Outcomes and Predictors of Response of Duloxetine for the Treatment of Persistent Idiopathic Dentoalveolar Pain: A Retrospective Multicenter Observational Study

Zipu Jia; Jinyong Yu; Chunmei Zhao; Hao Ren; Fang Luo

doi:10.2147/JPR.S379430

Outcomes and Predictors of Response of Duloxetine for the Treatment of Persistent Idiopathic Dentoalveolar Pain: A Retrospective Multicenter Observational Study

J Pain Res. 2022 Sep 27:15:3031-3041. doi: 10.2147/JPR.S379430. eCollection 2022.

Authors

Zipu Jia¹, Jinyong Yu², Chunmei Zhao², Hao Ren², Fang Luo²

Affiliations

¹ Department of Day Surgery Center; Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
² Department of Pain Management; Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.

Abstract

Background: Duloxetine has been reported to significantly relieve the pain of persistent idiopathic dentoalveolar pain (PIDP); however, the number of studies available is scarce and no study has identified the predictors of response of duloxetine for the treatment of PIDP.

Objective: To report the efficacy, safety, and identification of positive predictors of duloxetine for PIDP patients through a retrospective multicenter observational study.

Methods: We retrospectively reviewed the clinical database of PIDP patients who were prescribed duloxetine at 3 hospitals between January 2018 and November 2021. Demographic and pain-related baseline data, efficacy of patients after 3 months of medication by visual analog scale (VAS) scores for pain and adverse events were extracted and analyzed. The predictors of pain-relieving effect of duloxetine were identified by logistic regression analysis.

Results: A total of 135 patients were included in this study. Side effects occurred immediately after taking duloxetine in 24 (17.8%) patients, and the treatment with duloxetine was discontinued on 13 of them because they could not tolerate the side effects. Other 11 (8.1%) patients gradually tolerated the side effects within 2 weeks. Ninety-four out of 122 (77.0%) patients obtained pain relief with VAS significantly decreased (p < 0.01) and the other 28 (23.0%) patients stopped taking the drug because of weak efficacy. Binary logistic regression analysis showed that short disease duration (OR = 1.017, 95% CI = 1.004-1.030, P = 0.012) was an independent predictor of the positive response of duloxetine.

Conclusion: This study confirmed that duloxetine can significantly improve chronic pain of PIDP patients, and the safety was tolerable. Patients with shorter disease duration had more benefit from duloxetine.

Limitations: This is a retrospective observational study. Long-term efficacy and safety of duloxetine in the treatment of PIDP patients were not evaluated.

Keywords: duloxetine; efficacy; persistent idiopathic dentoalveolar pain; predictor of response; safety.

Grants and funding

There is no funding to report.