A randomised, double-blind, placebo-controlled trial of dolasetron, a 5-hydroxytryptamine 3 receptor antagonist, in
Pascale Vergne-Salle1, Carine Dufauret-Lombard, Christine Bonnet
1Pain Center and Department of Rheumatology, University Hospital of Limoges, Limoges, France. pascale.vergne-salle@chu-limoges.fr
Objective:
The purpose of the study was to evaluate the efficacy and safety of dolasetron for symptomatic relief of pain associated with fibromyalgia (FM).
Methods:
This prospective, double-blind, placebo-controlled trial randomly assigned 60 patients with FM to receive placebo (n = 31) or dolasetron (n = 29) 12.5mg/d via the intravenous route on 4 days at baseline (M0), 1 month (M1), 2 months (M2) and 3 months (M3) with follow-up to month 12. The primary outcome variable was the reduction in pain intensity measured by visual analogue scale (VAS) between M0 and M3. The secondary outcome variables were patient global impression of change (PGIC), the FM impact questionnaire, assessment of quality of life (SF-36), the hospital anxiety and depression scale, the manual tender point count, and functional symptoms associated with FM.
Results:
Reduction in pain intensity at M3 was significantly greater in dolasetron-treated patients (p = 0.04, -21.3 on a 0-100 scale) compared with placebo controls (-5.9). More patients in the dolasetron group had ≥ 30% and ≥ 50% improvement in pain (42.5% and 28% respectively in the dolasetron group versus 25% and 16% in the placebo group). The PGIC was significantly greater in the dolasetron group at M3 (p = 0.02). The other secondary outcomes failed to reach statistical significance. The most common adverse events were constipation, nausea, dizziness and headache, with no significant differences between the two groups.
Conclusion:
Intermittent IV dolasetron was safe and efficacious for the reduction of pain intensity associated with FM at 3 months.
Insights
Dolasetron effectively reduced fibromyalgia pain intensity over three months in a clinical trial. This treatment demonstrated significant improvements in pain scores and patient-reported outcomes, with a favorable safety profile.
Area of Science:
- Pharmacology
- Pain Management
- Rheumatology
Background:
- Fibromyalgia (FM) is a chronic condition characterized by widespread pain and other symptoms.
- Current FM treatments offer limited efficacy for many patients.
- Novel therapeutic strategies are needed for effective pain relief in FM.
Purpose of the Study:
- To assess the efficacy and safety of dolasetron for managing pain in patients with fibromyalgia.
- To evaluate dolasetron's impact on various secondary outcome measures related to FM.
Main Methods:
- A prospective, double-blind, placebo-controlled trial involving 60 FM patients.
- Patients received either intravenous dolasetron (12.5mg/d) or placebo on four occasions over three months.
- Pain intensity was measured using a visual analogue scale (VAS) as the primary outcome.
Main Results:
- Dolasetron significantly reduced pain intensity compared to placebo at three months (p=0.04).
- A higher percentage of patients in the dolasetron group achieved ≥30% and ≥50% pain reduction.
- Patient global impression of change (PGIC) was significantly improved with dolasetron (p=0.02).
Conclusions:
- Intermittent intravenous dolasetron is a safe and effective option for reducing pain intensity in fibromyalgia patients.
- The study supports dolasetron's potential as a therapeutic agent for symptomatic relief in FM.
- Further research may explore long-term efficacy and broader applications of dolasetron in FM management.
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