Effects of celecoxib combined with duloxetine on chronic pain, depression, and anxiety in patients with knee osteoarthritis

Table 1 Baseline patient data, n (%)

Factor		Control group (n = 57)	Study group (n = 66)	χ2	P value
Sex
	Male	14 (24.56)	20 (30.3)	0.504	0.478
	Female	43 (75.44)	46 (69.7)
Age (year)
	≥ 65	31 (54.39)	30 (45.45)	0.976	0.323
	< 65	26 (45.61)	36 (54.55)
BMI (kg/m2)
	≥ 23	13 (22.81)	18 (27.27)	0.324	0.569
	< 23	44 (77.19)	48 (72.73)
History of hypertension
	Yes	20 (35.09)	29 (43.94)	1.000	0.317
	No	37 (64.91)	37 (56.06)
History of diabetes
	Yes	9 (15.79)	13 (19.7)	0.318	0.573
	No	48 (84.21)	53 (80.3)
Smoking history
	Yes	15 (26.32)	21 (31.82)	0.447	0.504
	No	42 (73.68)	45 (68.18)
Alcohol consumption history
	Yes	7 (12.28)	9 (13.64)	0.050	0.824
	No	50 (87.72)	57 (86.36)
Education level
	≥ junior high school	6 (10.53)	5 (7.58)	0.327	0.567
	< junior high school	51 (89.47)	61 (92.42)
Employment status
	On-the-job	9 (15.79)	13 (19.7)	0.318	0.573
	Retired	48 (84.21)	53 (80.3)

BMI: Body mass index.

Table 2 Functional score comparisons

Group	VAS		WOMAC
	Pre-treatment	Post-treatment	Pre-treatment	Post-treatment
Control group (n = 57)	6.00 (5.00, 7.00)	2.50 (2.00, 3.00)a	49.17 ± 6.45	31.03 ± 4.60a
Study group (n = 66)	7.00 (5.00, 8.00)	3.00 (3.00, 4.00)a	47.30 ± 5.05	37.86 ± 3.92a
t value	-1.719	-5.145	1.799	-8.884
P value	0.081	< 0.001	0.075	< 0.001

^aP < 0.05 vs pre-treatment score.

VAS: Visual Analog Scale; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index.

Table 3 Hepatorenal function comparisons

Group	ALT (U/L)		AST (U/L)		Cr (μmol/L)		BUN (mmol/L)
	Pre-treatment	Post-treatment	Pre-treatment	Post-treatment	Pre-treatment	Post-treatment	Pre-treatment	Post-treatment
Control group (n = 57)	23.11 ± 10.18	24.74 ± 6.45	23.83 ± 6.79	26.08 ± 6.64	62.44 ± 17.62	62.49 ± 14.46	4.06 ± 1.15	4.34 ± 1.83
Study group (n = 66)	23.45 ± 7.88	26.76 ± 9.17	23.48 ± 5.11	25.57 ± 7.35	57.28 ± 16.39	62.16 ± 14.82	3.88 ± 1.83	4.30 ± 1.24
t value	-0.208	-1.393	0.321	0.403	1.681	0.127	0.631	0.155
P value	0.836	0.167	0.748	0.688	0.095	0.899	0.529	0.877

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; Cr: Creatinine; BUN: Blood urea nitrogen.

Table 4 Changes in anxiety and depression scores

Group	SAS		SDS
	Pre-treatment	Post-treatment	Pre-treatment	Post-treatment
Control group (n = 57)	64.98 ± 4.69	46.58 ± 5.11a	67.00 (63.00, 70.00)	48.26 ± 5.26a
Study group (n = 66)	64.16 ± 4.94	52.56 ± 5.86a	66.00 (64.00, 71.00)	52.46 ± 3.35a
t value	0.948	-5.988	0.573	-5.347
P value	0.345	< 0.001	0.567	< 0.001

^aP < 0.05 vs pre-treatment score.

SAS: Self-rating Anxiety Scales; SDS: Self-rating Depression Scales.

Table 5 Statistical comparison of adverse reactions

Group	Nausea and vomiting	Constipation	Somnolence	Erythema
Control group (n = 57)	5	3	3	4
Study group (n = 66)	6	4	3	3
χ2	-	-	-	-
P value	> 0.999	> 0.999	> 0.999	> 0.999

Fisher's exact test was used.

Table 6 Comparison of baseline data of patients with negative emotion, n (%)

Factor		Alleviation group (n = 83)	Non-alleviation group (n = 40)	χ2	P value
Sex
	Male	25 (30.12)	9 (22.5)	0.784	0.376
	Female	58 (69.88)	31 (77.5)
Age (year)
	≥ 65	30 (36.14)	31 (77.5)	18.467	< 0.001
	< 65	53 (63.86)	9 (22.5)
BMI (kg/m2)
	≥ 23	21 (25.3)	10 (25)	0.001	0.971
	< 23	62 (74.7)	30 (75)
History of hypertension
	Yes	35 (42.17)	14 (35)	0.579	0.447
	No	48 (57.83)	26 (65)
History of diabetes
	Yes	17 (20.48)	5 (12.5)	1.171	0.279
	No	66 (79.52)	35 (87.5)
Smoking history
	Yes	25 (30.12)	11 (27.5)	0.090	0.765
	No	58 (69.88)	29 (72.5)
Alcohol consumption history
	Yes	12 (14.46)	4 (10)	0.474	0.491
	No	71 (85.54)	36 (90)
Education level
	≥ junior high school	2 (2.41)	9 (22.5)	13.379	< 0.001
	< junior high school	81 (97.59)	31 (77.5)
Employment status
	On-the-job	16 (19.28)	6 (15)	0.336	0.562
	Retired	67 (80.72)	34 (85)
Therapeutic regimen
	Control group	25 (30.12)	32 (80)	27.007	< 0.001
	Study group	58 (69.88)	8 (20)
VAS before treatment, P50 (P25, P75)		6.00 (5.00, 8.00)	6.00 (5.00, 7.00)	0.729	0.461
WOMAC before treatment, P50 (P25, P75)		49.50 (44.75, 53.00)	48.00 (43.00, 52.00)	0.848	0.397
ALT (U/L) before treatment, mean ± SD		24.57 ± 10.18	22.64 ± 8.60	1.033	0.305
AST (U/L) before treatment, mean ± SD		22.98 ± 5.19	24.00 ± 6.43	-0.941	0.349
Cr before treatment (μmol/L), mean ± SD		58.46 ± 15.78	60.82 ± 17.87	-0.745	0.458
BUN (mmol/L) before treatment, mean ± SD		4.09 ± 1.79	3.92 ± 1.34	0.510	0.612

BMI: Body mass index; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; Cr: Creatinine; BUN: Blood urea nitrogen.

Table 7 Multivariable logistic regression analysis of risk factors for negative emotions

Factor	β	SE	Wald	Significance	OR value	95%CI
						Lower limit	Upper limit
Age	2.112	0.554	14.505	< 0.001	3.211	1.921	4.672
Education level	2.908	0.979	8.815	0.003	4.272	1.882	6.976
Treatment regimen	2.796	0.595	22.102	< 0.001	4.119	2.61	5.743