Duloxetine in OsteoArthritis (DOA) study: study protocol of a pragmatic open-label randomised controlled trial assessing the effect of preoperative pain treatment on postoperative outcome after total hip or knee arthroplasty

  title={Duloxetine in OsteoArthritis (DOA) study: study protocol of a pragmatic open-label randomised controlled trial assessing the effect of preoperative pain treatment on postoperative outcome after total hip or knee arthroplasty},
  author={Tim Blikman and Wietske Rienstra and Tom van Raaij and A ten Hagen and Baukje Dijkstra and Wierd P Zijlstra and Sjoerd K Bulstra and Inge van den Akker-Scheek and Martin Stevens},
  journal={BMJ Open},
INTRODUCTION Residual pain is a major factor in patient dissatisfaction following total hip arthroplasty or total knee arthroplasty (THA/TKA. [] Key MethodMETHODS AND ANALYSIS This multicentre, pragmatic, prospective, open-label, randomised controlled trial includes patients with idiopathic hip/knee OA who are on a waiting list for primary THA/TKA. Patients at risk for CS will be randomly allocated to the preoperative duloxetine treatment programme group or the care-as-usual control group.

Effect of preoperative duloxetine treatment on postoperative chronic residual pain after total hip or knee arthroplasty: a randomised controlled trial

Preoperative targeted treatment with duloxetine in end-stage knee and hip OA patients with sensitisation does not influence postoperative chronic residual pain after TKA/THA, and statistically significant difference was found in change score 6 months postoperatively.

Efficacy and safety of duloxetine for postoperative pain after total knee arthroplasty in centrally sensitized patients: study protocol for a randomized controlled trial

This randomized, placebo-controlled, triple-blind clinical trial is designed to evaluate the effects of preoperative screening and targeted duloxetine treatment of CS on postoperative residual pain compared with the care-as-usual control group.

Duloxetine in OsteoArthritis (DOA) study: effects of duloxetine on pain and function in end-stage hip and knee OA – a pragmatic enriched randomized controlled trial

Adding duloxetine treatment seems to be beneficial for end-stage knee OA patients with neuropathic-like symptoms (at risk of CS) and end stage Hip OA Patients seem to be nonresponsive to dulOxetine.

Duloxetine reduces pain after Total hip arthroplasty: a prospective, randomized controlled study

Although it did not result in a clinically meaning reduction in pain after total hip arthroplasty, perioperative administration of 60 mg of duloxetine daily significantly alleviated pain in the postoperative 3 weeks and morphine requirements during the postoperatively 48 h.

Efficacy of duloxetine compared with opioid for postoperative pain control following total knee arthroplasty

Duloxetine and opioid did not show any difference in pain control, function, and side effects for up to one year after TKA and can be considered as an alternative to opioid for postoperative pain control following TKA.

Preemptive Duloxetine Relieves Postoperative Pain and Lowers Wound Temperature in Centrally Sensitized Patients Undergoing Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial

Preemptive duloxetine effectively reduced pain and lowered wound temperature following TKA in CS patients, and both groups showed significantly lower wound temperature during the follow-up period.

A Case of Postoperative Neuropathic Pain Management after Thyroidectomy

The mediation Treatment with nortriptyline and pregabalin improved the neuropathic pain and allodynia significantly even one year after the surgery, without causing any severe side effects.

Factors contributing to 1-year dissatisfaction after total knee arthroplasty: a nomogram prediction model

This study developed a prediction nomogram model based on partially modifiable risk factors for predicting dissatisfaction 1 year after TKA that demonstrated good discriminative capacity for identifying those at greatest risk for dissatisfaction and may help surgeons and patients identify and evaluate the risk factorsfor dissatisfaction and optimize TKA outcomes.

Females have greater susceptibility to develop ongoing pain and central sensitization in a rat model of temporomandibular joint pain.

This model of TMJOA pain can be used to explore sex differences in pain processes implicated in development of neuropathic pain, ongoing pain, and central sensitization, allowing for development of individualized strategies for prevention and treatment of TMD joint pain.



Duloxetine for the management of pain in older adults with knee osteoarthritis: randomised placebo-controlled trial.

Evidence is provided for the efficacy and tolerability of duloxetine in reducing pain and subsequently improving function in older adults with knee OA and a statistically significant reduction in pain and a significant improvement in WOMAC scores at 16 weeks are provided.

Clinically Relevant Outcomes Based on Analysis of Pooled Data from 2 Trials of Duloxetine in Patients with Knee Osteoarthritis

Significantly more patients receiving duloxetine than placebo achieved an OMERACT-OARSI response, improvements in pain and function exceeding the level accepted as MCII, and reached PASS.

Duloxetine added to oral nonsteroidal anti-inflammatory drugs for treatment of knee pain due to osteoarthritis: results of a randomized, double-blind, placebo-controlled trial

Duloxetine added to oral NSAID therapy provided additional significant pain reduction, improved function, and patient-rated impression of improvement in patients with osteoarthritis of the knee.

A Systematic Review of Duloxetine for Osteoarthritic Pain: What is the Number Needed to Treat, Number Needed to Harm, and Likelihood to be Helped or Harmed?

Duloxetine appears efficacious and tolerable for the treatment of chronic pain associated with OA, and the NNT and NNH can be used to quantify efficacy and tolerability outcomes and help place duloxettine into clinical perspective.

The Modified painDETECT Questionnaire for Patients with Hip or Knee Osteoarthritis: Translation into Dutch, Cross-Cultural Adaptation and Reliability Assessment

Based on this study, the Dutch modified painDETECT Questionnaire seems to be fit as a discriminative tool to identify knee and hip osteoarthritis patients with a neuropathic pain profile and whether it is also suitable as an evaluation tool to record changes over time or after an intervention remains open to further investigation.