mobic and Diabetic-Neuropathies

To assess the safety of duloxetine at a fixed-dose of 60 mg twice daily (BID) for up to 52 weeks, and compare duloxetine with routine care in the management of patients with diabetic peripheral neuropathic pain (DPNP).. Patients who completed a 13-week, randomized, double-blind, placebo-controlled acute therapy period were randomly reassigned in a 2:1 ratio to therapy with duloxetine 60 mg BID (N = 197) or routine care (N = 96) for an additional 52 weeks.. The trial included outpatients > or =18 years of age diagnosed with moderate to severe DPNP caused by type 1 or type 2 diabetes.. Fourteen patients discontinued due to adverse events or death (11 [5.6%] duloxetine- and 3 [3.1%] routine care-treated patients). There were no significant therapy-group differences observed for patients with >/=1 serious adverse event. In total, 110 (55.8%) duloxetine- and 47 (49%) routine care-treated patients had > or =1 treatment-emergent adverse event (TEAE). The TEAE with a significant therapy-group difference, with patients in the duloxetine therapy group experiencing a higher percentage of events, was asthenia (11 [5.6%] duloxetine- vs no routine care-treated patients). Duloxetine did not appear to adversely affect lipid profiles, or nerve or eye function. There were no significant therapy-group differences observed in mean change in systolic blood pressure, weight, or electrocardiogram parameters. Significant therapy-group differences were observed in favor of duloxetine in the SF-36 physical component summary score, and subscale scores of physical functioning, bodily pain, mental health, and vitality.. The results of this study provide support for the use of duloxetine in the long-term management of DPNP.

Topics: Acetaminophen; Amitriptyline; Analgesics; Carbamazepine; Diabetes Complications; Diabetic Neuropathies; Diclofenac; Double-Blind Method; Duloxetine Hydrochloride; Female; Humans; Lipids; Male; Meloxicam; Middle Aged; Neuralgia; Pentoxifylline; Selective Serotonin Reuptake Inhibitors; Thiamine; Thiazines; Thiazoles; Thioctic Acid; Thiophenes; Time; Vitamin B 12

Only a few experimental studies have demonstrated the effectiveness of some cyclooxygenase-2 (COX-2) inhibitors for neuropathic pain in diabetic animals. In this study we investigated the usefulness of one such COX-2 inhibitor, meloxicam, for treatment of established diabetic neuropathic pain in mice. Intraperitoneal and perineural injection, but not intrathecal injection, of meloxicam elevated the lowered threshold in the von Frey test. These results suggest that meloxicam exerts antiallodynic effects on established neuropathic pain in diabetic mice, and that the site of its action is peripheral. Meloxicam may therefore be a potentially useful drug for treatment of diabetic neuropathic pain.

Topics: Analgesics; Animals; Cyclooxygenase 2 Inhibitors; Diabetes Mellitus, Experimental; Diabetic Neuropathies; Injections, Intraperitoneal; Injections, Spinal; Male; Meloxicam; Mice; Pain; Pain Measurement; Thiazines; Thiazoles