weeks.
Figuras y tablas -
Analysis 2.2

Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 2 Number of patients with = or >50% improvement of pain at >12 weeks.

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Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 3 Number of patients with = or >30% improvement of pain at = or <12 weeks.
Figuras y tablas -
Analysis 2.3

Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 3 Number of patients with = or >30% improvement of pain at = or <12 weeks.

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Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 4 Mean improvement in the SF36 mental component summary subscore.
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Analysis 2.4

Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 4 Mean improvement in the SF36 mental component summary subscore.

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Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 5 Mean improvement in the SF36 physical component summary subscore.
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Analysis 2.5

Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 5 Mean improvement in the SF36 physical component summary subscore.

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Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 6 Mean improvement in the SF36 Bodily Pain subscore.
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Analysis 2.6

Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 6 Mean improvement in the SF36 Bodily Pain subscore.

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Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 7 Mean improvement in the patient reported global impression of change at 12 weeks or less.
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Analysis 2.7

Comparison 2 Duloxetine versus placebo in the treatment of fibromyalgia, Outcome 7 Mean improvement in the patient reported global impression of change at 12 weeks or less.

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Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 1 Proportion of patients with any adverse event.
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Analysis 3.1

Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 1 Proportion of patients with any adverse event.

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Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 2 Nausea.
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Analysis 3.2

Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 2 Nausea.

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Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 3 Somnolence.
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Analysis 3.3

Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 3 Somnolence.

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Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 4 Dry mouth.
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Analysis 3.4

Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 4 Dry mouth.

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Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 5 Dizziness.
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Analysis 3.5

Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 5 Dizziness.

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Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 6 Adverse event leading to cessation.
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Analysis 3.6

Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 6 Adverse event leading to cessation.

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Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 7 Serious adverse event.
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Analysis 3.7

Comparison 3 Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia, Outcome 7 Serious adverse event.

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Duloxetine for treating painful neuropathy or chronic pain

Patient or population: patients with treating painful neuropathy or chronic pain

Settings:

Intervention: Duloxetine

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Duloxetine

Greater than 50% improvement of diabetic peripheral neuropathic pain‐ Duloxetine 60 mg daily
11 point Likert score1
(follow‐up: 12 weeks)

288 per 10002

475 per 1000
(386 to 585)

RR 1.65
(1.34 to 2.03)

655
(3)

⊕⊕⊕⊝
moderate3

Number needed to treat (NNT) for 50% or more improvement in pain with duloxetine 60 mg daily = 6 (CI 5 to 10)4

Improvement in diabetic peripheral neuropathic pain ‐ Duloxetine 60 mg daily
11‐point Likert Scale. Scale from: 0 to 10.
(follow‐up: 12 weeks)

The mean improvement in diabetic peripheral neuropathic pain ‐ duloxetine 60 mg daily in the control groups was
‐1.62 on Likert pain scale

The mean Improvement in diabetic peripheral neuropathic pain ‐ Duloxetine 60 mg daily in the intervention groups was
1.04 lower
(1.37 to 0.71 lower)

618
(3)

⊕⊕⊕⊝
moderate5

Greater than 30% improvement in diabetic peripheral neuropathic pain ‐ Duloxetine 60 mg daily
11‐point Likert Scale6
(follow‐up: 12 weeks)

429 per 1000

656 per 1000
(545 to 785)

RR 1.53
(1.27 to 1.83)

442
(2)

⊕⊕⊕⊝
moderate

NNT for 30% or more improvement in pain with duloxetine 60 mg daily = 5 (CI 3 to 8)

Greater than 50% improvement of fibromyalgia pain ‐ Duloxetine 60 mg daily
11‐point Likert scale
(follow‐up: 12 weeks)

233 per 1000

366 per 1000
(280 to 480)

RR 1.57
(1.2 to 2.06)

528
(2)

⊕⊕⊕⊝
moderate7

NNT for 50% or more improvement in fibromyalgia pain with duloxetine 60 mg daily = 8 (CI 5 to 17)

Adverse event leading to cessation ‐ Duloxetine 60 mg daily

83 per 1000

139 per 1000
(100 to 193)

RR 1.67
(1.2 to 2.32)

1215
(5)

⊕⊕⊕⊝
moderate

'Number needed to harm' (NNH) for cessation of duloxetine treatment at duloxetine 60 mg daily = 17 (CI 12 to 50)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: Confidence interval; RR: Risk ratio;

GRADE Working Group grades of evidance
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Titled 24 hour pain score or 24 hour pain severity

2 Assumed risks generated from placebo population

3 Three trials only all company sponsored and performed but all trials pre‐registered on clinical trials.gov have been published. No publication bias detected.

