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Efficacy of duloxetine and gabapentin in pain reduction in patients with knee osteoarthritis

Abstract

Introduction

Knee osteoarthritis (OA) is a common form of arthritis in elders which can lead to reduced daily activity and quality of life. It is important to administer a proper treatment with high efficacy and low side effects. In this study, we evaluated the efficacy of duloxetine and gabapentin in patients with moderate to severe knee OA.

Method

In this randomized clinical trial, 150 patients with moderate to severe knee OA were randomly allocated to receive duloxetine 30 mg (n = 50), gabapentin 300 mg (n = 50), or acetaminophen 1000 mg (n = 50) all twice a day for 12 weeks. Pain severity using visual analogue scale (VAS) and functional status using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured before, 2 weeks, 1 month, and 3 months after intervention.

Results

WOMAC total and its subscale score were significantly lower in duloxetine compared to gabapentin in 2 weeks and 1 months after intervention, with no significant difference at the end of the third month. Both gabapentin and duloxetine groups had significantly more reduction in pain VAS and WOMAC and its subscales compared to acetaminophen group, with no significant difference between groups.

Conclusions

Both gabapentin and duloxetine have similar and acceptable effects in pain reduction and improvement of functional status in patients with knee OA at the end of the third month’s treatment. Duloxetine effects begin from the first weeks, while gabapentin effects begin gradually with the best at the end of the third month.

Key Points

Medical treatment is used for releiving pain in knee osteoarthritis.

Gabapentin and duloxetine are both effective in reducing pain in knee osteoarthritis.

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Authors

Contributions

All the authors edited and critically reviewed the manuscript drafts and approved the final version submitted for publication. AEM was the principal investigator, performed a literature search, and was involved in the study design, collection, analysis, and interpretation of data and in writing the manuscript. AH and PJ were involved in the collection and interpretation of data and writing the manuscript. KI contributed to the conception and design of the study, the data interpretation, and the critical revision of the manuscript. HM was involved in collection and interpretation of data, performed a literature search, and in writing the manuscript.

Corresponding author

Correspondence to Hamed Mohebbi.

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The study was conducted in accordance with the Declaration of Helsinki and good clinical practice guidelines and with local requirements.

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Enteshari-Moghaddam, A., Azami, A., Isazadehfar, K. et al. Efficacy of duloxetine and gabapentin in pain reduction in patients with knee osteoarthritis. Clin Rheumatol 38, 2873–2880 (2019). https://doi.org/10.1007/s10067-019-04573-7

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Keywords

  • Duloxetine
  • Gabapentin
  • Knee osteoarthritis
  • Pain