A meta-analysis to determine the effect of pharmacological and non-pharmacological treatments on fibromyalgia symptoms comprising OMERACT-10 response criteria

Abstract

Fibromyalgia is characterized by widespread pain, sleep problems, fatigue, functional impairment, psychological distress, and cognitive dysfunction. The objective of this meta-analysis is to synthesize the available data on the effectiveness of pharmacological and non-pharmacological interventions across all domains included in the Outcome Measures in Rheumatology Clinical Trials (OMERACT-10) fibromyalgia response definitions, and to examine response based on these definitions. We searched Cochrane, PubMed, Scopus, and the reference lists of articles for randomized controlled trials of any drug formulation or non-pharmacological intervention used for fibromyalgia treatment. We extracted efficacy data regarding pain, sleep, physical function, fatigue, anxiety, depression, and cognition. The available data were insufficient to draw definite conclusions regarding response. Indirect evidence indicates that it may be expected with the use of serotonin noradrenaline reuptake inhibitors (SNRIs), noradrenaline reuptake inhibitors (NRIs), and multidisciplinary treatment.

Differences in Multidisciplinary and Interdisciplinary Treatment Programs for Fibromyalgia: A Mapping Review

“…Different from our study, the authors did not address the differences with regard to format, setting of the program, and integration of operators and therapeutic components. More recently, Papadopoulou et al [11] evaluated all the pharmacological and nonpharmacological interventions for fibromyalgia, finding support for multidisciplinary treatments based on 8 RCTs, which were not described. Similarly, other reviews focusing on various chronic pain conditions found that multicomponent programs are effective for the treatment of fibromyalgia but did not address their heterogeneity [12, 78].…”

“…Given its multifaceted nature and the poor efficacy of standard medical interventions, the integration of different health disciplines for its understanding and for the development of specific treatments has long been advocated [6–10]. As a result, a large number of interventions combining techniques drawn from different fields (e.g., medicine, psychology, and physical therapy) have been developed and have proven to be effective for the improvement of the various symptoms of the syndrome [11–15]. Nonetheless, these programs are very heterogeneous in terms of duration, objectives, setting, format, therapeutic components, and professionals involved.…”

Recent strategies for drug development in fibromyalgia syndrome

“…However, during the ensuing 7 years since the approval of milnacipran no additional medications for FMS have gained US-FDA approval. This is a particularly disappointing development since the clinical efficacy of currently available therapies may be statistically superior to placebo, but possibly of little clinical importance due to their small effect size [2,3].…”

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

“…The pharmacologic treatments are usually combined with other alternatives like acupuncture. 28 In a nutshell, fibromyalgia is present with a high incidence in many countries and affects patients with a large amount of different symptoms. However, there is very little information about its causes, which has a negative impact, both physically and psychologically on patients who have to be constantly monitored.…”

“…In the absence of a curative treatment, the aim is to relieve the symptoms through a personalized one, depending on multiple factors as the trigger points affected or the symptoms. The pharmacologic treatments are usually combined with other alternatives like acupuncture . In a nutshell, fibromyalgia is present with a high incidence in many countries and affects patients with a large amount of different symptoms.…”