A Study of Duloxetine in Patients With Osteoarthritis Knee Pain

Lilly

Status and phase: Completed; Phase 3

Conditions: Osteoarthritis Knee Pain

Treatments: Drug: Placebo (PLA); Drug: Duloxetine (DLX)

Study type: Interventional

Funder types: Industry

Identifiers

NCT00945945

13214

F1J-MC-HMGP (Other Identifier)

Details and patient eligibility

About

The primary purpose of this study is to determine if duloxetine 60 mg once daily (QD) reduces pain severity in patients with osteoarthritis (OA) knee pain compared with placebo.

Enrollment: 424 patients

Sex: All

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Male or female outpatients with osteoarthritis knee pain for greater than or equal to 14 days of each month for 3 months prior to study entry.
• Have a rating of greater than or equal to 4 on the BPI average pain item (Question 3 of the Brief Pain Inventory [BPI] modified short form) at screening and randomization

Exclusion criteria

• Have had any previous exposure to duloxetine.
• Have any previous diagnosis of psychosis, bipolar disorder, or schizoaffective disorder.
• Have Major Depression Disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, as assessed by the Mini International Neuropsychiatric Interview (Sheehan et al. 1998), or diagnosed within the past year.
• Have a history of substance abuse or dependence within the past year, excluding nicotine and caffeine.
• Are taking any excluded medications that cannot be discontinued at screening visit.
• Have current or pending disability compensation or litigation issues that may compromise response to treatment, in the opinion of the investigator.
• Have had treatment with a monoamine oxidase inhibitor (MAOI) within 14 days of randomization or the potential need to use an MAOI during the study or within 5 days of discontinuation of study drug.
• Have a positive urine drug screen for any substance of abuse or excluded medication.
• Are pregnant or breast-feeding.
• Have serious cardiovascular, hepatic, renal, respiratory, or hematologic illness, or other medical or psychiatric condition that, in the opinion of the investigator, would compromise participation or be likely to lead to hospitalization during the course of the study.
• Have a history of recurrent seizures other than febrile seizures.
• Are judged by the investigator to be at suicidal risk.
• Have uncontrolled narrow-angle glaucoma.
• Have acute liver injury (such as hepatitis) or severe cirrhosis (Child- Pugh Class C).
• Have known hypersensitivity to duloxetine or any of the inactive ingredients or patients with frequent or severe allergic reactions to multiple medications.
• Have frequent falls that could result in hospitalization or could compromise response to treatment.
• Have a confounding painful condition that may interfere with assessment of the index joint, that is, knee. (Knee pain should be the predominant pain. Mild OA pain of other joints is allowed.)
• Have a diagnosis of inflammatory arthritis (that is, rheumatoid arthritis) or an autoimmune disorder (excluding inactive Hashimoto's thyroiditis).
• Have received intraarticular hyaluronate or steroids, joint lavage, or other invasive therapies to the knee in the past 3 months.
• Have had knee arthroscopy of the index knee within the past year or joint replacement of the index knee at anytime.
• Have surgery planned during the study for the index joint.
• Have a body mass index (BMI) over 40.
• Use of acupuncture, chiropractic maneuvers, transcutaneous electrical nerve stimulation (TENS), or similar procedures aimed to relieve any kind of pain.
• Patients who are anticipated by the investigator to require use of analgesic agents including but not limited to non-steroidal anti-inflammatory drugs(NSAIDs), acetaminophen/paracetamol, and opioids, or other excluded medication for the duration of the study.
• Are unwilling or unable to comply with the data collection method used to record their patient rated outcome data.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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424 participants in 2 patient groups, including a placebo group

DLX30-PLA

Experimental group

Description:

Per the protocol, patients randomized to the duloxetine group were to receive duloxetine for the entire 13-week acute treatment period. Patients were to start at a 30 mg daily (QD) dose of duloxetine for 1 week, then increase to 60 mg QD of duloxetine for the following 12 weeks. However, due to a study drug labeling error, patients randomized to this group received 30 mg of duloxetine for the initial 1-week, but received placebo instead of receiving 60 mg QD of duloxetine for the next 12 weeks. The resulting unintended, mixed treatment group was labeled as DLX30-PLA throughout this document. Per protocol, the last week of the study (week 14) was intended to be a 1-week taper period. Patients in this treatment group were to receive 30 mg QD of duloxetine during that week, and that did occur per protocol.

Treatment:

Drug: Placebo (PLA)

Drug: Duloxetine (DLX)

PLA-DLX60

Placebo Comparator group

Description:

Per the protocol, patients randomized to the placebo group were to receive placebo for the entire 13-week acute treatment period. Patients were to start on placebo for the first week, then continue on placebo for the following 12 weeks. However, due to a study drug labeling error, patients in this group received placebo for the initial 1-week, but received 60 mg QD of duloxetine instead of receiving placebo for the next 12 weeks. The resulting unintended, mixed treatment group was labeled as PLA-DLX60 throughout this document. Per protocol, the last week of the study (week 14) was intended to be a 1-week taper period. Patients in this treatment group were to receive placebo that week, and that did occur per protocol.

Treatment:

Drug: Placebo (PLA)

Drug: Duloxetine (DLX)