POS1366 EFFICACY OF DULOXETINE COMPARED TO NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN THE TREATMENT OF KNEE OSTEOARTHRITIS IN IRAQI KURDISTAN REGION
Bibliographic record
Abstract
Background Osteoarthritis (OA) is the most common degenerative joint disease [1]. Knee OA is an insidious disease related to structural changes in the joint over many years. Duloxetine, a selective serotonin, and norepinephrine reuptake inhibitor, seems to be effective in treating neuropathic and chronic pain conditions [6]. Objectives The objective of this study was to assess the efficacy of duloxetine tablet compared to nonsteroidal anti-inflammatory (NSAID) for the reduction of pain in Osteoarthritis. Methods A Randomized open labelled clinical trial of a 13-weeks done in Rizgary Teaching and CMC (Consultant Medical City) hospitals in Iraqi Kurdistan Region. From 5th of September 2022 to 2nd of January 2023 with Trial Registration ID (NCT05486026). Those eligible to enter the study their ages were ≥ 40years, both Genders were included, who will meet the American College of Rheumatology clinical and radiographic criteria for the diagnosis of osteoarthritis of the knee [8]. Patients were divided into two groups, The first group received Duloxetine tablet 30 mg for two weeks then titrated up to 30 mg BID. were compared to control group that received NSAID (nonsteroidal anti-inflammatory drug). End points were recorded at baseline then 2nd visits at 13 weeks. Measurement of pain severity was done by the weekly mean of the 24-h average pain scores in patients with osteoarthritis knee pain by Brief pain inventory (BPI). Another tool is (WOMAC) WESTERN ONTARIO AND MCMASTER OSTEOARTHITIS INDEX used for evaluation of pain in knee Osteoarthritis which involve three categories. The Patient Global Impression of Improvement (PGI-I) scale measured patients’ perceived change in overall well-being (in response to therapy/treatment) and even side effects. Results Out of two hundred patients, forty-six participants were excluded: one hundred fifty-four were enrolled in the study. Their mean ages ±SD (57.38 ±10.58, 58.47±12.03) in Duloxetine, NSAID group Respectively. BPI-Severity average pain improved significantly after treatment with Duloxetine were 4.64 (95%CI:4.25 to 5.02) and P value was 0.00. BPI during 24-hour pain interfere with (activity, Mood, walking ability, work, relations with other people, sleep, enjoyment of life) were lower in Duloxetine group after treatment in comparison to control group (NSAID) 4.45 (95% CI:4.01 to 4.87), 5.47 (95%CI:5.11 to 5.82) respectively p value was significant ‹ 0.001. The total WOMAC score after treatment in Duloxetine group decreased 31.74 (95%CI:27.05 to 36.42) while in NSAID groups were 42.46(95%CI:38.05 to 46.86). about (PGI-I) scale, the patients who treated with Duloxetine was generally better than those treated with NSAID group; as the response and cure rate were higher in the Duloxetine(34.2%,30.3%,7.9%) much improve, very much improved, minimally improved respectively so; total (72.4%) were improved in comparison to the control group(28.2%, 6.4%, 11.5%) much improved, much improved,minimally improved respectively so; total (46.1%) were improved, the p value were significant 0.002 and about adverse effect in Duloxetine group most common side effects were epigastric pain and headache(3,3), with one patient with nausea, one with tremor and one fatigability, the symptoms were mild they continue study with symptomatic treatment of side effects, and 4 in NSAID developed side effect. Conclusion Duloxetine reduced pain and improved function in patients with knee osteoarthritis, by reducing BPI inventory and WOMAC score, with much improvement on PGI scales in comparison to NSAID. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".