Rheumatology

Duloxetine, milnacipran, and pregabalin provide significant pain relief for 1 in 10 adults with fibromyalgia

January 21, 2025

Duloxetine, milnacipran, and pregabalin can be considered for short-term management of moderate to severe fibromyalgia syndrome (FMS) pain, with careful monitoring for adverse events. However, consider weighing the potential benefits against the risk of adverse events, as well as the limited efficacy data, for other pharmacological options.

Study design: Researchers reviewed Cochrane Database of Systematic Reviews up to May 2024, assessing the quality and efficacy of pharmacological therapies for FMS. The study included 21 reviews (87 trials, 17,631 patients) and utilized AMSTAR-2 criteria for quality assessment.

Results: Duloxetine, milnacipran, and pregabalin demonstrated strong evidence that approximately 10% of individuals with moderate to severe pain experienced a reduction in pain intensity by at least half over 4 to 12 weeks. No significant efficacy was observed beyond 6 months. Serious adverse events were comparable to placebo. Other medications, including antipsychotics, cannabinoids, and NSAIDs, had limited or no substantial efficacy evidence.

Source:

Moore A, et al. (2024, December 20). Rheumatology. Effectiveness of pharmacological therapies for fibromyalgia syndrome in adults: an overview of Cochrane Reviews. https://pubmed.ncbi.nlm.nih.gov/39705187/