By Amy Orciari Herman
Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD
NEJM Journal Watch
Evidence is insufficient to support most treatments for fibromyalgia, according to a meta-analysis in JAMA Internal Medicine.
Researchers examined data from over 220 randomized trials among nearly 30,000 people with fibromyalgia. High-quality evidence suggested a statistically significant benefit for cognitive behavioral therapy for improving pain in the short term. High-quality evidence also favored antidepressants and central nervous system depressants for improving pain in the medium term, antidepressants for improving quality of life (QOL) in the short term, and antidepressants and central nervous system depressants for improving QOL in the medium term.
However, none of these outcomes met the researchers’ criteria for a clinically important benefit. In addition, high- or moderate-quality evidence did not support any treatment for pain or QOL in the long term.
The researchers conclude, “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.”