EULAR evidence-based recommendations for the management of fibromyalgia syndrome.

Authors: Carville SF (1) , Arendt-Nielsen L (2) , Bliddal H (3) , Blotman F (4) , Branco JC (5) , Buskila D (6) , Da Silva JA (7) , Danneskiold-Samsøe B (3) , Dincer F (8) , Henriksson C (9) , Henriksson KG (10) , Kosek E (11,12) , Longley K (13) , McCarthy GM (14) , Perrot S (15) , Puszczewicz M (16) , Sarzi-Puttini P (17) , Silman A (18) , Späth M (19) , Choy E (1)

Affiliations:

(1) Academic Rheumatology Unit, King’s College London, Weston Education Centre (2) Aalborg University, Center for Sensory-Motor Interaction, Department of Health Sciences and Technology (3) The Parker Institute, Frederiksberg Hospital (4) Rheumatology Department, Hospital Lapyeronie (5) Serviço de Reumatologia, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental (6) Departement of Medicine D, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev (7) Reumatologia, Hopitais Da Universidade, Coimbra (8) Department of Physical and Rehabilitation Medicine, Hacettepe Medical School (9) INR, Section of Occupational Therapy, Faculty of Health Sciences, Linköping University (10) Neuromuscular Unit, University Hospital, Linkoping (11) Department of Clinical Neuroscience, Karolinska Institute (12) Stockholm Spine Center, Löwenströmska Hospital (13) FMA, Bath (14) Rheumatology, Mater Misericordiae University Hospital (15) Pain Clinic, Hospital Cochin (16) Department of Rheumatology, Rehabilitation and Internal Medicine University of Medical Sciences, Poznan (17) Rheumatology Unit, L. Sacco University Hospital (18) Faculty of Medical and Human Sciences ARC Epidemiology Unit, The University of Manchester (19) Bahnhofstr. 95 82166 Graefelfing, Germany

Source: Ann Rheum Dis. 2008 Apr;67(4):536-41

Language: English Countries: Not specified Location: Not specified Correspondence address: Dr Serena Carville,
Sir Alfred Baring Garrod Clinical Trials Unit, Academic Rheumatology Unit, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
Email : serena.carville@kcl.ac.uk

Keywords

Article abstract

OBJECTIVE:

To develop evidence-based recommendations for the management of fibromyalgia syndrome.

METHODS:

A multidisciplinary task force was formed representing 11 European countries. The design of the study, including search strategy, participants, interventions, outcome measures, data collection and analytical method, was defined at the outset. A systematic review was undertaken with the keywords "fibromyalgia", "treatment or management" and "trial". Studies were excluded if they did not utilise the American College of Rheumatology classification criteria, were not clinical trials, or included patients with chronic fatigue syndrome or myalgic encephalomyelitis. Primary outcome measures were change in pain assessed by visual analogue scale and fibromyalgia impact questionnaire. The quality of the studies was categorised based on randomisation, blinding and allocation concealment. Only the highest quality studies were used to base recommendations on. When there was insufficient evidence from the literature, a Delphi process was used to provide basis for recommendation.

RESULTS:

146 studies were eligible for the review. 39 pharmacological intervention studies and 59 non-pharmacological were included in the final recommendation summary tables once those of a lower quality or with insufficient data were separated. The categories of treatment identified were antidepressants, analgesics, and "other pharmacological" and exercise, cognitive behavioural therapy, education, dietary interventions and "other non-pharmacological". In many studies sample size was small and the quality of the study was insufficient for strong recommendations to be made.

CONCLUSIONS:

Nine recommendations for the management of fibromyalgia syndrome were developed using a systematic review and expert consensus.

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