Analgesic Medication in Fibromyalgia Patients: A Cross-Sectional Study.

Abstract

There is no approved drug for fibromyalgia syndrome (FMS) in Europe. In the German S3 guideline, amitriptyline, duloxetine, and pregabalin are recommended for temporary use. The aim of this study was to cross-sectionally investigate the current practice of medication in FMS patients in Germany. We systematically interviewed 156 patients with FMS, while they were participating in a larger study. The patients had been stratified into subgroups with and without a decrease in intraepidermal nerve fiber density. The drugs most commonly used to treat FMS pain were nonsteroidal anti-inflammatory drugs (NSAIDs) (41.0% of all patients), metamizole (22.4%), and amitriptyline (12.8%). The most frequent analgesic treatment regimen was "on demand" (53.9%), during pain attacks, while 35.1% of the drugs were administered daily and the remaining in other regimens. Median pain relief as self-rated by the patients on a numerical rating scale (0-10) was 2 points for NSAIDS, 2 for metamizole, and 1 for amitriptyline. Drugs that were discontinued due to lack of efficacy rather than side effects were acetaminophen, flupirtine, and selective serotonin reuptake inhibitors. Reduction in pain severity was best achieved by NSAIDs and metamizole. Our hypothesis that a decrease in intraepidermal nerve fiber density might represent a neuropathic subtype of FMS, which would be associated with better effectiveness of drugs targeting neuropathic pain, could not be confirmed in this cohort. Many FMS patients take "on-demand" medication that is not in line with current guidelines. More randomized clinical trials are needed to assess drug effects in FMS subgroups.

• Authors: H-C Aster, D Evdokimov, A Braun, N Üçeyler, C Sommer
• Journal: Pain research & management (Pain Res Manag) Vol. 2022 Pg. 1217717 ( 2022) ISSN: 1918-1523 [Electronic] United States
• PMID: 36247103 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 H.-C. Aster et al.

Chemical References

• Analgesics
• Anti-Inflammatory Agents
• Anti-Inflammatory Agents, Non-Steroidal
• Serotonin Uptake Inhibitors
• Amitriptyline
• Acetaminophen
• Pregabalin
• Dipyrone
• Duloxetine Hydrochloride

Topics

• Acetaminophen (therapeutic use)
• Amitriptyline (therapeutic use)
• Analgesics (therapeutic use)
• Anti-Inflammatory Agents (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Cross-Sectional Studies
• Dipyrone (therapeutic use)
• Duloxetine Hydrochloride (therapeutic use)
• Fibromyalgia (drug therapy)
• Humans
• Neuralgia (drug therapy)
• Pregabalin (therapeutic use)
• Selective Serotonin Reuptake Inhibitors (therapeutic use)