4 CI = confidence interval

5 Risk of bias relevant in 2 of 3 studies. Quality of evidence graded moderate because of high dropout and company sponsorship of all studies.

6 Titled 24 hour pain score or 24 hour pain severity

7 Risk of bias relevant in 2 of 3 studies. Quality of evidence graded moderate because of high dropout and company sponsorship of all studies.

Figuras y tablas -
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Comparison 1. Duloxetine versus placebo in the treatment of painful neuropathy

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of patients with >50% improvement of pain at 12 weeks or less Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Duloxetine 20 mg daily

1

213

Risk Ratio (M‐H, Fixed, 95% CI)

1.43 [0.98, 2.09]

1.2 Duloxetine 60 mg daily

3

655

Risk Ratio (M‐H, Fixed, 95% CI)

1.65 [1.34, 2.03]

1.3 Duloxetine 120 mg daily

3

655

Risk Ratio (M‐H, Fixed, 95% CI)

1.66 [1.35, 2.04]

1.4 All doses

3

1102

Risk Ratio (M‐H, Fixed, 95% CI)

1.63 [1.35, 1.97]

2 Mean improvement in pain at 12 weeks or less Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 Duloxetine 20 mg daily

1

179

Mean Difference (IV, Fixed, 95% CI)

‐0.45 [‐1.05, 0.15]

2.2 Duloxetine 60 mg daily

3

618

Mean Difference (IV, Fixed, 95% CI)

‐1.04 [‐1.37, ‐0.71]

2.3 Duloxetine 120 mg daily

3

612

Mean Difference (IV, Fixed, 95% CI)

‐1.16 [‐1.49, ‐0.83]

3 Number of patients with >30% improvement in pain at 12 weeks or less Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Duloxetine 60 mg daily

2

442

Risk Ratio (M‐H, Fixed, 95% CI)

1.53 [1.27, 1.83]

3.2 Duloxetine 120 mg daily

2

444

Risk Ratio (M‐H, Fixed, 95% CI)

1.55 [1.30, 1.86]

3.3 All doses

2

667

Risk Ratio (M‐H, Fixed, 95% CI)

1.54 [1.30, 1.82]

4 Mean improvement in SF‐36 Physical subscore at 12 weeks or less Show forest plot

2

Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Duloxetine 20 mg daily

1

200

Mean Difference (IV, Random, 95% CI)

‐0.27 [‐2.42, 1.88]

4.2 Duloxetine 60 mg daily

2

410

Mean Difference (IV, Random, 95% CI)

2.51 [1.00, 4.01]

4.3 Duloxetine 120 mg daily

2

409

Mean Difference (IV, Random, 95% CI)

2.80 [1.04, 4.55]

5 Mean improvement in SF‐36 Mental Subscore at 12 weeks or less Show forest plot

2

1019

Mean Difference (IV, Fixed, 95% CI)

1.67 [0.71, 2.64]

5.1 Duloxetine 20 mg daily

1

200

Mean Difference (IV, Fixed, 95% CI)

1.11 [‐0.98, 3.20]

5.2 Duloxetine 60 mg daily

2

410

Mean Difference (IV, Fixed, 95% CI)

1.42 [‐0.12, 2.96]

5.3 Duloxetine 120 mg daily

2

409

Mean Difference (IV, Fixed, 95% CI)

2.23 [0.69, 3.77]

6 Mean improvement in SF‐36 Bodily Pain Subscore at 12 weeks or less Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 Duloxetine 20 mg daily

1

209

Mean Difference (IV, Fixed, 95% CI)

2.90 [‐2.37, 8.17]

6.2 Duloxetine 60 mg daily

2

421

Mean Difference (IV, Fixed, 95% CI)

5.58 [1.74, 9.42]

6.3 Duloxetine 120 mg daily

2

420

Mean Difference (IV, Fixed, 95% CI)

8.19 [4.33, 12.05]

7 Mean improvement in Patient Reported Global Impression of Change at 12 weeks or less Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 Duloxetine 20 mg daily

1

219

Mean Difference (IV, Fixed, 95% CI)

‐0.23 [‐0.56, 0.10]

7.2 Duloxetine 60 mg daily

3

660

Mean Difference (IV, Fixed, 95% CI)

‐0.59 [‐0.78, ‐0.41]

