Thorpe et al., 2018 [ 1818. THORPE J, SHUM B, MOORE RA, WIFFEN PJ, GILRON I. Combination pharmacotherapy for the treatment of fibromyalgia in adults. Cochrane Pain, Palliative and Supportive Care Group, editor. Cochrane database of systematic reviews. 2018. Available from: https://doi.org/10.1002/14651858.CD010585.pub2. [cited 2019 May 26]. https://doi.org/10.1002/14651858.CD01058...
] |
2 |
1 |
133 |
To assess the efficacy, safety and tolerability of combination of drugs with monotherapy or placebo, or both, in the treatment of FMS |
Double-blind RCT comparing combinations of two or more drugs with placebo or other comparatives, or both, in the treatment of FMS |
Single-blind studies, complementary studies to those already selected, non-randomized, studies with other therapies and with patients having diverse fibromyalgia diseases |
VAS, NPS, pain reduction of 30% or more and 50% or more, FIQ, NNTH |
Sommer et al., 2017 [ 1919. SOMMER C, ALTEN R, K-J BÄR, BERNATECK M, BRÜCKLE W, FRIEDEL E, et al. Drug therapy of fibromyalgia syndrome. Updated guidelines 2017 and overview of systematic review articles. Schmerz. 2017;31(3):274-84. https://doi.org/10.1007/s00482-017-0207-0. https://doi.org/10.1007/s00482-017-0207-...
] |
10 |
14 |
6038 |
To assess the efficacy and safety of drugs and nondrug therapy in the treatment of FMS |
Randomized clinicaltrials with drugs used to treat FMS, in databases, non-published articles and specialists’ opinion |
Studies with downgraded quality evidence according to the application of the GRADE method used by the authors |
50% pain reduction, NNTB, VAS, FIQ |
Smith et al., 2011 [ 2020. SMITH B, Peterson K, Fu R, McDonagh M, Thakurta S. Drug class review: drugs for fibromyalgia: final original report. Portland: Oregon Health & Science University; 2011. Accessed on: 27 Nov 2018. Available from: http://www.ncbi.nlm.nih.gov/books/NBK55552/. http://www.ncbi.nlm.nih.gov/books/NBK555...
] |
9 |
24 |
1368 |
To compare the efficacy and harms of drugs used in the treatment of FMS |
Studies with patients with FMS, according to the ACR criteria of 1990 and 2010, involving the use of diverse drugs and direct and indirect comparisons, assessing efficacy and damages |
Studies with ineligible results, intervention, population, publication and study design |
50% pain reduction, MFI, MAF, VAS, FIQ |
Häuser et al., 2011 [ 55. HÄUSER W, BERNARDY K, ÜÇEYLER N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants: A meta-analysis. JAMA. 2009;301(2): 198Available from. https://doi.org/10.1001/jama.2008.944. https://doi.org/10.1001/jama.2008.944...
] |
4 |
10 |
2023 |
To assess and compare the efficacy and acceptability of amitriptyline (AMT), duloxetine (DLX) and milnacipran (MLN) antidepressants in the treatment of FMS |
RCT comparing AMT, DLX or MLN with placebo, assessing at least one FMS key domain: pain, sleep, fatigue or health-related quality of life; treatment discontinuation rate |
RCTs with combination of drugs with any other treatment |
VAS, 30% pain reduction, NPS, NNTB, Cohen's category, VAS, FIQ |
Üçeyler et al., 2008 [ 2222. ÜÇEYLER N, HÄUSER W, Sommer C. A systematic review on the effectiveness of treatment with antidepressants in fibromyalgia syndrome. Arthritis Rheum. 2008;59(9):1279-98. https://doi.org/10.1002/art.24000. https://doi.org/10.1002/art.24000...
] |
2 |
13 |
891 |
To review systematically the efficacy of antidepressants in the treatment of FMS |
FMS or CWP diagnosis based on recognized criteria, controlled study design with a control group who received placebo, usual treatment or any other well-defined treatment; treatment with antidepressants, and measurement of specific symptom results |
Studies with cyclobenzaprine, which combines characteristics of antidepressant with relaxant, and studies with S-adenosylmethionine, because this substance is officially available in two countries only (UK and Italy) as food supplement |
VAS, tender point count, VAS, BDI, HAM-D, FIQ |
Roskell et al., 2011 [ 66. ROSKELL NS, BEARD S, ZHAO Y, KIM LE TK. A meta-analysis of pain response in the treatment of fibromyalgia. Meta-analysis of fibromyalgia treatments. Pain Pract. 2011;11(6):516-27. https://doi.org/10.1111/j.1533-2500.2010.00441.x. https://doi.org/10.1111/j.1533-2500.2010...
] |
2 |
5 |
538 |
To compare pain response to licensed drugs or drugs commonly used in fibromyalgia, also addressing treatment discontinuation due to adverse reactions |
Randomized Controlled Clinical Trials with at least 4-week duration with patients aged 18 years or over with clinical FMS diagnosis, using Duloxetine (60 mg /day), Fluoxetine (40 to 50 mg / day), Gabapentin (2400 mg / day), Milnacipran (100 or 200 mg / day), Placebo, Pramipexol (4.5 mg / day), Pregabalin (300 or 450 mg / day), TCA (amitriptyline 25 to 75 mg / day or cyclobenzaprine 1030 mg /day), Tramadol with paracetamol(200 to 300 mg /day) |
Treatment of no interest for meta-analysis, no major outcome reported, different treatment doses, study not properly controlled, duplicated or of short duration, poor quality testing and when the article was irretrievable |
FIQ, BDI |
Häuser et al., 2009 [ 55. HÄUSER W, BERNARDY K, ÜÇEYLER N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants: A meta-analysis. JAMA. 2009;301(2): 198Available from. https://doi.org/10.1001/jama.2008.944. https://doi.org/10.1001/jama.2008.944...
] |
3 |
7 |
927 |
To determine the efficacy of antidepressants in the treatment of FMS through meta-analysis and randomized controlled clinical trials |
Patients effectively diagnosed FMS, RCT with one control group receiving placebo and one group treated with antidepressants (TCA, SSRIs, SNRIs or MAOIs) |
Studies assessing cyclobenzaprine, S-adenosylmethionine, or antidepressant combinations. Studies where only categorial data were provided and studies with incomplete data |
VAS, FIQ, NRS, HRQOL scale |
Perrot et al., 2008 [ 2323. PERROT S, R-M JAVIER, MARTY M, LE JEUNNE C, LAROCHE F, the CEDR (Cercle d’Etude de la Douleur en Rhumatologie France), French Rheumatological Society, Pain Study Section. Is there any evidence to support the use of anti-depressants in painful rheumatological conditions? Systematic review of pharmacological and clinical studies. Rheumatology. 2008;47(8):1117-23. https://doi.org/10.1093/rheumatology/ken110. https://doi.org/10.1093/rheumatology/ken...
] |
2 |
4 |
910 |
To review evidences of use of antidepressants in painful rheumatological conditions |
Articles published between 1966 and 2007 in 5 European idioms, addressing the use of antidepressants in various rheumatological conditions, including FMS. The authors attributed a rating scale based on the Jadad method (0-5), including studies with scoring above 2 |
Articles that were scored below 2 in the Jadad scale |
VAS, FIQ, NRS |