Predictors of duloxetine response in patients with neuropathic cancer pain: a secondary analysis of a randomized controlled trial—JORTC-PAL08 (DIRECT) study

Hiromichi Matsuoka, Satoru Iwase, Tempei Miyaji, Takashi Kawaguchi, Keisuke Ariyoshi, Shunsuke Oyamada, Eriko Satomi, Hiroto Ishiki, Hideaki Hasuo, Hiroko Sakuma, Akihiro Tokoro, Yoshinobu Matsuda, Kazuki Tahara, Hiroyuki Otani, Yoichi Ohtake, Hiroaki Tsukuura, Yoshihisa Matsumoto, Yoshikazu Hasegawa, Yuki Kataoka, Masatomo OtsukaKiyohiro Sakai, Miki Nakura, Tatsuya Morita, Takuhiro Yamaguchi, Atsuko Koyama

Research output: Contribution to journalArticle

Abstract

Purpose: Duloxetine has some effect against cancer neuropathic pain (CNP); however, predictors of duloxetine response are unclear. This study sought to identify predictors of duloxetine response in patients with CNP. Methods: Patients (N = 70) with CNP unresponsive to or intolerant of opioid–pregabalin combination therapy, with a brief pain inventory-short form (BPI-SF) Item 5 score (average pain) ≥ 4, and with a total hospital anxiety and depression scale score < 20, were randomized to a duloxetine or a placebo group. Multiple linear regression analysis was conducted to identify predictors of duloxetine response as a secondary analysis with the change in the average pain score on day 10 from day 0 as the dependent variable, and the following five covariates; baseline (day 0) average pain score, baseline opioid dose, continuation/discontinuation of pregabalin, and items 20 and 21 score of the short-form McGill pain questionnaire 2 (SF-MPQ-2) as independent variables. Results: Of the four domains (continuous pain, intermittent pain, neuropathic pain, and affective descriptors) score of SF-MPQ-2 on day 0, significant differences were observed in the neuropathic pain domain (p = 0.040) in change on the average pain between day 10 and day 0 in the duloxetine group. Multiple linear regression analysis revealed that patients with a high score for SF-MPQ-2 Item 21 (tingling pain) on day 0 had a significantly greater change in average pain between day 10 and day 0 (p = 0.046). Conclusion: Patients with a high score for SF-MPQ-2 Item 21 might benefit more from duloxetine.

Original languageEnglish
Pages (from-to)2931-2939
Number of pages9
JournalSupportive Care in Cancer
Volume28
Issue number6
DOIs
Publication statusPublished - 2020 Jun 1

Keywords

  • Duloxetine
  • Neuropathic cancer pain
  • Palliative care
  • Randomized controlled trial
  • Secondary analyses

ASJC Scopus subject areas

  • Oncology

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    Matsuoka, H., Iwase, S., Miyaji, T., Kawaguchi, T., Ariyoshi, K., Oyamada, S., Satomi, E., Ishiki, H., Hasuo, H., Sakuma, H., Tokoro, A., Matsuda, Y., Tahara, K., Otani, H., Ohtake, Y., Tsukuura, H., Matsumoto, Y., Hasegawa, Y., Kataoka, Y., ... Koyama, A. (2020). Predictors of duloxetine response in patients with neuropathic cancer pain: a secondary analysis of a randomized controlled trial—JORTC-PAL08 (DIRECT) study. Supportive Care in Cancer, 28(6), 2931-2939. https://doi.org/10.1007/s00520-019-05138-9