7.3 Duloxetine 120 mg daily

3

655

Mean Difference (IV, Fixed, 95% CI)

‐0.62 [‐0.80, ‐0.44]

8 Mean improvement in BPI severity ‐ average pain at 12 weeks or less Show forest plot

2

Mean Difference (IV, Random, 95% CI)

Subtotals only

8.1 Duloxetine 60 mg daily

2

433

Mean Difference (IV, Random, 95% CI)

‐0.97 [‐1.38, ‐0.57]

8.2 Duloxetine 120 mg daily

2

428

Mean Difference (IV, Random, 95% CI)

‐1.16 [‐1.91, ‐0.41]

9 Mean improvement in pain at rest (night pain) at 12 weeks or less Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

9.1 Duloxetine 20 mg daily

1

222

Mean Difference (IV, Random, 95% CI)

‐0.28 [‐0.90, 0.34]

9.2 Duloxetine 60 mg daily

3

664

Mean Difference (IV, Random, 95% CI)

‐0.92 [‐1.27, ‐0.57]

9.3 Duloxetine 120 mg daily

3

664

Mean Difference (IV, Random, 95% CI)

‐1.10 [‐1.45, ‐0.75]
Figuras y tablas -
Comparison 1. Duloxetine versus placebo in the treatment of painful neuropathy
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Comparison 2. Duloxetine versus placebo in the treatment of fibromyalgia

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of patients with = or >50% improvement of pain at = or <12 weeks Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Duloxetine 20 mg

1

223

Risk Ratio (M‐H, Fixed, 95% CI)

1.39 [0.91, 2.14]

1.2 Duloxetine 60 mg daily

2

528

Risk Ratio (M‐H, Fixed, 95% CI)

1.57 [1.20, 2.06]

1.3 Duloxetine 120 mg daily

3

727

Risk Ratio (M‐H, Fixed, 95% CI)

1.73 [1.36, 2.19]

1.4 All doses

3

1072

Risk Ratio (M‐H, Fixed, 95% CI)

1.71 [1.37, 2.13]

2 Number of patients with = or >50% improvement of pain at >12 weeks Show forest plot

1

664

Risk Ratio (M‐H, Fixed, 95% CI)

1.62 [1.25, 2.11]

2.1 Duloxetine 60 mg daily

1

373

Risk Ratio (M‐H, Fixed, 95% CI)

1.58 [1.10, 2.27]

2.2 Duloxetine 120 mg daily

1

291

Risk Ratio (M‐H, Fixed, 95% CI)

1.67 [1.15, 2.45]

3 Number of patients with = or >30% improvement of pain at = or <12 weeks Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Duloxetine 20 mg daily

1

223

Risk Ratio (M‐H, Fixed, 95% CI)

1.30 [0.94, 1.79]

3.2 Duloxetine 60 mg daily

2

528

Risk Ratio (M‐H, Fixed, 95% CI)

1.52 [1.24, 1.85]

3.3 Duloxetine 120 mg daily

2

523

Risk Ratio (M‐H, Fixed, 95% CI)

1.52 [1.24, 1.86]

3.4 All doses

2

868

Risk Ratio (M‐H, Fixed, 95% CI)

1.50 [1.25, 1.80]

4 Mean improvement in the SF36 mental component summary subscore Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Duloxetine 20 mg

1

223

Mean Difference (IV, Random, 95% CI)

0.81 [‐2.37, 3.99]

4.2 Duloxetine 60 mg daily

2

515

Mean Difference (IV, Random, 95% CI)

3.31 [0.59, 6.02]

4.3 Duloxetine 120 mg daily

3

691

Mean Difference (IV, Random, 95% CI)

3.09 [1.47, 4.70]

5 Mean improvement in the SF36 physical component summary subscore Show forest plot

3

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

5.1 Duloxetine 20 mg

1

223

Mean Difference (IV, Fixed, 95% CI)

0.81 [‐1.92, 3.54]

5.2 Duloxetine 60 mg daily

2

515

Mean Difference (IV, Fixed, 95% CI)

1.28 [‐0.33, 2.89]

5.3 Duloxetine 120 mg daily

3

691

Mean Difference (IV, Fixed, 95% CI)

1.80 [0.50, 3.10]

6 Mean improvement in the SF36 Bodily Pain subscore Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

6.1 Duloxetine 60 mg daily

1

221

Mean Difference (IV, Fixed, 95% CI)

8.2 [3.20, 13.20]

