Clinical aspects and main forms of treatment for Fibromyalgia - Literature Review

Authors

DOI:

https://doi.org/10.33448/rsd-v9i11.9495

Keywords:

Fibromyalgia; Pathophysiology; Pharmacological treatment.

Abstract

Fibromyalgia is considered an incurable pathology and an idiopathic syndrome because its pathophysiology is not defined. The patient has symptoms such as chronic and generalized pain, tiredness and difficulty sleeping. It is considered frequent and its diagnosis is made by excluding other pathologies. Although there is still no effective treatment, pharmacological therapy helps patients to reduce symptoms. The purpose of this review was to analyze the pathophysiology involved in the development of fibromyalgia, as well as the pharmacological therapies, plants and medicinal compounds currently existing and studied for the treatment of this pathology, considering a period between 2009 and 2020. For that, the Scielo databases, Pubmed and Google Scholar were consulted. Thus, it can be seen that the existing pharmacological therapies mainly cover four classes of drugs, which are the antiepileptic drugs, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs) and noradrenaline reuptake inhibitors, in addition to muscle relaxants, benzodiazepines, analgesic anti-inflammatories and herbal medicines. Despite the several published guidelines regarding the treatment of fibromyalgia, so far there is no fully effective therapy and in view of this the need for new specific drugs for this pathology is evident.

References

Ablin, J. N., & Buskila, D. (2013). Fibromyalgia syndrome–Novel therapeutic targets. Maturitas, 75 (4), 335-340. https://doi.org/10.1016/j.maturitas.2013.05.004

Ammad, N. (2018). Comparative Efficacy of Pharmacological and Nonpharmacological Interventions in Managing Primary and Secondary Outcomes of Fibromyalgia Syndrome. Medical Student Research Journal,6 (1), 11-20.

Atsak, P., Guenzel, F. M., Kantar-Gok, D., Zalachoras, I., Yargicoglu, P., Meijer, O. C., Quirarte, G. L., Lobo, O.T., Schwabe, L., & Roozendaal, B. (2016). Glucocorticoids mediate stress-induced impairment of retrieval of stimulus-response memory. Psychoneuroendocrinology, 67 (1), 207-215. https://doi.org/10.1016/j.psyneuen.2016.02.006

Atzeni, F., Gerardi, M. C., Masala, I. F., Alciati, A., Batticciotto, A., & Sarzi-Puttini, P. (2017). An update on emerging drugs for fibromyalgia treatment. Expert opinion on emerging drugs, 22(4), 357-367. https://doi.org/10.1080/14728214.2017.1418323

Azevedo, P. M. (2018). A ciência da dor: Sobre fibromialgia e outras síndromes dolorosas persistentes e sobre a natureza humana. São Paulo: Editora Unesp Digital.

Barceló-Martinez, E., Gelves-Ospina, M., Navarro Lechuga, E., Allegri , R. F., Orozco-Acosta, E., Benítez-Agudelo, J. C., León-Jacobus, A., Román, N. F. (2018). Serum cortisol levels and neuropsychological impairments in patients diagnosed with Fibromyalgia. Actas Esp Psiquiatr, 46 (1), 1-11.

Benlidayi, I. C. (2019). Role of inflammation in the pathogenesis and treatment of fibromyalgia. Rheumatology international, 39(5), 781-791. https://doi.org/10.1007/s00296-019-04251-6

Bradley, L.A. (2009). Pathophysiology of fibromyalgia. The American Journal of Medicine 122 (12), S22-S30. https://doi.org/10.1016/j.amjmed.2009.09.008

Calandre, E. P., Rico-Villademoros, F., & Slim, M. (2015). An update on pharmacotherapy for the treatment of fibromyalgia. Expert opinion on pharmacotherapy, 16(9), 1347-1368. https://doi.org/10.1517/14656566.2015.1047343

Casanueva, B., Rodero, B., Quintial, C., Llorca, J., & González-Gay, M. A. (2013). Short-term efficacy of topical capsaicin therapy in severely affected fibromyalgia patients. Rheumatology International, 33(10), 2665-2670. https://doi.org/10.1007/s00296-012-2490-5

Chinn, S., Caldwell, W., & Gritsenko, K. (2016). Fibromyalgia pathogenesis and treatment options update. Current Pain and Headache Reports, 20(4), 1-10. https://doi.org/10.1007/s11916-016-0556-x

Cooper, T. E., Derry, S., Wiffen, P. J., & Moore, R. A. (2017). Gabapentin for fibromyalgia pain in adults. Cochrane Database of Systematic Reviews, 1 (1), 1-28. https://doi.org/10.1002/14651858.CD012188.pub2

