Treatments for Fibromyalgia in Adult Subgroups

Project Summary Title and Description

Title
Treatments for Fibromyalgia in Adult Subgroups
Description
We conducted a systematic literature review of clinical trials to assess the comparative effectiveness of treatments for fibromyalgia in subgroups of highly affected or clinically complex adults. We focused on patient subgroups rather than overall treatment effects to complement a large systematic review being conducted on fibromyalgia treatments at McMaster University.
Attribution
N/A
Authors of Report
N/A
Methodology description
Two investigators screened abstracts of identified references for eligibility (enrolled adults with fibromyalgia, examined treatment effects, had a control group, and assessed outcomes at least 3 months after treatment initiation). Full-text articles were reviewed to identify outcomes reporting for at least one adult subgroup: women, older or obese adults, individuals with coexisting mental health conditions, high severity or longer fibromyalgia duration, multiple medical comorbidities, or other chronic pain conditions. Primary outcomes included pain, symptom improvement, function, fatigue, sleep quality, participation, and health-related quality of life. We extracted data, assessed risk of bias of individual studies, and evaluated strength of evidence for each comparison and outcome.
PROSPERO
N/A
DOI
10.7301/Z0B85626
Notes
- Web Address: http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=1887&pageaction=displayproduct - PMID:25719189 - Data was retrospectively entered into the project importing of data. - The report files uploaded for this project include the following: Appendix Table E4. Fibromyalgia randomized clinical trials with subgroups and mixed samples, by class of treatment; Appendix Table E5. Fibromyalgia randomized clinical trials with pure subgroup samples, by class of treatment; Appendix Table E6. Fibromyalgia pooled studies of patient-level RCT data with subgroup reporting, by pharmacologic treatment; Appendix Table E7. Fibromyalgia observational studies with subgroups, by class of treatment; Appendix Table E10. Fibromyalgia risk of bias summary for RCTs. mixed samples and pure subgroups; Appendix Table E11. Fibromyalgia risk of bias summary for observational studies; Appendix Table E12. Quality issues and risk of bias summary for pooled analyses of patient-level randomized clinical trial data on fibromyalgia subgroups; and Appendix Table E17. Justification for retaining potentially-overlapping individual RCTs and associated pooled patient-level data duloxetine studies
Funding Source
Agency for Healthcare Research and Quality (AHRQ)

Key Questions

1. What are the efficacy and comparative effectiveness of treatments for fibromyalgia in specific adult subpopulations (RCT with subgroups and mixed samples)?
2. What are the harms of treatments for fibromyalgia in specific adult subpopulations (RCT with subgroups and mixed samples)?
3. What are the efficacy and comparative effectiveness of treatments for fibromyalgia in specific adult subpopulations (RCT with pure subgroup samples)?
4. What are the harms of treatments for fibromyalgia in specific adult subpopulations (RCT with pure subgroup samples)?
5. What are the efficacy and comparative effectiveness of treatments for fibromyalgia in specific adult subpopulations (pooled studies of patient-level RCT data with subgroup reporting)?
6. What are the harms of treatments for fibromyalgia in specific adult subpopulations (pooled studies of patient-level RCT data with subgroup reporting)?
7. What are the efficacy and comparative effectiveness of treatments for fibromyalgia in specific adult subpopulations (observational studies with subgroups)?
8. What are the harms of treatments for fibromyalgia in specific adult subpopulations (observational studies with subgroups)?
9. Fibromyalgia risk of bias summary (Appendix Table E10)
10. Fibromyalgia risk of bias summary (Appendix Table E11)
11. Fibromyalgia risk of bias summary (Appendix Table E12)
12. Justification for retaining potentially-overlapping individual RCTs and associated pooled patient-level data duloxetine studies (Appendix Table E17)

