ISTANBUL, TURKEY — Early marked reduction in pain in response to duloxetine proved to be the strongest predictor of significant long-term improvement in depressive symptoms in depressed subjects in the German PADRE study.
A 50% or greater improvement in self-gauged overall pain symptoms on a visual analog scale (VAS) after 4 weeks on the selective norepinephrine reuptake inhibitor was associated with a threefold greater likelihood of achieving at least a 50% decrease on the clinician-rated Inventory for Depressive Symptomatology (IDS) scale at 6 months, the primary study end point, Dr. Michael Linden reported the annual congress of the European College of Neuropsychopharmacology.
PADRE (PAinful physical symptoms in Depressed patients: RElation to treatment outcomes in clinical practice) was a prospective observational study in which 4,517 adult patients with a depressive episode received duloxetine at 693 centers across Germany. The mean age was 52 years, and 72% were women.
The mean VAS pain score in the overall study population improved from 55 at baseline to 31 at 6 months. Forty-eight percent of patients reported at least a 50% reduction in pain on the VAS after 4 weeks of treatment, which was deemed clinically significant. Nearly two-thirds of these early pain responders went on to experience remission of their depression by 6 months as defined by an Inventory for IDS score of 12 or less; this remission rate was twice that of patients who did not achieve at least a 50% decrease in pain at 4 weeks, according to Dr. Linden of Charité University Hospital, Berlin.
PADRE was sponsored by Lilly Deutschland and Boehringer Ingelheim.