Derry, S., Wiffen, P. J., Haeuser, W., Mücke, M., Tölle, T. R., Bell, R. F., & Moore, R. A. (2017). Oral nonsteroidal anti‐inflammatory drugs for fibromyalgia in adults. Cochrane Database of Systematic Reviews, 1 (3), 1-39. https://doi.org/10.1002/14651858.CD012332.pub2

Di Franco, M., Lannuccelli, C., & Valesini, G. (2010). Neuroendocrine immunology of fibromyalgia. Annals of the New York Academy of Sciences, 1193 (1), 84-90. https://doi.org/10.1111/j.1749-6632.2009.05344.x

Dursun, M., Besiroglu, H., Tellioglu, E., Saglam, Y., & Ortac, M. (2019). Association Between Sexual Dysfunction, Sleep Impairment and Depression in Women with Fibromyalgia. Sexuality and Disability, 1 (1), 1-9. https://doi.org/10.1007/s11195-019-09592-5

Faria, P. C.; Silva, L. R. T.; Fonseca, A. C. S.; Silva, R. V.; Meireles, C.; Pernambuco, A. P. (2014). Fibromialgia: diagnóstico, fisiopatologia e tratamentos. Conexão ciência (Online), 9 (1), 01-19. https://doi.org/10.24862/cco.v9i1.248

Fischer, S., Doerr, J. M., Strahler, J., Mewes, R., Thieme, K., & Nater, U. M. (2016). Stress exacerbates pain in the everyday lives of women with fibromyalgia syndrome - the role of cortisol and alpha-amylase. Psychoneuroendocrinology, 63 (1), 68-77. https://doi.org/10.1016/j.psyneuen.2015.09.018

Freitas, R. P.A, de Andrade, S. C., Spyrides, M. H. C., Micussi, M. T. A. B. C., & de Sousa, M. B. C. (2017). Impacto do apoio social sobre os sintomas de mulheres brasileiras com fibromialgia. Revista Brasileira de Reumatologia, 57(3), 197-203.

https://doi.org/10.1016/j.rbr.2016.05.002

Gaskell, H., Moore, R. A., Derry, S., & Stannard, C. (2016). Oxycodone for pain in fibromyalgia in adults. Cochrane Database of Systematic Reviews, 1 (9), 1-22. https://doi.org/10.1002/14651858.CD012329

Gavi, M. B. R. D. O., Coser, P. H. P., Macedo, D. C. F., Oliveira, C. G. T. D., & Silva, L. C. G. D. (2018). O uso do Mini-Exame do estado Mental colabora no tratamento da fibromialgia. Ciências & Cognição, 23 (1), 108-116.

Gilron, I., Chaparro, L. E., Tu, D., Holden, R. R., Milev, R., Towheed, T., DuMerton-Shore, D, & Walker, S. (2016). Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial. Pain, 157(7), 1532-1540. doi: 10.1097 / j.pain.0000000000000558

Glass, J. M., Williams, D. A., Fernandez-Sanchez, M. L., Kairys, A., Barjola, P., Heitzeg, M. M., Clauw, D.J, & Schmidt-Wilcke, T. (2011). Executive function in chronic pain patients and healthy controls: different cortical activation during response inhibition in fibromyalgia. The journal of pain, 12(12), 1219-1229. https://doi.org/10.1016/j.jpain.2011.06.007

Halpern, R., Shah, S. N., Cappelleri, J. C., Masters, E. T., & Clair, A. (2016). Evaluating guideline‐recommended pain medication use among patients with newly diagnosed fibromyalgia. Pain Practice, 16 (8), 1027-1039. https://doi.org/10.1111/papr.12364

Häuser, W., Ablin, J., Fitzcharles, M. A., Littlejohn, G., Luciano, J. V., Usui, C., & Walitt, B. (2015). Fibromyalgia. Nature reviews Disease primers, 1(1), 1-16. https://doi.org/10.1038/nrdp.2015.22

Kaouk, S., Wilke, W. S., & Gota, C. E. (2018). Characteristics of fibromyalgia patients prescribed opioid medications: data from the Cleveland clinic fibromyalgia registry. International Journal of Clinical Rheumatology, 13(2), 82-93.

