Antidepressants in the Treatment for Chronic Low Back Pain: Questioning the Validity of Meta-Analyses
| Autor: | Doron Sagman, Alexander Schacht, Luc J. Boulay, Owen Douglas Williamson, Robert Bruins |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Thiophenes Duloxetine Hydrochloride Placebo law.invention chemistry.chemical_compound Meta-Analysis as Topic Randomized controlled trial law medicine Humans Duloxetine Brief Pain Inventory Randomized Controlled Trials as Topic Analgesics business.industry Antidepressive Agents Review Literature as Topic Anesthesiology and Pain Medicine Systematic review chemistry Sample size determination Anesthesia Meta-analysis Physical therapy business Low Back Pain |
| Zdroj: | Pain Practice. 14:E33-E41 |
| ISSN: | 1530-7085 |
| Popis: | Objectives To contrast the analgesic effect of duloxetine with antidepressants reported in other published randomized clinical trials (RCTs) and review articles in patients with chronic low back pain (CLBP). Methods In this narrative review, the results of 13 RCTs and 5 systematic reviews examining the analgesic effect of various antidepressants in CLBP were contrasted with those of 3 placebo-controlled duloxetine RCTs. Treatment effects based on the Brief Pain Inventory (BPI) average score in the duloxetine RCTs were assessed in all completers (by study and overall) and in last-observation-carried-forward (LOCF) analyses (extracted from study reports). 30%- and 50%-reduction response rates were compared between duloxetine and placebo. Results Eleven different antidepressants were examined in 13 individual RCTs. Sample sizes, treatment durations, and analysis methods varied across studies. Reviews each included 5 to 9 of the RCTs and came to different conclusions regarding the analgesic effect of antidepressants: 2 found no evidence while 3 reported some evidence. The completer analysis showed greater improvements in BPI average scores with duloxetine vs. placebo (significant in 2 studies). Overall, the least square mean (standard error) difference between treatments was − 0.7 (0.15) (P |
| Databáze: | OpenAIRE |
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