Summary:
Objectives:
Fibromyalgia is characterized by widespread pain, sleep problems,
fatigue, functional impairment, psychological distress, and cognitive
dysfunction. The objective of this meta-analysis is:
1. to synthesize the available data on the effectiveness of
pharmacological and non-pharmacological interventions across all domains
included in the OMERACT-10 fibromyalgia response definitions
2. to examine response, based on OMERACT 10 definitions.
3. to examine response in pain and based on patient global impression of
change.
Materials and methods:
The Cochrane, PubMed, SCOPUS and the reference lists of articles were
wearched for randomized controlled trials of any drug formulation, or
non-pharmacological intervention used for fibromyalgia treatment. Efficacy data
regarding pain, sleep, physical function, fatigue, anxiety, depression,
cognition, pain response >30%, pain response >50%, PGIC>2 and PGIC: 3 were
extracted.
Results:
Efficacy was different across different symptoms and treatments. Overall,
in the analysis of continuous data based on OMERACT criteria, SNRIs, NRIs,
exercise and multidisciplinary treatment demonstrated the best results, while
SNRIs, NRIs, GABA agonists and anticonvulsants had the best results in the
analysis of dichotomous data.
Conclusion:
A multi-modal approach may be more appropriate for symptom management in
fibromyalgia. Application of new OMERACT criteria in future trials is
necessary, to be able to draw definite conclusions about overall response.
Keywords:
Fibromyalgia, Management, Treatment, Trials, Meta-analysis
