Duloxetine updated on 07-01-2025

Nervous system anomalies

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S11682
R42916		 Ankarfeldt a (Controls unexposed, NOS), 2021 Nervous system malformations 1st trimester population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 1.00 [0.28;3.54]
excluded (control group) 		-/1,438   12/5,751 - 1,438
ref
S11683
R42932		 Ankarfeldt a (Controls unexposed, sick), 2021 Nervous system malformations 1st trimester population based cohort retrospective unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 1.50 [0.25;8.98] -/1,434   -/1,435 - 1,434
ref
S11747
R43164		 Huybrechts (Controls unexposed, NOS), 2020 Central Nervous System malformations 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 0.81 [0.30;2.16]
excluded (control group) 		-/2,532   -/- - 2,532
ref
S11748
R43178		 Huybrechts (Controls unexposed, sick), 2020 Central Nervous System malformations 1st trimester retrospective cohort (claims database) unexposed, sick Adjustment: Yes Monotherapy: no or not specified Unexposed sick: intermediate history of illness/treatment (3-12 months before pregnancy) 0.67 [0.18;2.42] -/2,532   -/2,456 - 2,532
ref
Total 2 studies 0.88 [0.31;2.53] 0 3,966
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Ankarfeldt a (Controls unexposed, sick), 2021Ankarfeldt a, 2021 1 1.50[0.25; 8.98]-1,43434%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: low Huybrechts (Controls unexposed, sick), 2020Huybrechts, 2020 2 0.67[0.18; 2.42]-2,53266%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: low Total (2 studies) I2 = 0% 0.88[0.31; 2.53]-3,9660.25.01.0ROB: A: confusion, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick; 2: Controls unexposed, sick;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 0.88[0.31; 2.53]-3,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 0.88[0.31; 2.53]-3,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 Tags Adjustment   - Yes  - Yes 0.88[0.31; 2.53]-3,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 Monotherapy   - no or not specified  - no or not specified 0.88[0.31; 2.53]-3,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 Unexposed sick   - intermediate history of illness/tre ...  - intermediate history of illness/treatment (3-12 months before pregnancy) 0.88[0.31; 2.53]-3,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 All studiesAll studies 0.88[0.31; 2.53]-3,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 20.25.01.0

Publication bias and p-hacking diagnosis

funnel plot

Funnel plot not drawn. Less than 3 points.

Asymetry test p-value = NaN (by Egger's regression)

not enought points

p values plot

Funnel plot not drawn. Less than 3 points.

Sub-groups analysis using all included studies

excluded 11747, 11682

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed controls (disease free or unspecified)unexposed controls (disease free or unspecified) 0.88[0.40; 1.91]33,9700%NAAnkarfeldt a (Controls unexposed, NOS), 2021 Huybrechts (Controls unexposed, NOS), 2020 2 unexposed, sick controlsunexposed, sick controls 0.88[0.31; 2.53]-3,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 20.510.01.0