6.2 Duloxetine 120 mg daily

2

403

Mean Difference (IV, Fixed, 95% CI)

8.42 [4.80, 12.03]

7 Mean improvement in the patient reported global impression of change at 12 weeks or less Show forest plot

2

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

7.1 Duloxetine 20 mg daily

1

223

Mean Difference (IV, Fixed, 95% CI)

‐0.54 [‐0.96, ‐0.12]

7.2 Duloxetine 60 mg daily

2

519

Mean Difference (IV, Fixed, 95% CI)

‐0.45 [‐0.73, ‐0.18]

7.3 Duloxetine 120 mg daily

2

513

Mean Difference (IV, Fixed, 95% CI)

‐0.54 [‐0.81, ‐0.26]
Figuras y tablas -
Comparison 2. Duloxetine versus placebo in the treatment of fibromyalgia
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Comparison 3. Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Proportion of patients with any adverse event Show forest plot

4

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

1.1 Duloxetine 60 mg daily

4

899

Risk Ratio (M‐H, Fixed, 95% CI)

1.21 [1.12, 1.30]

1.2 Duloxetine 120 mg daily

3

688

Risk Ratio (M‐H, Fixed, 95% CI)

1.19 [1.09, 1.30]

2 Nausea Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Duloxetine 20 mg daily

1

230

Risk Ratio (M‐H, Random, 95% CI)

1.45 [0.71, 3.00]

2.2 Duloxetine 60 mg daily

3

824

Risk Ratio (M‐H, Random, 95% CI)

2.26 [1.33, 3.83]

2.3 Duloxetine 120 mg daily

3

739

Risk Ratio (M‐H, Random, 95% CI)

2.98 [2.00, 4.45]

3 Somnolence Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Duloxetine 20 mg daily

1

230

Risk Ratio (M‐H, Fixed, 95% CI)

1.0 [0.41, 2.43]

3.2 Duloxetine 60mg daily

3

824

Risk Ratio (M‐H, Fixed, 95% CI)

2.77 [1.62, 4.74]

3.3 Duloxetine 120 mg daily

3

739

Risk Ratio (M‐H, Fixed, 95% CI)

4.61 [2.74, 7.74]

4 Dry mouth Show forest plot

2

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

4.1 Duloxetine 20 mg daily

1

230

Risk Ratio (M‐H, Fixed, 95% CI)

0.86 [0.30, 2.47]

4.2 Duloxetine 60 mg daily

2

602

Risk Ratio (M‐H, Fixed, 95% CI)

2.05 [1.12, 3.77]

4.3 Duloxetine 120 mg daily

2

519

Risk Ratio (M‐H, Fixed, 95% CI)

3.41 [1.93, 6.04]

5 Dizziness Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Duloxetine 20 mg daily

1

230

Risk Ratio (M‐H, Fixed, 95% CI)

0.88 [0.33, 2.33]

5.2 Duloxetine 60 mg daily

3

824

Risk Ratio (M‐H, Fixed, 95% CI)

1.87 [1.15, 3.03]

5.3 Duloxetine 120 mg daily

3

739

Risk Ratio (M‐H, Fixed, 95% CI)

2.48 [1.55, 3.97]

6 Adverse event leading to cessation Show forest plot

6

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

6.1 Duloxetine 20 mg daily

2

453

Risk Ratio (M‐H, Fixed, 95% CI)

1.37 [0.78, 2.39]

6.2 Duloxetine 60 mg daily

5

1215

Risk Ratio (M‐H, Fixed, 95% CI)

1.67 [1.20, 2.32]

6.3 Duloxetine 120 mg daily

6

1414

Risk Ratio (M‐H, Fixed, 95% CI)

2.30 [1.74, 3.05]

6.4 All doses

6

2220

Risk Ratio (M‐H, Fixed, 95% CI)

1.93 [1.48, 2.52]

7 Serious adverse event Show forest plot

5

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

7.1 Duloxetine 20 mg daily

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

7.2 Duloxetine 60 mg daily

5

1219

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.32, 1.33]

7.3 Duloxetine 120 mg daily

5

1209

Risk Ratio (M‐H, Fixed, 95% CI)

0.59 [0.25, 1.35]

7.4 All doses

5

1856

Risk Ratio (M‐H, Fixed, 95% CI)

0.64 [0.33, 1.25]
Figuras y tablas -
Comparison 3. Duloxetine versus placebo: adverse events during first 12 weeks of treatment for painful neuropathy or fibromyalgia
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