Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review

Nascimento, Simone de Souza; DeSantana, Josimari Melo; Nampo, Fernando Kenji; Ribeiro, Êurica Adélia Nogueira; Silva, Daniel Lira da; Araújo-Júnior, João Xavier de; Almeida, Jackson Roberto Guedes da Silva; Bonjardim, Leonardo Rigoldi; Araújo, Adriano Antunes de Souza; Quintans‐Júnior, Lucindo José

doi:10.1155/2013/149468

Cited by 27 publications

(26 citation statements)

References 61 publications

(121 reference statements)

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“…Satisfaction with non-pharmacological treatments is higher in our study. These results agree with evidence on the effectiveness of medicinal plants or natural products in improving symptoms compared to the use of a drug or placebo (De Souza et al, 2013). There is also a spontaneous improvement of pain in FM and a shorter need for medication over time (P€ oyhi€ a, Da Costa, & Fitzcharles, 2001) What this paper brings to the debate are the solutions to the problems perceived by the group-the result of reflecting on their experience using GPST-and the importance of emotions in the management of symptoms and of asking for help and of not wanting to do it all alone.…”

Section: Discussionsupporting

confidence: 89%

Problems and solutions for patients with fibromyalgia: Building new helping relationships

Montesó‐Curto

García-Martínez

Romaguera

et al. 2017

Journal of Advanced Nursing

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The majority of patients' problems were associated with their previous history and the onset of fibromyalgia; which may be related to trauma in adolescence, early adulthood or later. The solutions provided during the groups appeared to be accepted by the participants. These findings can improve the self-management of fibromyalgia patients by helping to enhance adaptive behaviours and incorporating the female gender approach.

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Section: Discussionsupporting

confidence: 89%

Problems and solutions for patients with fibromyalgia: Building new helping relationships

Montesó‐Curto

García-Martínez

Romaguera

et al. 2017

Journal of Advanced Nursing

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“…The most recent review, a narrative review of two trials, considered data on 153 patients 94. Both showed some evidence of positive effect in terms of pain relief, although results were not consistent for other outcomes.…”

Section: Resultsmentioning

confidence: 99%

EULAR revised recommendations for the management of fibromyalgia

et al. 2016

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Objective The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were 'expert opinion'. Methods A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pharmacological/nonpharmacological management for fibromyalgia. A review, in May 2015, identified eligible publications and key outcomes assessed were pain, fatigue, sleep and daily functioning. The Grading of Recommendations Assessment, Development and Evaluation system was used for making recommendations. Results 2979 titles were identified: from these 275 full papers were selected for review and 107 reviews (and/or meta-analyses) evaluated as eligible. Based on metaanalyses, the only 'strong for' therapy-based recommendation in the guidelines was exercise. Based on expert opinion, a graduated approach, the following four main stages are suggested underpinned by shared decision-making with patients. Initial management should involve patient education and focus on nonpharmacological therapies. In case of non-response, further therapies (all of which were evaluated as 'weak for' based on meta-analyses) should be tailored to the specific needs of the individual and may involve psychological therapies (for mood disorders and unhelpful coping strategies), pharmacotherapy (for severe pain or sleep disturbance) and/or a multimodal rehabilitation programme (for severe disability). Conclusions These recommendations are underpinned by high-quality reviews and meta-analyses. The size of effect for most treatments is relatively modest. We propose research priorities clarifying who will benefit from specific interventions, their effect in combination and organisation of healthcare systems to optimise outcome.

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“…However, nine [30, 32, 43, 44, 46–49, 75] of the 15 reviews report on adverse events. A range of adverse events were reported, depending on which CAM was utilised.…”

Section: Resultsmentioning

confidence: 99%

An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools

et al. 2017

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BackgroundFibromyalgia (FM) is a chronic, debilitating pain disorder. Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine (CAM). Two previous overviews of systematic reviews of CAM for FM have been published, but they did not assessed for risk of bias in the review process.MethodsFive databases Medline, Embase, AMED (via OVID), Web of Science and Central were searched from their inception to December 2015. Reference lists were hand-searched. We had two aims: the first was to provide an up-to-date and rigorously conducted synthesis of systematic reviews of CAM literature on FM; the second was to evaluate the quality of the available systematic review evidence using two different tools: AMSTAR (Shea et al. BMC Med Res Methodol 15; 7:10, 2007) and a more recently developed tool ROBIS (Whiting et al. J Clin Epidemiol 69:225-34, 2016) specifically designed to assess risk of bias in systematic reviews. Any review that assessed one of eight CAM therapies for participants diagnosed with FM was considered. The individual studies had to be randomised controlled trials where the intervention was compared to placebo, treatment as usual or waitlist controls to be included. The primary outcome measure was pain, and the secondary outcome measure was adverse events.ResultsWe identified 15 reviews that met inclusion criteria. There was low-quality evidence that acupuncture improves pain compared to no treatment or standard treatment, but good evidence that it is no better than sham acupuncture. The evidence for homoeopathy, spinal manipulation and herbal medicine was limited.ConclusionsOverall, five reviews scored 6 or above using the AMSTAR scale and the inter-rater agreement was good (83.6%), whereas seven reviews achieved a low risk of bias rating using ROBIS and the inter-rater agreement was fair (60.0%). No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM. There is limited evidence for topical Capsicum, but further research is required. There is some evidence to support the effectiveness of acupuncture for FM, but further high-quality trials are needed to investigate its benefits, harms and mechanisms of action, compared with no or standard treatment.Systematic review registrationPROSPERO CRD42016035846.

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Efficacy and Safety of Medicinal Plants or Related Natural Products for Fibromyalgia: A Systematic Review

Cited by 27 publications

References 61 publications

Problems and solutions for patients with fibromyalgia: Building new helping relationships

Problems and solutions for patients with fibromyalgia: Building new helping relationships

EULAR revised recommendations for the management of fibromyalgia

An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools

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