Systematic review and network meta-analysis of interventions for fibromyalgia: a protocol

Abstract

BackgroundFibromyalgia is associated with substantial socioeconomic loss and, despite considerable research including numerous randomized controlled trials (RCTs) and systematic reviews, there exists uncertainty regarding what treatments are effective. No review has evaluated all interventional studies for fibromyalgia, which limits attempts to make inferences regarding the relative effectiveness of treatments.Methods/designWe will conduct a network meta-analysis of all RCTs evaluating therapies for fibromyalgia to determine which therapies show evidence of effectiveness, and the relative effectiveness of these treatments. We will acquire eligible studies through a systematic search of CINAHL, EMBASE, MEDLINE, AMED, HealthSTAR, PsychINFO, PapersFirst, ProceedingsFirst, and the Cochrane Central Registry of Controlled Trials. Eligible studies will randomly allocate patients presenting with fibromyalgia or a related condition to an intervention or a control. Teams of reviewers will, independently and in duplicate, screen titles and abstracts and complete full text reviews to determine eligibility, and subsequently perform data abstraction and assess risk of bias of eligible trials. We will conduct meta-analyses to establish the effect of all reported therapies on patient-important outcomes when possible. To assess relative effects of treatments, we will construct a random effects model within the Bayesian framework using Markov chain Monte Carlo methods.DiscussionOur review will be the first to evaluate all treatments for fibromyalgia, provide relative effectiveness of treatments, and prioritize patient-important outcomes with a focus on functional gains. Our review will facilitate evidence-based management of patients with fibromyalgia, identify key areas for future research, and provide a framework for conducting large systematic reviews involving indirect comparisons.

The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial

“…The available treatments that are directed toward FMS are highly variable, and long-term prospective observational studies have found that patient outcomes are typically poor [7][8][9]. A survey of 1200 primary care physicians in the USA (33 % response rate) found that only 14 % of respondents indicated very good or excellent satisfaction with the management of patients with FMS and other medically unexplained symptoms [10].…”

Implications for eicosapentaenoic acid- and docosahexaenoic acid-derived resolvins as therapeutics for arthritis

“…Fibromyalgia is a complex painful syndrome, accompanied by a series of psychological and behavioral alterations (Busse et al, 2013), and characterized by chronic musculoskeletal pain (Wolfe et al, 2010). The hallmark symptom is chronic widespread pain, but patients also present fatigue, depression, cognitive dysfunctions, and sleep disturbances (Ceko et al, 2012;Wolfe et al, 2010).…”

An Application of Fuzzy Prototypes to the Diagnosis and Treatment of Fuzzy Diseases

“…9 Fibromyalgia prevalence in overall levels is between 2% and 5% of the world population, and it predominates in people about 20 and 50 years old, 10 with a higher proportion of women (10 times more than men). 11 The total amount of affected people in different countries are not negligible 12 : 3.2% in Germany, 2.4% in Spain, 2% in the United States, 1.4% in France, 3.7% in Italy, 3.6% in Portugal, and 2.5% in Sweden. In Spain, 15% of the rheumatology consults and between 5% and 10% of the primary health care are dedicated to these patients, which mean a total expense in public health of about 11 million euros per year.…”

“…Fibromyalgia prevalence in overall levels is between 2% and 5% of the world population, and it predominates in people about 20 and 50 years old, with a higher proportion of women (10 times more than men) . The total amount of affected people in different countries are not negligible 12 : 3.2% in Germany, 2.4% in Spain, 2% in the United States, 1.4% in France, 3.7% in Italy, 3.6% in Portugal, and 2.5% in Sweden.…”