Fibromyalgia: principles of diagnostics and complex therapy
DOI: https://dx.doi.org/10.18565/therapy.2018.7-8.38-46
An.B. Danilov
The Department of nervous diseases of I.M. Sechenov First Moscow State Medical University FSAEI of HE of the Ministry of Health of Russia (Sechenov University)
The review presents data on the etiology and pathogenesis of fibromyalgia, its clinical manifestations, current diagnostic criteria and recommendations for therapy based on the principles of evidence-based medicine. In the section, devoted to the treatment of the disease, both non-drug and drug methods with a high degree of evidence are considered in details. The proven effectiveness of multidisciplinary therapeutic programs suggests that the combination of medicamentous treatment, physical exercises and cognitive-behavioral component is the method of choice for treating all patients with fibromyalgia.
Keywords: фибромиалгия, хроническая боль, болезненные точки, центральная сенситизация, антидепрессанты, антиконвульсанты, психотерапия
Literature
Данилов А.Б. Фибромиалгия: новые возможности терапии. РМЖ. 2010; 18(16): 998–1003. Иваничев Г. А., Старосельцева Н. Г. Миофасциальный генерализованный болевой (фибромиалгический) синдром. Казань, 2002. 162 с. Калягин А.Н. Современные диагностические подходы при фибромиалгии. Современная ревматология. 2012; 1: 11–14. Колоколов О.В., Ситкали И.В., Шахпазов С.Ж., Колоколова А.М. Синдром хронической распространенной боли – новая междисциплинарнаяпроблема или компетенция врача общей практики. Фарматека. 2018; 5: 71–80. Табеева Г.Р., Короткова С.Б. Фибромиалгия (обзор). Журнал невропатологии и психиатрии им. Корсакова. 2000; 100(4): 69–77. Чичасова Н.В. Первичная фибромиалгия: клинические проявления, диагностика, лечение. Терапевтический архив. 1994; 66(11): 89–92. Arnold L.M., Rosen A., Pritchett Y.L.et al. A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder. Pain 2005; 119(1-3): 5–15. Arnold L.M., Goldenberg D.L., Stanford S.B. et al. Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum. 2007; 56 (4): 1336–44. Arnold L.M., Russell I.J., Diri E.W. et al. A 14-week, randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia. J Pain. 2008; 9: 792–805. Bennett M.I., Tai Y.M. Intravenous lidocaine in the management of primary fibromyalgia syndrome. Int J Clin Pharmacol Res. 1995; 15(3): 115–9. Bennett R.M., Kamin M., Karim R. et al. Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebocontrolled study. Am J Med. 2003; 114(7): 537-45. Bennett R. The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol. 2005; 23(5): S154–62. Borchers A.T., Gershwin M.E. Fibromyalgia: A Critical and Comprehensive. Review. Clin. Rev. Allergy Immunol. 2015; 49: 100–51. Choy E.H.S., Mease P.J., Kajdasz D.K. et al. Safety and tolerability of duloxetine in the treatment of patients with fibromyalgia: pooled analysis of data from five clinical trials. Clin Rheumatol 2009; 28(9): 1035–44. Crofford L.J., Rowbotham M.C., Mease P.J. et al. Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double- blind, placebo-controlled trial. Arthritis Rheum. 2005; 52(4): 1264–73. Crofford L.J., Mease P.J., Simpson S.L. et al. Fibromyalgia relapse evaluation and efficacy for durability of meaningful relief (FREEDOM): a 6-months, double-blind, placebo-controlled trial with pregabalin. Pain. 2008; 136: 419–31. Grayston R., Czanner G., Elhadd K. et. al. A systematic review and meta-analysis of the prevalence of small fiber pathology in fibromyalgia: Implications for a new paradigm in fibromyalgia etiopathogenesis. Seminars in Arthritis and Rheumatism. 