PainA Systematic Review and Mixed Treatment Comparison of the Efficacy of Pharmacological Treatments for Fibromyalgia
Section snippets
Systematic Review
A systematic review of electronic databases and conference proceedings was conducted to identify relevant studies. Medline, Embase, and the Cochrane Library were accessed on 28 February 2008. The search combined the terms “fibromyalgia” and “fibrositis” and publication type “controlled clinical trial” or “randomized controlled trial.” The following conference proceedings were hand-searched (2003–2008 inclusive): World Congress of Pain, British Pain Society, World Institute of Pain, American
Systematic Review
In total, 464 studies were identified (following removal of duplicates), of which 378 were excluded on the basis of title and abstract (Fig. 1). A further 34 relevant publications were identified from searching reference lists and conference proceedings. Seventy-five publications were excluded on examination of the full article, leaving a total of 45 RCTs that were included in the systematic review. Study characteristics for the included publications are reported in the online appendix. Across
Discussion
The present analysis extends previous research by comparing different treatments using MTC. The result of our analyses found few statistically significant differences between FDA-approved treatments. The absolute difference between pregabalin and duloxetine was very small and did not reach statistical significance at licensed doses. Pregabalin produced significantly greater improvements in sleep (MOS sleep scores) compared with milnacipran at licensed doses. Although pregabalin, milnacipran,
References (92)
- et al.
Patient perspectives on the impact of fibromyalgia
Patient Educ Couns
(2008) - et al.
Treatment of fibromyalgia syndrome with gabapentin and pregabalin—A meta-analysis of randomized controlled trials
Pain
(2009) - et al.
Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome
J Pain
(2010) - et al.
Assessing the quality of reports of randomized clinical trials: is blinding necessary?
Control Clin Trials
(1996) - et al.
Bayesian meta-analysis of multiple treatment comparisons: an introduction to mixed treatment comparisons
Value Health
(2008) - et al.
A randomized, controlled, trial of controlled release paroxetine in fibromyalgia
Am J Med
(2007) - et al.
Efficacy and tolerability of paroxetine in patients with fibromyalgia syndrome: A single-blind study
Curr Therapeut Res Clin Exp
(1999) - et al.
Citalopram in patients with fibromyalgia—a randomized, double-blind, placebo-controlled study
Eur J Pain
(2000) - et al.
A randomized controlled trial of citalopram in the treatment of fibromyalgia
Pain
(1995) - et al.
Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: Results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial
Pain
(2008)
A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder
Pain
Milnacipran for the treatment of fibromyalgia in adults: A 15-week, multicenter, randomized, double-blind, placebo-controlled, multiple-dose clinical trial
Clin Ther
A 14-week randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia
J Pain
Fibromyalgia relapse evaluation and efficacy for durability of meaningful relief (FREEDOM): a 6-month, double-blind, placebo-controlled trial with pregabalin
Pain
Comparison of tenoxicam and bromazepan in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled trial
Pain
The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials
J Clin Epidemiol
A randomized, placebo-controlled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia
Am J Med
Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study
Am J Med
Nabilone for the treatment of pain in fibromyalgia
J Pain
Classification, epidemiology, and natural history of fibromyalgia
Curr Pain Headache Rep
The American College of Rheumatology 1990 Criteria for the Classification of FibromyalgiaReport of the Multicenter Criteria Committee
Arthritis Rheum
Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment
J Rheumatol Suppl
The health status burden of people with fibromyalgia: a review of studies that assessed health status with the SF-36 or the SF-12
Int J Clin Pract
Efficacy of acupuncture for the treatment of fibromyalgia: systematic review and meta-analysis of randomized trials
Open Rheumatol J
A systematic review on the effectiveness of treatment with antidepressants in fibromyalgia syndrome
Arthritis Rheum
Pathogenetic aspects of responsiveness to ondansetron (5-hydroxytryptamine type 3 receptor antagonist) in patients with primary fibromyalgia syndrome—a preliminary study
J Rheumatol
Fibromyalgia: effects of temazepam, amitriptyline and placebo on pain and sleep
Sleep Res
A randomized trial of cyclobenzaprine for the treatment of fibromyalgia
J Rheumatol Suppl
Psychophysical and neurochemical abnormalities of pain processing in fibromyalgia
CNS Spectr
Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy
Rheumatology (Oxford)
Gabapentin and pregabalin in the treatment of fibromyalgia: a systematic review and a meta-analysis
J Clin Pharm Ther
Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: a systematic review with meta-analysis
Rheumatology (Oxford)
EULAR evidence-based recommendations for the management of fibromyalgia syndrome
Ann Rheum Dis
Management of fibromyalgia syndrome
JAMA
[Definition, classification and diagnosis of fibromyalgia syndrome]
Z Rheumatol
The efficacy and safety of milnacipran for treatment of fibromyalgiaA randomized, double-blind, placebo-controlled trial
J Rheumatol
A randomized double-blind, placebo-controlled, phase III trial of pregabalin in the treatment of patients with fibromyalgia
J Rheumatol
A 1-year safety and efficacy study of duloxetine in patients with fibromyalgiaAbstract no. THU 0370
Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia
Clin J Pain
Pharmacologic treatment of fibromyalgia
Curr Pain Headache Rep
The treatment of fibromyalgia: a review of clinical trials
Curr Rheumatol Rep
A meta-analysis of fibromyalgia treatment interventions
Ann Behav Med
Systematic review of discriminating power of outcome measures used in clinical trials of fibromyalgia
J Rheumatol
Combination of direct and indirect evidence in mixed treatment comparisons
Stat Med
Simultaneous comparison of multiple treatments: combining direct and indirect evidence
BMJ
OMERACT: An international initiative to improve outcome measurement in rheumatology
Trials
Cited by (58)
Phoneutria nigriventer Tx3-3 peptide toxin reduces fibromyalgia symptoms in mice
2021, NeuropeptidesCitation Excerpt :Although it is speculative, it is conceivable that agents, such as pramipexole, may possess beneficial effects for those patients with FM (Smith et al., 2011). However, the currently available therapies exhibit limited efficacy and they can trigger several undesirable effects (Bennett et al., 2007; Choy et al., 2011; Macfarlane et al., 2017). Besides, according to the Brazilian Consensus for the treatment of fibromyalgia, pramipexole is recommended for a decrease in pain and it is frequently prescribed in clinical practices in the country (Heymann et al., 2010).
Effectiveness of Tai Chi on fibromyalgia patients: A meta-analysis of randomized controlled trials
2019, Complementary Therapies in MedicineCitation Excerpt :Universal guideline recommends that the combination of pharmacological and nonpharmacological interventions as initial treatment may achieve favorable outcomes.5 Current drug interventions such as analgesics, anticonvulsants, and antidepressants provide short-term benefits for FM symptoms; however, recent reviews have debated the clinical effectiveness of such drug interventions because of the side effects and inefficacy.6–8 Among nonpharmacological interventions, conventional therapeutic exercise is one of the recommended strategies, it includes aerobic training, coordination training, flexibility exercises, relaxation techniques, and muscle-strengthening exercises.9
Fibromyalgia: Diagnosis and Management
2023, American Family PhysicianPregabalin administration in patients with fibromyalgia: a Bayesian network meta-analysis
2022, Scientific Reports
This review was funded by Pfizer Ltd.
Zahava Gabriel is a paid employee of Pfizer Ltd.
Ernest Choy, David Marshall, Stephen Mitchell, Elizabeth Gylee, and Helen Dakin undertook paid consultancy work for Pfizer Ltd.