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
Efficacy and safety of duloxetine 30 mg/d in patients with fibromyalgia: a randomized, double-blind, placebo-controlled study.
Flexible dosed duloxetine in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled trial.
A six-month double-blind, placebo-controlled, randomized clinical trial of duloxetine for the treatment of fibromyalgia.
Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: Results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial.
A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder.
A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder.
Efficacy of milnacipran in patients with fibromyalgia.
A randomized, placebo-controlled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia.
Differential efficacy of written emotional disclosure for subgroups of fibromyalgia patients.
Multidisciplinary treatment of fibromyalgia: does cognitive behavior therapy increase the response to treatment?
Relationships among pain, depressed mood, and global status in fibromyalgia patients: post hoc analyses of a randomized, placebo-controlled trial of milnacipran.
Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study.
Efficacy of an EMG-biofeedback therapy in fibromyalgia patients. A comparative study of patients with and without abnormality in (MMPI) psychological scales.
Effect of amitriptyline vs. physiotherapy in management of fibromyalgia syndrome: What predicts a clinical benefit?
Hormonal replacement therapy does not affect self-estimated pain or experimental pain responses in post-menopausal women suffering from fibromyalgia: a double-blind, randomized, placebo-controlled trial.
Efficacy of Raloxifen in treatment of fibromyalgia in menopausal women.
Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial.
Effect of weight reduction on the quality of life in obese patients with fibromyalgia syndrome: a randomized controlled trial.
Tilt vibratory exercise and the dynamic balance in fibromyalgia: A randomized controlled trial.
Effects of concurrent strength and endurance training on physical fitness and symptoms in postmenopausal women with fibromyalgia: a randomized controlled trial.
A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia.
Effects of strength training on muscle strength, cross-sectional area, maximal electromyographic activity, and serum hormones in premenopausal women with fibromyalgia.
Is brief psychodynamic psychotherapy in primary fibromyalgia syndrome with concurrent depression an effective treatment? A randomized controlled trial.
Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial.
Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: a randomized controlled trial.
Effects of lifestyle physical activity on perceived symptoms and physical function in adults with fibromyalgia: results of a randomized trial.
Evaluation of patient-rated stiffness associated with fibromyalgia: a post-hoc analysis of 4 pooled, randomized clinical trials of duloxetine.
Effect of duloxetine in patients with fibromyalgia: tiredness subgroups.
Comparisons of the efficacy and safety of duloxetine for the treatment of fibromyalgia in patients with versus without major depressive disorder.
Effect of milnacipran on body weight in patients with fibromyalgia.
A pooled analysis of two randomized, double-blind, placebo-controlled trials of milnacipran monotherapy in the treatment of fibromyalgia.
Relationships among pain and depressive and anxiety symptoms in clinical trials of pregabalin in fibromyalgia.
Medical conditions in fibromyalgia patients and their relationship to pregabalin efficacy: pooled analysis of Phase III clinical trials.
Exposure-response analyses of the effects of pregabalin in patients with fibromyalgia using daily pain scores and patient global impression of change.
Efficacy and safety of duloxetine 30 mg/d in patients with fibromyalgia: a randomized, double-blind, placebo-controlled study.
Flexible dosed duloxetine in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled trial.
A six-month double-blind, placebo-controlled, randomized clinical trial of duloxetine for the treatment of fibromyalgia.
Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: Results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial.
A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder.
A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder.
Efficacy of milnacipran in patients with fibromyalgia.2005
A randomized, placebo-controlled, double-blind, flexible-dose study of fluoxetine in the treatment of women with fibromyalgia.2002
Differential efficacy of written emotional disclosure for subgroups of fibromyalgia patients.
Multidisciplinary treatment of fibromyalgia: does cognitive behavior therapy increase the response to treatment?2009
Hormonal replacement therapy does not affect self-estimated pain or experimental pain responses in post-menopausal women suffering from fibromyalgia: a double-blind, randomized, placebo-controlled trial.2011
Efficacy of Raloxifen in treatment of fibromyalgia in menopausal women.2008
Strengthening exercises improve symptoms and quality of life but do not change autonomic modulation in fibromyalgia: a randomized clinical trial.
Effect of weight reduction on the quality of life in obese patients with fibromyalgia syndrome: a randomized controlled trial.2012
Tilt vibratory exercise and the dynamic balance in fibromyalgia: A randomized controlled trial.2010
Effects of concurrent strength and endurance training on physical fitness and symptoms in postmenopausal women with fibromyalgia: a randomized controlled trial.
A randomized controlled trial of deep water running: clinical effectiveness of aquatic exercise to treat fibromyalgia.
Effects of strength training on muscle strength, cross-sectional area, maximal electromyographic activity, and serum hormones in premenopausal women with fibromyalgia.
Is brief psychodynamic psychotherapy in primary fibromyalgia syndrome with concurrent depression an effective treatment? A randomized controlled trial.-- Not Found --
Behavioral insomnia therapy for fibromyalgia patients: a randomized clinical trial.2005
Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: a randomized controlled trial.2014
Effects of lifestyle physical activity on perceived symptoms and physical function in adults with fibromyalgia: results of a randomized trial.
Relationships among pain, depressed mood, and global status in fibromyalgia patients: post hoc analyses of a randomized, placebo-controlled trial of milnacipran.-- Not Found --
Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study.-- Not Found --
Efficacy of an EMG-biofeedback therapy in fibromyalgia patients. A comparative study of patients with and without abnormality in (MMPI) psychological scales.-- Not Found --
Effect of amitriptyline vs. physiotherapy in management of fibromyalgia syndrome: What predicts a clinical benefit?-- Not Found --
Evaluation of patient-rated stiffness associated with fibromyalgia: a post-hoc analysis of 4 pooled, randomized clinical trials of duloxetine.
Effect of duloxetine in patients with fibromyalgia: tiredness subgroups.
Comparisons of the efficacy and safety of duloxetine for the treatment of fibromyalgia in patients with versus without major depressive disorder.
Effect of milnacipran on body weight in patients with fibromyalgia.2012
A pooled analysis of two randomized, double-blind, placebo-controlled trials of milnacipran monotherapy in the treatment of fibromyalgia.-- Not Found --
Relationships among pain and depressive and anxiety symptoms in clinical trials of pregabalin in fibromyalgia.-- Not Found --
Medical conditions in fibromyalgia patients and their relationship to pregabalin efficacy: pooled analysis of Phase III clinical trials.2010
Exposure-response analyses of the effects of pregabalin in patients with fibromyalgia using daily pain scores and patient global impression of change.2010
A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder.
A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder.
A six-month double-blind, placebo-controlled, randomized clinical trial of duloxetine for the treatment of fibromyalgia.
Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: Results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial.
Comparisons of the efficacy and safety of duloxetine for the treatment of fibromyalgia in patients with versus without major depressive disorder.-- Not Found --
Evaluation of patient-rated stiffness associated with fibromyalgia: a post-hoc analysis of 4 pooled, randomized clinical trials of duloxetine.
Effect of duloxetine in patients with fibromyalgia: tiredness subgroups.2010

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