Dealing fibromyalgia with duloxetine, pregabalin, and milnacipran: A comparison
Fibromyalgia (FM) is a medical condition characterized by chronic widespread pain and a great pain response to pressure. There are different medications which are prescribed to treat fibromyalgia symptoms. These includes pain medicines, sleeping pills and antidepressants. Some of them help to ease pain and others boost mood and also improves sleep. Still new researches have been made to find the best medicine with better tolerability and efficacy. A study was conducted to assess the relative efficacy and tolerability of few drugs like duloxetine, pregabalin and milnacipran prescribed in patients suffering from fibromyalgia with recommended doses.
In the trial, efficacy and safety of duloxetine 60 mg, pregabalin 300 mg, pregabalin 150 mg, milnacipran 200 mg and milnacipran 100 mg were examined and compared with placebo in fibromyalgia patients and results from this meta-analysis were included in the Bayesian Network. In 9 different randomized controlled trials, 5140 patients met the inclusion criteria. Significantly higher improvements of pain were observed in the duloxetine 60 mg, pregabalin 300 mg, milnacipran 100 mg and milnacipran 200 mg groups than in the placebo group. However, the ranking probability based on the surface under the cumulative ranking curve (SUCRA) indicated that duloxetine 60 mg had the highest probability of being the best treatment for achieving the response level, followed by pregabalin 300 mg, milnacipran 100 mg, milnacipran 200 mg, pregabalin 150 mg and placebo.
It was observed that the withdrawal risk due to adverse effects was lower in the placebo group than in pregabalin 300 mg, duloxetine 60 mg, milnacipran 100 mg and milnacipran 200 mg groups. No significant difference was observed in the efficacy and tolerability between the medications at the recommended doses, but duloxetine 60 mg, pregabalin 300 mg, milnacipran 100 mg and milnacipran 200 mg were proven to be more efficacious than placebo. At the prescribed recommended doses, no significant difference in the efficacy and tolerability between the medications.