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Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients

Lipkovich, Ilya A, Choy, Ernest, Van Wambeke, Peter, Deberdt, Walter and Sagman, Doron 2014. Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients. BMC Musculoskeletal Disorders 15 , 450. 10.1186/1471-2474-15-450

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Abstract

Background: To identify distinct groups of patients with fibromyalgia (FM) with respect to multiple outcome measures. Methods: Data from 631 duloxetine-treated women in 4 randomized, placebo-controlled trials were included in a cluster analysis based on outcomes after up to 12 weeks of treatment. Corresponding classification rules were constructed using a classification tree method. Probabilities for transitioning from baseline to Week 12 category were estimated for placebo and duloxetine patients (Ntotal = 1188) using logistic regression. Results: Five clusters were identified, from “worst” (high pain levels and severe mental/physical impairment) to “best” (low pain levels and nearly normal mental/physical function). For patients with moderate overall severity, mental and physical symptoms were less correlated, resulting in 2 distinct clusters based on these 2 symptom domains. Three key variables with threshold values were identified for classification of patients: Brief Pain Inventory (BPI) pain interference overall scores of <3.29 and <7.14, respectively, a Fibromyalgia Impact Questionnaire (FIQ) interference with work score of <2, and an FIQ depression score of ≥5. Patient characteristics and frequencies per baseline category were similar between treatments; >80% of patients were in the 3 worst categories. Duloxetine patients were significantly more likely to improve after 12 weeks than placebo patients. A sustained effect was seen with continued duloxetine treatment. Conclusions: FM patients are heterogeneous and can be classified into distinct subgroups by simple descriptive rules derived from only 3 variables, which may guide individual patient management. Duloxetine showed higher improvement rates than placebo and had a sustained effect beyond 12 weeks.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Publisher: BioMed Central
ISSN: 1471-2474
Date of First Compliant Deposit: 21 August 2018
Date of Acceptance: 17 December 2014
Last Modified: 27 Mar 2019 15:43
URI: http://orca.cf.ac.uk/id/eprint/79271

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