Fibromyalgia & musculoskeletal pain
Effectiveness of pharmacological therapies for fibromyalgia syndrome in adults: an overview of Cochrane Reviews
Authors' conclusion
Duloxetine, milnacipran and pregabalin had good evidence that about 1 person in 10 with moderate or severe pain experienced pain intensity reduction by at least 50%.
Study context
- Population
- Adults with FM pain; Cochrane reviews of pharmacological therapies, searched to May 202421 reviews
- Participants
- 17,631 adults87 trials
- Comparison
- Pharmacological therapies vs placebo for FM pain
- Outcome
- Participant-reported pain relief of ≥30% or ≥50%, or PGIC much or very much improved
Methodological detailsAMSTAR-2 quality assessment, validity checks of critical pain criteria, publication bias assessment
- AMSTAR-2 quality assessment
- Validity checks of critical pain criteria
- Publication bias assessment
Main finding
As reported in the abstract
Substantial pain relief · 4-12 weeks
- Duloxetine, milnacipran and pregabalin: moderate/good evidence of substantial pain relief in around 1 in 10 adults with moderate or severe FM pain
- No evidence of efficacy beyond six months
- Mirtazapine: moderate evidence of no effect
- Seven reviews found no trials (carbamazepine, clonazepam, lamotrigine, phenytoin, oxycodone, topiramate, valproate)
- Seven reviews had limited and inadequate data (antipsychotics, cannabinoids, combination therapy, gabapentin, lacosamide, MAO inhibitors, NSAIDs)
- Two reviews subject to publication bias (amitriptyline, SSRI)
- No substantial efficacy evidence for other medicines
Further findings
Review quality (AMSTAR-2)
- Moderate quality
- 15
- High quality
- 6
- Reviews meeting ≥7 of 8 critical pain criteria
- 13 of 21
Safety
Serious adverse events
- No more common than with placebo
- No evidence about who might benefit or experience adverse events
Original publication
Effectiveness of pharmacological therapies for fibromyalgia syndrome in adults: an overview of Cochrane Reviews. Rheumatology (Oxford). Published 20 December 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →