Identifying the most effective therapy for patients with fibromyalgia (FM) stays contentious. Thus, a recent study conducted a Bayesian network meta-analysis to compare several drugs used as pharmacological management for FM.

Databases like PubMed, Google Scholar, Embase, and Scopus were searched for the relevant studies. All the randomized clinical trials (RCTs) comparing two or more pharmacological management for fibromyalgia were accessed and studies involving at least 10 patients with a length of follow-up longer than 4 weeks were included. The fibromyalgia impact questionnaire (FIQ) and the physical and mental subscales short form 36 (SF36) scores were extracted at the last follow-up. Additionally, the number of adverse events leading to the study of discontinuation was pulled out. The compounds like duloxetine, pregabalin, fluoxetine, gabapentin, milnacipran, trazodone, placebo, nortriptyline, IGF-I, amitriptyline, and the combination of fluoxetine and amitriptyline, pregabalin, and trazodone were investigated.

The published evidence suggested pregabalin, and duloxetine to show the greatest improvement of the FIQ and SF36 Physical and Mental subscales, along with the lowest rate of adverse events leading to study discontinuation. These results must be interpreted considering the possible adverse events associated with the use of these drugs.

Expert Review of Clinical Pharmacology. 2022;15(2):205-214. DOI: 10.1080/17512433.2022.2044792