Fibromyalgia: Is it a Neuropathic Pain?

Cheng, Christina W.; Wong, Clara Sm; Hui, Grace Km; Chung, Edmond Kn; Wong, Shawn

doi:10.2217/pmt-2018-0024

Cited by 25 publications

(25 citation statements)

References 53 publications

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“…At present, according to the IASP definition of neuropathic pain, it would not be included in this group of syndromes. However, recent studies have shown that there may be neuropathic small-fiber injuries [81], which would include, at the very least, fibromyalgia in neuropathic pain syndromes, influencing diagnosis and treatment.…”

Section: Fibromyalgiamentioning

confidence: 99%

“…Side effects, such as sweating, cardiac conduction abnormalities and high blood pressure are seen during the titration to the target dose. If a single-drug treatment is not effective for pain relief, adding venlafaxine to gabapentin may be more effective in the treatment of painful diabetic neuropathy [81]. This class of drugs shows its effectiveness not only on neuropathic pain but also on depressed mood, which is a common consequence derived by persistent pain.…”

Section: Serotonin Norepinephrine Reuptake Inhibitors (Snris)mentioning

confidence: 99%

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Neuropathic Pain in the Elderly

et al. 2021

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Neuropathic pain due to a lesion or a disease of the somatosensory system often affects older people presenting several comorbidities. Moreover, elderly patients are often poly-medicated, hospitalized and treated in a nursing home with a growing risk of drug interaction and recurrent hospitalization. Neuropathic pain in the elderly has to be managed by a multidimensional approach that involves several medical, social and psychological professionals in order to improve the quality of life of the patients and, where present, their relatives.

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Section: Fibromyalgiamentioning

confidence: 99%

Section: Serotonin Norepinephrine Reuptake Inhibitors (Snris)mentioning

confidence: 99%

Neuropathic Pain in the Elderly

et al. 2021

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“…Fibromyalgia is a chronic pain syndrome with high prevalence and still unclear pathophysiology 4 . It is believed to be a dysfunction of the central nervous system, but no definite structural lesion has been identified so far.…”

Section: Introductionmentioning

confidence: 99%

“…Despite a number of changes in the diagnostic criteria, diagnosis remains a clinical one. Since the 2011 revision of the International Association Study of Pain definition of neuropathic pain, fibromyalgia has been excluded from the diagnosis of neuropathic pain 4 . More recent studies, however, found newer evidences of pathophysiology including small fiber neuropathy in patients with fibromyalgia 4,5 .…”

Section: Introductionmentioning

confidence: 99%

The mirogabalin ALDAY phase 3 program in pain associated with fibromyalgia: the lessons learned

Merante

2020

Current Medical Research and Opinion

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Aims:The main aim of this work was to identify and to share the lessons learned from the negative outcome of the mirogabalin ALDAY phase 3 clinical program in pain associated with fibromyalgia. These lessons are important to improve planning and design of future phase 3 programs in fibromyalgia. Methods: A systematic review from Cochrane Library, Medline, Embase, clinicaltrials.gov, pharmaceutical companies, and regulatory agencies' websites, was carried out starting from the development of gabapentin, the first a2d ligand studied for the treatment of neuropathic pain and ending with the mirogabalin program. Results: Based on the outcome of the main fibromyalgia programs, several differences in design, primary endpoint choice, magnitude of placebo response, presence of an active comparator, and size of the entire clinical program were identified. This analysis focused on the negative primary results of the mirogabalin ALDAY program and found several contributing factors. Above all, the magnitude of placebo response and the unprecedented size of the program were identified. The number of study visits and procedures was also high and highly demanding on all subjects involved in ALDAY. Outcome: In terms of main lessons learned from ALDAY, the first was the need for a comprehensive patient-focused strategy to preliminarily identify the challenges of fibromyalgia based on patient perspective and study complexity. Second, there was a need for a harmonized, truly patient-centric, global regulatory guidance accepted by regulatory agencies. Third, ALDAY proved that a phase 2 proof of concept, dose ranging study is necessary before commencing any phase 3 program in fibromyalgia. ARTICLE HISTORY

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“…Central sensitization, hypothalamic-pituitary-adrenal axis abnormalities, increased levels of substance P, neurotrophins, and psychological factors including depression and anxiety, are responsible for the pathogenesis. 4,5 Since chronic pain is the major symptom of FMS, it is important to evaluate how patients perceive pain and how their life is affected by pain. The term "centrality" is a distinct concept from pain mechanisms (central sensitization).…”

Section: Introductionmentioning

confidence: 99%

Cross‐cultural adaptation and validation of the Turkish version of Centrality of Pain Scale in patients with fibromyalgia syndrome

Özsoy-Ünübol¹,

Ünal-Ulutatar²

2020

Int J of Rheum Dis

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Aim: The purpose of this study was to perform a cross-cultural adaptation of the Turkish version of the Centrality of Pain Scale (COPS) and to evaluate its psychometric properties in patients with fibromyalgia syndrome (FMS). Methods: Centrality of Pain Scale was translated and culturally adapted according to guidelines. Clinical and demographic data of the patients were recorded. In addition to the Turkish version of the COPS (COPS-TR), fibromyalgia impact questionnaire (FIQ), Pain Catastrophizing Scale (PCS), Brief Pain Inventory-Short Form (BPI-SF), Beck Depression Inventory (BDI), Generalized Anxiety Disorder 7-item (GAD-7) scale and Short Form-36 were applied. Internal consistency and test-retest methods were used for reliability analysis. Convergent validity was assessed by analyzing the correlations between COP-TR and functional parameters. Divergent validity and responsiveness were also evaluated. Results: One hundred and four patients (90 female and 14 male) were included. The mean age was 44 years. Good internal consistency (α = .84) and high test-retest reliability (intraclass correlation coefficient = 0.95) were determined. Highest correlations were detected between COPS-TR and BPI-SF pain interference score (r = .64), COPS-TR and PCS (r = .61). There was no significant correlation with non-functional parameters (body mass index, disease duration). It showed high responsiveness (effect size and standardized response mean were 1.66 and 1.94, respectively). The patients filled out COPS-TR in 2 minutes. Conclusions: COPS-TR is a reliable and valid instrument that shows good psychometric properties. It can be used in clinical practice and scientific research.

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Fibromyalgia: Is it a Neuropathic Pain?

Cited by 25 publications

References 53 publications

Neuropathic Pain in the Elderly

Neuropathic Pain in the Elderly

The mirogabalin ALDAY phase 3 program in pain associated with fibromyalgia: the lessons learned

Cross‐cultural adaptation and validation of the Turkish version of Centrality of Pain Scale in patients with fibromyalgia syndrome

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