2018 Aug 23. pii: S0049-0172(18)30363-9. Hauser W., Bernardy K., Uceyler N. et al. Treatment of fibromyalgia syndrome with gabapentin and pregabalin: a meta-analysis of randomized controlled trials. Pain. 2009; 145(1-2): 69–81. Hauser W., Bernardy K., Uceyler N. et al. Treatment of fibromyalgia syndrome with antidepressants: a metaanalysis. JAMA. 2009; 301(2): 198–209. Häuser W., Fitzcharles M.A. Facts and myths pertaining to fibromyalgia. Dialogues Clin Neurosci. 2018 Mar; 20(1): 53–62. Jones K.D., Adams D., Winters-Stone K. et al. A comprehensive review of 16 exercise treatment studies in fibromyalgia (1988-2005). Health Qual Life Outcomes. 2006; 4: 67–73. Macfarlane G. et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. doi:10.1136/annrheumdis-2016-209724. Mease P.J., Clauw D.J., Gendreau R.M. et al. The efficacy and safety of milnacipran for treatment of fibromyalgia: a randomized, double- blind, placebo-controlled trial. J Rheumatol. 2009; 36 (2): 398-409. Mease P. Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. J Rheumatol. 2005; 32 Suppl. 75: 6–21. Mease P.J., Russell I.J., Arnold L.M. et al. A randomized, double-blind, placebo-controlled, phase III trial of pregabalin in the treatment of patients with fibromyalgia. J Rheumatol. 2008; 35: 502–514. Smythe H.A., Moldofsky H. Two contributions to understanding of the «fibrositis» syndrome. Bull Rheum Dis. 1977; 28: 928–931. Staud R., Weyl E.E., Bartley E., Price D.D., Robinson M.E. Analgesic and anti-hyperalgesic effects of muscle injections with lidocaine or saline in patients with fibromyalgia syndrome. Eur J Pain. 2014 Jul; 18(6): 803–12. Staud R., Nagel S., Robinson M.E. et al. Enhanced central pain processing of fibromyalgia patients is maintained by muscle afferent input: a randomized, double-blind, placebo-controlled trial. Pain. 2009; 145: 96–104. Straube S., Derry S., Moore R., McQuay H. Pregabalin in fibromyalgia: meta-analysis of efficacy and safety from company clinical trial reports. Rheumatology. 2010; 49: 706–715. Talotta R., Bazzichi L., Di Franco M. One year in review 2017: fibromyalgia. Clin Exp Rheumatol. 2017; 35 (Suppl. 105): S6–S12. Vitton O., Gendreau M., Gendreau J. et al. A double-blind placebo-controlled trial of milnacipran in the treatment of fibromyalgia. Hum Psychopharmacol. 2004; 19 Suppl. 1: S27–35. Wolfe F., Smythe H.A., Yunus M.B. et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum. 1990; 33(2): 160–72. Wolf F., Clauw D.J., Fitzcharles M.-A. et al. The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom. Severity. Arthr Care Res. 2010; 62(5): 600–17. Wolfe F., Clauw D.J., Fitzcharles M.A. et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J. Rheum. 2011; 38(6): 1113–22. Wolfe F., Fitzcharles M.A., Goldenberg D.L. et al. Comparison of Physician-Based and Patient-Based Criteria for the Diagnosis of Fibromyalgia. Arthr. Care Res. (Hoboken). 2016; 68(5): 652–59. Zijlstra T.R., Barendregt P.J., van de Laar MA.. Venlafaxine in fibromyalgia: results of a randomized, placebo-controlled, double-blind trial [abstract]. Arthritis Rheum 2002; 46: S105.
About the Autors
Andrey B. Danilov, MD, Professor of the Department of nervous diseases of the Institute Of Professional Education I.M. Sechenov First Moscow State Medical University FSAEI of HE of the Ministry of Health of Russia (Sechenov University). Address: 119991, Moscow, 2, bld. 4 Bolshaya Pirogovskaya St. Tel. +74956091400. E-mail: nervkafedra@gmail.com