Is an SNRI effective in knee OA?

A random comment offers the chance to determine duloxetine’s efficacy

Fatima, a 59-year-old woman living with painful knee osteoarthritis, was brought in by her daughter, a pharmacy assistant who is one of my regular patients.

During the consultation, the potential analgesic role of duloxetine, a serotonin and noradrenaline reuptake inhibitor antidepressant, came up.

I reflected afterwards that although it was frequently mentioned in pain discussions on an online GP forum, I had never previously commenced the drug for chronic pain.

So, what is the evidence?

Clinical question

Is duloxetine an effective treatment for knee osteoarthritis pain (and dysfunction)?

What does the research evidence say?

Step 1: The Cochrane Library

The Cochrane Library has a systematic review that largely focuses on peripheral neuropathy, but not other types