Comparison of efficacy and safety of gabapentin and duloxetine in painful diabetic peripheral neuropathy: A systematic review and meta-analysis of randomised controlled trials

Int J Clin Pract. 2021 Nov;75(11):e14576. doi: 10.1111/ijcp.14576. Epub 2021 Jul 9.

Abstract

Background: In patients with diabetes mellitus, painful diabetic peripheral neuropathy (PDPN) is a frequent complication and can cause poor quality of life. We compared the efficacy and safety of duloxetine with those of gabapentin in patients with PDPN through a systematic review and meta-analysis of randomised controlled trials.

Materials and methods: PubMed, Embase and the Cochrane Library were searched for eligible studies published from database inception to January 2021. Visual Analogue Scale (VAS), sleep interference score, Clinical Global Impression of Change (CGIC), Patient Global Impression of Change (PGIC), Diabetic Neuropathy Symptom (DNS) score, Diabetic Neuropathic Examination (DNE) score, Neuropathic Disability Score (NDS) and side effects were used to compare duloxetine and gabapentin in patients with PDPN.

Results: Three eligible randomised controlled trials involving 290 patients were included. No significant differences were observed between patients receiving duloxetine and gabapentin with respect to VAS (mean change difference = -1.23, 95% CI, -6.09 to 3.62; P = .62), sleep interference score (mean change difference = 0.42, 95% CI, -0.15 to 1.00; P = .15), CGIC (mean difference = 0.04, 95% CI, -0.11 to 0.20; P = .60), PGIC (mean difference= 0.24, 95% CI, -0.13 to 0.60; P = .21), DNS (mean change difference = 0.14, 95% CI, -0.35 to 0.63; P = .58), DNE (mean change difference = 0.26, 95% CI, -0.35 to 0.86; P = .41) and NDS (mean change difference = 0.30, 95% CI, -0.02 to 0.63; P = .07).

Conclusions: No significant differences were observed in the efficacy of duloxetine and gabapentin when treating patients with PDPN.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Analgesics / adverse effects
  • Diabetes Mellitus*
  • Diabetic Neuropathies* / drug therapy
  • Duloxetine Hydrochloride / adverse effects
  • Gabapentin / adverse effects
  • Humans
  • Quality of Life
  • Randomized Controlled Trials as Topic

Substances

  • Analgesics
  • Gabapentin
  • Duloxetine Hydrochloride