Kato, K., Sullivan, P. F., Evengård, B., & Pedersen, N. L. (2009). A population-based twin study of functional somatic syndromes. Psychological medicine, 39(3), 497-505. Doi: 10.1017 / S0033291708003784

Kia, S., & Choy, E. (2017). Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology. Biomedicines, 5(2), 20. https://doi.org/10.3390/biomedicines5020020

Klein, C.P., Rodrigues Cintra, M., Binda, N., Montijo Diniz, D., Gomez, M. V., Souto, A. A., & Souza, A. H. (2016). Coadministration of Resveratrol and Rice Oil Mitigates Nociception and Oxidative State in a Mouse Fibromyalgia-Like Model. Pain Research & Treatment, 1(1), 1-10. http://dx.doi.org/10.1155/2016/3191638

Lauche, R., Cramer, H., Häuser, W., Dobos, G., & Langhorst, J. (2015). A systematic overview of reviews for complementary and alternative therapies in the treatment of the fibromyalgia syndrome. Evidence-Based Complementary and Alternative Medicine, 1 (1), 1-10. https://doi.org/10.1155/2015/610615

Lawson, K. (2016). Potential drug therapies for the treatment of fibromyalgia. Expert opinion on investigational drugs, 25(9), 1071-1081. https://doi.org/10.1080/13543784.2016.1197906

Littlejohn, G., & Guymer, E. (2017). Modulation of NMDA receptor activity in fibromyalgia. Biomedicines, 5(2), 15. https://doi.org/10.3390/biomedicines5020015

Loggia, M. L., Berna, C., Kim, J., Cahalan, C. M., Gollub, R. L., Wasan, A. D., Harris, R E., Edwards, R.R., & Napadow, V. (2014). Disrupted brain circuitry for pain‐related reward/punishment in fibromyalgia. Arthritis & rheumatology, 66(1), 203-212. https://doi.org/10.1002/art.38191

Marlow, N. M., Simpson, K. N., Vaughn, I. A., Jo, A., Zoller, J. S., & Short, E. B. (2017). Healthcare Costs and medication adherence among patients with fibromyalgia: combination medication vs. duloxetine, milnacipran, venlafaxine, and pregabalin initiators. Pain Practice, 18(2), 154-169. https://doi.org/10.1111/papr.12585

Marques, A. P., Santo, A. D. S. D. E., Berssaneti, A. A., Matsutani, L. A., & Yuan, S. L. K. (2017). Prevalence of fibromyalgia: literature review update. Revista Brasileira de Reumatologia, 57(4), 356-363. https://doi.org/10.1016/j.rbre.2017.01.005

Martínez, S. S., Almela, Z. M., Carrasco, P. C., González, B. E., Moya, A. L., & Redolat, I. R. (2011). Hormonas, Estado de ánimo y función cognitiva. Ed. Delta. Madrid: España, 215-222.

Matarín Jimenez, T. M., Fernández‐Sola, C., Hernández‐Padilla, J. M., Correa Casado, M., Antequera Raynal, L. H., & Granero‐Molina, J. (2017). Perceptions about the sexuality of women with fibromyalgia syndrome: A phenomenological study. Journal of Advanced Nursing, 73(7), 1646-1656. https://doi.org/10.1111/jan.13262

Mease, P. J., Dundon, K., & Sarzi-Puttini, P. (2011). Pharmacotherapy of fibromyalgia. Best Practice & Research Clinical Rheumatology , 25 (2), 285-297. https://doi.org/10.1016/j.berh.2011.01.015

Metyas, S., Rezk, T., Arkfeld, D., & Leptich, T. (2017). Autoinflammation and immunomodulation in inflammatory fibromyalgia syndrome-a review. Current rheumatology reviews, 13(2), 98-102. https://doi.org/10.2174/1573397112666160919120530

Montserrat-de la Paz, S., Garcia-Gimenez, M. D., Quilez, A. M., De la Puerta, R., & Fernandez-Arche, A. (2018). Ginger rhizome enhances the anti-inflammatory and anti-nociceptive effects of paracetamol in an experimental mouse model of fibromyalgia. Inflammopharmacology, 26 (4), 1093-1101. https://doi.org/10.1007/s10787-018-0450-8

Morales, K. O., Passarelli, B. S., Casimiro, E. F., Pereira, J. C., Deliberato, P. C. P., & dos Santos, B. R. M. (2019). O uso da técnica manual shiatsu no alívio dos sintomas decorrentes da fibromialgia. Unisanta Health Science, 3(1), 1-17.

