Duloxetine updated on 07-01-2025

Limb defects

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
R42915		 Ankarfeldt a (Controls unexposed, NOS), 2021 Limb malformations 1st trimester population based cohort retrospective unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 0.67 [0.42;1.06]
excluded (control group) 		21/1,438   125/5,751 146 1,438
ref
S11683
R42931		 Ankarfeldt a (Controls unexposed, sick), 2021 Limb 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) 0.56 [0.32;0.96] 20/1,434   36/1,435 56 1,434
ref
S11747
R43173		 Huybrechts (Controls unexposed, NOS), 2020 Limb defects 1st trimester retrospective cohort (claims database) unexposed (general population or NOS) excluded Adjustment: Yes Monotherapy: no or not specified 0.60 [0.25;1.43]
excluded (control group) 		-/2,532   -/- - 2,532
ref
S11748
R43187		 Huybrechts (Controls unexposed, sick), 2020 Limb defects 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) 0.48 [0.16;1.42] -/2,532   -/2,456 - 2,532
ref
Total 2 studies 0.54 [0.33;0.89] 56 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 0.56[0.32; 0.96]561,43480%ROB confusion: seriousROB selection: moderateROB classification: criticalROB missing: lowROB mesure: moderateROB reporting: low Huybrechts (Controls unexposed, sick), 2020Huybrechts, 2020 2 0.48[0.16; 1.42]-2,53220%ROB confusion: moderateROB selection: moderateROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: low Total (2 studies) I2 = 0% 0.54[0.33; 0.89]563,9660.22.01.0ROB: 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 0.54[0.33; 0.89]563,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 0.54[0.33; 0.89]563,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 Tags Adjustment   - Yes  - Yes 0.54[0.33; 0.89]563,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 Monotherapy   - no or not specified  - no or not specified 0.54[0.33; 0.89]563,9660%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) 0.54[0.33; 0.89]563,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 2 All studiesAll studies 0.54[0.33; 0.89]563,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 20.210.01.0

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) 0.65[0.43; 0.98]1463,9700%NAAnkarfeldt a (Controls unexposed, NOS), 2021 Huybrechts (Controls unexposed, NOS), 2020 2 unexposed, sick controlsunexposed, sick controls 0.54[0.33; 0.89]563,9660%NAAnkarfeldt a (Controls unexposed, sick), 2021 Huybrechts (Controls unexposed, sick), 2020 20.510.01.0