Is There Evidence for any Truly Effective Therapy in Fibromyalgia?

Goldenberg, Don L.

doi:10.2217/pmt-2016-0017

Cited by 2 publications

(4 citation statements)

References 19 publications

(26 reference statements)

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“…The benefits of these drugs have been reported to be limited in the treatment of FM 39–41 . Even though duloxetine and milnacipran are viewed as first-line treatments for FM, adverse effects are commonly reported, and only a minority of patients report substantial improvement on these medications 42,43 . Further, studies have found that often patients do not comply with medication prescriptions, with many never achieving the recommended dosage 42 …”

Section: Discussionmentioning

confidence: 99%

“…[39][40][41] Even though duloxetine and milnacipran are viewed as first-line treatments for FM, adverse effects are commonly reported, and only a minority of patients report substantial improvement on these medications. 42,43 Further, studies have found that often patients do not comply with medication prescriptions, with many never achieving the recommended dosage. 42 Educating health care providers across the spectrum of medical care from primary care settings to subspecialty practices that often include rheumatology, neurology, pain medicine, and physical medicine and rehabilitation regarding the specific recommendations of the current guidelines for the treatment of FM may provide alternatives for the management of the pain associated with this chronic illness.…”

Section: Discussionmentioning

confidence: 99%

“…42,43 Further, studies have found that often patients do not comply with medication prescriptions, with many never achieving the recommended dosage. 42 Educating health care providers across the spectrum of medical care from primary care settings to subspecialty practices that often include rheumatology, neurology, pain medicine, and physical medicine and rehabilitation regarding the specific recommendations of the current guidelines for the treatment of FM may provide alternatives for the management of the pain associated with this chronic illness. Health care providers could better focus their care of FM, especially the patients at most risk of opioid use, on the strategies of education, exercise, and cognitive behavioral treatment rather than opioids.…”

Section: Discussionmentioning

confidence: 99%

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Opioid Use in Fibromyalgia Continues Despite Guidelines That Do Not Support Its Efficacy or Risk

Bruce

Allman

Rivera³

et al. 2020

J Clin Rheumatol

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Background/Objective: The aim of this cross-sectional study is to determine the prevalence of opioid use in a large sample of fibromyalgia (FM) patients and examine the factors associated with opioid prescription/use despite multiple clinical guidelines that do not recommend opioid use in this population. Methods: Data were collected from a convenience sample of 698 patients admitted from August 2017 to May 2019 into an intensive 2-day Fibromyalgia Treatment Program at a tertiary medical center in the United States after FM diagnosis. Patients were administered the Fibromyalgia Impact Questionnaire-Revised, the Center for Epidemiologic Study of Depression Scale, and the Pain Catastrophizing Scale upon admission to the program. Demographic information and opioid use were self-reported. Logistic regression analysis was utilized to determine associations between patientrelated variables and opioid use in this prospective study.Results: Of 698 patients, 27.1% (n = 189) were taking opioids at intake. Extended duration of symptoms (>3 years), increased age, higher degree of functional impairment, and increased pain catastrophizing were significantly associated with opioid use. Conclusions:Opioids are not recommended for the treatment of FM under current guidelines. Greater burden of illness appeared to be associated with the prescription and use of opioids in this population. These findings suggest that some providers may not be aware of current recommendations that have been found to be effective in the management of FM that are contained in guidelines. Alternative approaches to the management of FM that do not involve opioids are reviewed in an effort to improve care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Opioid Use in Fibromyalgia Continues Despite Guidelines That Do Not Support Its Efficacy or Risk

Bruce

Allman

Rivera³

et al. 2020

J Clin Rheumatol

View full text Add to dashboard Cite

show abstract

“…As the aetiology of fibromyalgia remains unclear, there is no single disease‐specific treatment available for the disorder. In addition, there is an absence of evidence to support the current commonly used treatments for fibromyalgia (Goldenberg, ). For example, in the limited instances of support for pharmacological intervention (e.g.…”

Section: Introductionmentioning

confidence: 99%