Multimodal Pain Management in Knee Osteoarthritis: A Comparative Study of Pregabalin and Duloxetine as Adjuncts to Naproxen.

Objective: This single-blinded, randomised, prospective study was carried out to investigate the effectiveness of a combination drug regimen including pregabalin and duloxetine as adjuncts to naproxen in pain management of patients with knee osteoarthritis (OA).

Methods: One hundred and five patients were inducted into the study following the inclusion and exclusion criteria. Using simple randomisation, patients were allocated into group A (naproxen only), group B (naproxen + duloxetine), and group C (naproxen + pregabalin). Visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used to measure pain severity, while secondary outcomes of sleep quality and depression were assessed by using the Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI) scale, respectively. Assessments were done at day 0, week 4, and week 12 in the study. Appropriate tests were utilised to analyse the data.

Results: Mean pain scores at 12 weeks were significantly lower in group B (p=0.009 for VAS, p=0.002 for WOMAC) and group C (p=0.012 for VAS, p=0.005 for WOMAC), as compared to group A (naproxen only). Sleep quality (p=0.00) and depression scales (p=0.00) were also similarly improved in the combination drug regimen groups as compared to the naproxen-only group.

Conclusions: Addition of either duloxetine or pregabalin to the naproxen drug regimen may result in better management and improved quality of life in patients suffering from knee OA.