Oliveira Júnior, J. O. D., & Almeida, M. B. D. (2018). The current treatment of fibromyalgia. BrJP, 1(3), 255-262. http://dx.doi.org/10.5935/2595-0118.20180049

Parkitny, L., & Younger, J. (2017). Reduced pro-inflammatory cytokines after eight weeks of low-dose naltrexone for fibromyalgia. Biomedicines, 5(2), 16. https://doi.org/10.3390/biomedicines5020016

Pernambuco, A. P., Schetino, L. P., Carvalho, L. S. C., & Reis, D. A. (2016). Involvement of oxidative stress and nitric oxide in fibromyalgia pathophysiology: a relationship to be elucidated. Journal of Pain & Relief, 5 (3), 1-7. http://dx.doi.org/10.4172/2167-0846.C1.006.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. [E-book]. Santa Maria. Ed. UAB/NTE/UFSM. https://www.ufsm.br/app/uploads/sites/358/2019/02/Metodologia-da-Pesquisa-Cientifica_final.pdf.

Puretić, M. B, & Demarin, V. (2012). Neuroplasticity mechanisms in the pathophysiology of chronic pain. Acta Clinica Croatica, 51(2), 425-429. https://hrcak.srce.hr/107233

Quilez, A. M., Montserrat-de la Paz, S., Fernandez-Arche, A., De la Puerta, R., & Garcia-Gimenez, M. D. (2018). Diets supplemented with Annona muricata improve the symptoms of fibromyalgia. PharmaNutrition, 6(3), 81-84. https://doi.org/10.1016/j.phanu.2018.04.001

Rizzi, M., Cristiano, A., Frassanito, F., Macaluso, C., Airoldi, A, & Sarzi-Puttini, P. (2016). Sleep disorders in fibromyalgia syndrome. Journal of Pain & Relief, 5 (2), 1-5. DOI: 10.4172/2167-0846.1000232

Sagy, I., Bar-Lev Schleider, L., Abu-Shakra, M., & Novack, V. (2019). Safety and efficacy of medical cannabis in fibromyalgia. Journal of clinical medicine, 8(6), 1-12. https://doi.org/10.3390/jcm8060807

Salvat-Pujol, N., Labad, J., Urretavizcaya, M., de Arriba-Arnau, A., Segalàs, C., Real, E., Ferre, A., Cresco, J.M., Jiménez-Murcia, S., Soriano-Mas, C., Menchón, J. M., & Soria, V. (2017). Hypothalamic-pituitary-adrenal axis activity and cognition in major depression: the role of remission status. Psychoneuroendocrinology, 76 (1), 38-48. https://doi.org/10.1016/j.psyneuen.2016.11.007

Sarzi-Puttini, P., Atzeni, F., Di Franco, M., Buskila, D., Alciati, A., Giacomelli, C., Rossi, A., & Bazzichi, L. (2012). Dysfunctional syndromes and fibromyalgia: a 2012 critical digest. Clin Exp Rheumatol, 30(6 Suppl 74), 143-151.

Schafranski, M. D., Merlini, A. B., de Oliveira Prestes, A. L., Ribeiro, B., da Silva Geraldino, J., & Gauer, M. F. (2013). Eficácia dos antidepressivos na fibromialgia: uma análise crítica a partir de dados raramente encontrados nos artigos científicos. Publicatio UEPG: Ciências Biológicas e da Saúde, 19(2), 131-141. https://doi.org/10.5212/publicatio%20uepg.v19i2.5601

Shakiba, M., Moazen-Zadeh, E., Noorbala, A. A., Jafarinia, M., Divsalar, P., Kashani, L., Shahmansouri, N., Tafakhori, A., Bayat, H., & Akhondzadeh, S. (2018). Saffron (Crocus sativus) versus duloxetine for treatment of patients with fibromyalgia: A randomized double-blind clinical trial. Avicenna journal of phytomedicine, 8(6), 513-523.

Sharma, S., & Kochhar, K. P. (2019). Use of medicinal plants in treatment of fibromyalgia. International Journal of Pharmaceutical and Biological Science Archive, 7(5), 7-11.

Souza Nascimento, S., Santana, J. M., Nampo, F. K., Ribeiro, Ê. A. N., Silva, D. L., Araújo-Júnior, J. X., Almeida, J.R.G.S., Bonjardim, L.R., Souza Araujo, A.A., & Quintans-Júnior, L. J. (2013). Efficacy and safety of medicinal plants or related natural products for fibromyalgia: a systematic review. Evidence-Based Complementary and Alternative Medicine, 1 (1), 1-11.

https://doi.org/10.1155/2013/149468

Souza Nascimento, S., Serafini, M. R., de Santana, J. M., & Quintans Junior, L. J. (2012). Utilização de plantas medicinais no tratamento da fibromialgia: uma prospecção tecnológica. Revista GEINTEC-Gestão, Inovação e Tecnologias, 3(1), 068-075. DOI: https://doi.org/10.7198/geintec.v3i1.88

