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Duloxetine in addition to self-management for painful temporomandibular disorders: a post hoc responder analysis of a randomized, placebo-controlled clinical trial
FERREIRA, Dyna Mara Araújo Oliveira; SOARES, Flávia Fonseca Carvalho; RAIMUNDINI, Amanda Ayla; BONJARDIM, Leonardo Rigoldi; COSTA, Yuri Martins; CONTI, Paulo César Rodrigues.
Afiliação
  • FERREIRA, Dyna Mara Araújo Oliveira; Universidade de São Paulo. Faculdade de Odontologia de Bauru. Departamento de Prótese e Periodontia. Bauru. BR
  • SOARES, Flávia Fonseca Carvalho; Universidade de São Paulo. Faculdade de Odontologia de Bauru. Departamento de Ciências Biológicas. Bauru. BR
  • RAIMUNDINI, Amanda Ayla; Universidade de São Paulo. Faculdade de Odontologia de Bauru. Departamento de Ciências Biológicas. Bauru. BR
  • BONJARDIM, Leonardo Rigoldi; Universidade de São Paulo. Faculdade de Odontologia de Bauru. Departamento de Ciências Biológicas. Bauru. BR
  • COSTA, Yuri Martins; Universidade de Campinas. Faculdade de Odontologia de Piracicaba. Departamento de Biociências. Piracicaba. BR
  • CONTI, Paulo César Rodrigues; Universidade de São Paulo. Faculdade de Odontologia de Bauru. Departamento de Prótese e Periodontia. Bauru. BR
J. appl. oral sci ; 32: e20240035, 2024. tab
Article em En | LILACS-Express | LILACS | ID: biblio-1564710
Biblioteca responsável: BR1.1
ABSTRACT
Abstract Aim To identify the phenotypic characteristics of individuals with temporomandibular disorders (TMD) who may benefit from adding duloxetine to self-management (SM) strategies. Methodology This was a post hoc exploratory analysis of a randomized, placebo-controlled clinical trial with SM-duloxetine (duloxetine 60 mg/day plus SM strategies for 12 weeks) in adult participants with painful TMD. The primary outcome was the proportion of responders to treatment (individuals with ≥ 30% reduction in pain intensity) in SM-duloxetine and SM-placebo group at week 12. For responder analysis, five phenotyping domains recommended by Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials were assessed pain, psychological, sleep, quantitative sensory testing, and conditioned pain modulation. Relative risk (RR), 95% confidence intervals (CI), and absolute risk reduction were calculated. Results Among participants treated with SM-duloxetine, severe pain intensity (RR 1.33, 95% CI 0.56, 3.17), pain disability (RR 1.30, 95% CI 0.63, 2.67), ≥ 1 painful comorbidity (RR 1.48, 95% CI 0.57, 3.79), and anxiety symptoms (RR 1.80, 95% CI 0.75, 4.34) were associated with greater likelihood of response to treatment. Among individuals treated with SM-placebo, only temporal summation of pain was associated with greater likelihood of response to treatment. Conclusion Personalized medicine may be implemented in painful TMD management, and phenotype characteristics related to pain and psychological domains may predict which individuals with painful TMD are more likely to respond to the addition of serotonin and norepinephrine reuptake inhibitors to SM strategies to clinically and significantly reduce pain intensity.
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Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Idioma: En Revista: J. appl. oral sci Assunto da revista: ODONTOLOGIA Ano de publicação: 2024 Tipo de documento: Article / Project document País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: LILACS Idioma: En Revista: J. appl. oral sci Assunto da revista: ODONTOLOGIA Ano de publicação: 2024 Tipo de documento: Article / Project document País de afiliação: Brasil País de publicação: Brasil