Fibromyalgia: Which Therapies Are Most Effective?

A significant portion of current fibromyalgia therapies are not supported by high-quality evidence, according to the results of a recent meta-analysis.

“There are many therapies available for fibromyalgia, including exercise, electrotherapy, pharmacologic therapies, psychological therapies, and complementary and alternative treatments. Many systematic reviews have reported the outcomes of these therapies for patients with fibromyalgia; however, the methods adopted by some reviews might have compromised the effect estimates presented,” the researchers wrote.

In order to further investigate the effectiveness of available therapies for fibromyalgia and their effects on quality of life (QOL), the researchers conducted a meta-analysis including 224 trials involving 29,962 participants.

Overall, high-quality evidence was found for cognitive behavioral therapy for pain in the short term and for central nervous system depressants and antidepressants for pain in the medium term, as well as for antidepressants for QOL in the short term. However, these associations did not meet the minimal clinically important change of 2 points on an 11-point scall for pain and 14 points on a 101-point scale for QOL. There was also a lack of evidence available detailing long-term outcomes.

“Clinicians should be aware that current evidence for most of the available therapies for the management of fibromyalgia is limited to small trials of low methodological quality,” the researchers concluded.

“Clinicians and patients should choose therapies by considering other important outcomes in addition to those presented in this review, such as adverse effects, out-of-pocket costs, and patient preferences.”

—Michael Potts

Reference:

Mascarenhas RO, Souza MB, Oliveira MX, et al. Association of therapies with reduced pain and improved quality of life in patients with fibromyalgia. JAMA Intern Med. 2021;181(1):104-112. doi:10.1001/jamainternmed.2020.5651