Souza, J. B. D., & Perissinotti, D. M. N. (2018). The prevalence of fibromyalgia in Brazil–a population-based study with secondary data of the study on chronic pain prevalence in Brazil. BrJP, 1(4), 345-348. https://doi.org/10.5935/2595-0118.20180065

Steudte-Schmiedgen, S., Wichmann, S., Stalder, T., Hilbert, K., Muehlhan, M., Lueken, U., & Beesdo-Baum, K. (2017). Hair cortisol concentrations and cortisol stress reactivity in generalized anxiety disorder, major depression and their comorbidity. Journal of psychiatric research, 84 (1), 184-190. https://doi.org/10.1016/j.jpsychires.2016.09.024

Tanwar, M. S., Jain, S., Kumar, U., Dada, R., & Bhatia, R. (2016). Reproductive Hormones in Pathophysiology of Fibromyalgia Syndrome. Indian Obstetrics and Gynaecology, 6(3), 35-42.

Torquato, A. C., Dias, F. A., Wachholz, L. B., & Nesello, L. Â. N. (2019). Comparação entre os resultados obtidos por diferentes métodos de avaliação da composição corporal em mulheres com síndrome de fibromialgia. RBONE-Revista Brasileira de Obesidade, Nutrição e Emagrecimento, 13(77), 103-110.

Tsilioni, I., Russell, I. J., Stewart, J. M., Gleason, R. M., & Theoharides, T. C. (2016). Neuropeptides CRH, SP, HK-1, and inflammatory cytokines IL-6 and TNF are increased in serum of patients with fibromyalgia syndrome, implicating mast cells. Journal of Pharmacology and Experimental Therapeutics, 356(3), 664-672. DOI: https://doi.org/10.1124/jpet.115.230060

Tzeng, N. S., Chung, C. H., Liu, F. C., Chiu, Y. H., Chang, H. A., Yeh, C. B., Huang, S., Lu, R., Yeh, H., Kao, Y., Chiang, W. S., Tsao, C.H., Wu, Y.F., Chou, Y.C., Lin, F.H., & Chien, W.C. (2018). Fibromyalgia and risk of dementia—a nationwide, population-based, cohort study. The American Journal of the Medical Sciences, 355(2), 153-161. https://doi.org/10.1016/j.amjms.2017.09.002

Vilaça, M. M. O., Santos Lima, K. B., Alencar, E. V. M., da Conceição Machado, K., & Conceição Machado, K. (2020). New fibromyalgia treatment medicinal products. Research, Society and Development, 9(3), 1-14. DOI: https://doi.org/10.33448/rsd-v9i3.2308

Welsch, P., Bernardy, K., Derry, S., Moore, R. A., & Häuser, W. (2018). Mirtazapine for fibromyalgia in adults. Cochrane Database of Systematic Reviews, 1 (8), 1-6. https://doi.org/10.1002/14651858.CD012708.pub2

White, C., Kwong, W. J., Armstrong, H., Behling, M., Niemira, J., & Lang, K. (2018). Analysis of Real-World Dosing Patterns for the 3 FDA-Approved Medications in the Treatment of Fibromyalgia. American health & drug benefits, 11(6), 293-301.

Wolfe, F., Walitt, B., Perrot, S., Rasker, J. J., & Häuser, W. (2018). Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias. PLoS One, 13(9), e0203755. https://doi.org/10.1371/journal.pone.0203755

Wu, Y. L., Chang, L. Y., Lee, H. C., Fang, S. C., & Tsai, P. S. (2017). Sleep disturbances in fibromyalgia: A meta-analysis of case-control studies. Journal of psychosomatic research, 96 (1), 89-97. https://doi.org/10.1016/j.jpsychores.2017.03.011

Yolanda Castaño, M., Garrido, M., Rodríguez, A. B., & Gómez, M. Á. (2019). Melatonin Improves Mood Status and Quality of Life and Decreases Cortisol Levels in Fibromyalgia. Biological research for nursing, 21(1), 22-29. https://doi.org/10.1177/1099800418811634

Published

05/11/2020

How to Cite

COSTA, S. M. L. .; SILVA, M. P. M. P. e .; PINTO, L. P. .; SOUSA, D. L. R. . Clinical aspects and main forms of treatment for Fibromyalgia - Literature Review. Research, Society and Development, [S. l.], v. 9, n. 11, p. e729119495, 2020. DOI: 10.33448/rsd-v9i11.9495. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/9495. Acesso em: 5 dec. 2024.

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Review Article