Martinez JE, Guimarães I. "Fibromyalgia - are there any new approaches?".
Best Pract Res Clin Rheumatol 2024:101933. [PMID:
38355316 DOI:
10.1016/j.berh.2024.101933]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION
Approaching patients with fibromyalgia (FM) is challenging due to the limited availability of scientifically proven effective therapies.
OBJECTIVE
Review the treatments in use for FM and present new knowledge that could benefit these patients. Non-pharmacological interventions are recommended as the first line of treatment: aerobic exercise, cognitive behavioral therapy and patient education, all aimed at improving pain and other symptoms. Additional approaches have been studied, such as, digital health interventions, combined treatments, noninvasive neuromodulation, and others. Concerning pharmacological therapy, the mechanism of action of the medications currently used is to promote pain modulation. Medications approved by Food and Drug Administration are duloxetine, milnacipran and pregabalin. Amitriptyline, cyclobenzaprine, gabapentin and naltrexone are considered for off-label use. Cannabinoids, vitamin D supplementation are still controversial and further research is needed.
CONCLUSION
The combination of therapies, whether old, recent or reformulated, are the most effective strategy for managing symptoms in patients with fibromyalgia.
KEY WORDS
fibromyalgia, treatment, nonpharmacological interventions, pharmacological treatment.
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