A total of 524 patients randomly received duloxetine 60/120 mg/day (N = 264) or placebo (N = 260). In total, 74% of the patients completed the study. Mean age was 61 years (SD ), 57% were female, and 81% were white. Duloxetine-treated patients had significantly greater pain reduction at week 8 (p < ) than placebo-treated patients. In addition, relative to placebo at week 8, duloxetine-treated patients had significant improvements in physical function as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (p < ), and Patient Global Impression of Improvement (p < ). Compared to placebo, significantly more nausea, dry mouth, constipation, fatigue and decreased appetite were reported by patients taking duloxetine (each p < ). Discontinuation due to adverse events occurred more commonly in the duloxetine group than the placebo group (p = ).
Information for Pet Owners: Metacam ® (meloxicam) is a nonsteroidal anti-inflammatory drug (NSAID) and as with others in this group, side effects may occur in treated dogs. The most common adverse effects reported involve the gastrointestinal tract and usually occur within the first week of treatment. Typical symptoms include loss of appetite, vomiting, diarrhea, dark stools and depression. It is important in these situations to discontinue treatment and contact your veterinarian. In most cases, the side effects are transient and disappear after termination of treatment but in rare instances may be serious. Dogs undergoing prolonged treatment with Metacam ® should be monitored periodically. Consult your veterinarian.
NSAIDS have antipyretic activity and can be used to treat fever.   Fever is caused by elevated levels of prostaglandin E2 , which alters the firing rate of neurons within the hypothalamus that control thermoregulation.   Antipyretics work by inhibiting the enzyme COX, which causes the general inhibition of prostanoid biosynthesis ( PGE2 ) within the hypothalamus .   PGE2 signals to the hypothalamus to increase the body's thermal set point.   Ibuprofen has been shown more effective as an antipyretic than paracetamol (acetaminophen).   Arachidonic acid is the precursor substrate for cyclooxygenase leading to the production of prostaglandins F, D & E.