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

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. Co...

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Autores principales: Lipkovich, Ilya A, Choy, Ernest H, Van Wambeke, Peter, Deberdt, Walter, Sagman, Doron
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364643/
https://www.ncbi.nlm.nih.gov/pubmed/25532971
http://dx.doi.org/10.1186/1471-2474-15-450
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author Lipkovich, Ilya A
Choy, Ernest H
Van Wambeke, Peter
Deberdt, Walter
Sagman, Doron
author_facet Lipkovich, Ilya A
Choy, Ernest H
Van Wambeke, Peter
Deberdt, Walter
Sagman, Doron
author_sort Lipkovich, Ilya A
collection PubMed
description 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 (N(total) = 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2474-15-450) contains supplementary material, which is available to authorized users.
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spelling pubmed-43646432015-03-19 Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients Lipkovich, Ilya A Choy, Ernest H Van Wambeke, Peter Deberdt, Walter Sagman, Doron BMC Musculoskelet Disord Research Article 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 (N(total) = 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2474-15-450) contains supplementary material, which is available to authorized users. BioMed Central 2014-12-23 /pmc/articles/PMC4364643/ /pubmed/25532971 http://dx.doi.org/10.1186/1471-2474-15-450 Text en © Lipkovich et al.; licensee BioMed Central. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lipkovich, Ilya A
Choy, Ernest H
Van Wambeke, Peter
Deberdt, Walter
Sagman, Doron
Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients
title Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients
title_full Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients
title_fullStr Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients
title_full_unstemmed Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients
title_short Typology of patients with fibromyalgia: cluster analysis of duloxetine study patients
title_sort typology of patients with fibromyalgia: cluster analysis of duloxetine study patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364643/
https://www.ncbi.nlm.nih.gov/pubmed/25532971
http://dx.doi.org/10.1186/1471-2474-15-450
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