Clinical evaluation and prevalence of fibromyalgia in hepatitis C patients

Introduction: Fibromyalgia (FM) is a condition of generalized musculoskeletal pain, associated with fatigue, autonomic dysfunction and sleep disorders. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, tested in several diseases, including FM and depending on the parameters used, tDCS can reach several brain neural networks, including the central processing network of the pain. Another therapy that promotes analgesia is manual therapy (MT) which is defined as a set of techniques that uses the hands as the main therapeutic agents. Evidence indicates that MT, applied at points along the vagus nerve (VN), may improve pain in patients with chronic pain. This study will examine the immediate and late effects of tDCS associated with MT on the VN pathway in pain in women with FM. Methods: This is a controlled, randomized, double-blind clinical trial with intention-to-treat analysis that will follow the guidelines of CONSORT (Consolidated Reporting Standards). The study will consist of thirty women diagnosed with FM who will be randomly allocated to the experimental group (tDCS 2 mA active for 20 minutes associated with MT) or to the control group (tDCS for 20 minutes associated with MT sham) and will receive daily sessions of treatment for five days. Outcome measures will occur at the beginning of the study, after the first visit, at the end of treatment and thirty days after the end of treatment. Discussion: The search for therapies to improve pain in FM is quite challenging, mainly due to the lack of knowledge about its etiopathogenesis and the complexity of symptoms that are associated with it. Thus, the results of this clinical trial may result in an important advance for the rehabilitation of FM patients. Clinical trial registration: U1111-1264-9863

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Direct-Acting Antiviral Drugs Reduce Fibromyalgia Symptoms in Patients with Chronic Hepatitis C

Tang

Lin

Chen

et al. 2022

JCM

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Background Fibromyalgia (FM) is a complex disorder characterized by chronic widespread pain and significant patient burden. Patients with chronic hepatitis C are reportedly predisposed to the development of FM. Direct-acting antiviral drugs (DAA) achieved a remarkable therapeutic efficacy in CHC patients. We therefore investigated the impact of DAA on FM symptoms in CHC patients. Methods We enrolled consecutive CHC patients who received DAA. FM symptoms were evaluated based on the 2016 American College of Rheumatology (ACR) fibromyalgia scale at baseline and 12 and 24 weeks after cessation of DAA therapy. Logistic regression was performed to determine the influence of HCV on FM at baseline. We also recruited individuals who underwent a health checkup examination as the control group, and calculated the standardized prevalence ratio of FM in CHC patients. Comparisons of fibromyalgia in different time points were undertaken using the Wilcoxon signed-rank test. Results A total of 33 CHC patients (15 males and 18 females) and 402 controls were recruited. All CHC patients achieved sustained virological response. Two (6%) patients and two (0.5%) controls fulfilled the diagnostic criteria for FM, and the standardized prevalence ratio was 23.9 in CHC patients. Logistic regression also showed increased odds for FM in CHC patients after adjusting for age and sex (OR: 14.4; 95%CI: 1.6, 128.0). In addition, their fibromyalgianess scale decreased at 12 and 24 weeks after DAA therapy. In conclusion, CHC patients were more likely to develop FM. Implementation of DAA therapy might improve FM symptoms in these patients.

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Clinical evaluation and prevalence of fibromyalgia in hepatitis C patients

Cited by 3 publications

References 30 publications

Fibromyalgia syndrome in chronic hepatitis C virus (HCV) infection patients: A potential association and pathogenic role

Fibromyalgia syndrome in chronic hepatitis C virus (HCV) infection patients: A potential association and pathogenic role

Effects of transcranial direct current stimulation, associated with manual vagus nerve therapy, on pain in women with fibromyalgia: Study protocol for a double-blind, randomized, controlled clinical trial.

Direct-Acting Antiviral Drugs Reduce Fibromyalgia Symptoms in Patients with Chronic Hepatitis C

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