Determining the most effective therapy for patients with fibromyalgia (FM) remains controversial. Thus, a recent study conducted a Bayesian network meta-analysis to compare several drugs employed as pharmacological management for FM.

It explored PubMed, Google Scholar, Embase, and Scopus for the randomized clinical trials (RCTs) that compared two or more pharmacological management for fibromyalgia. 

It included studies involving a minimum of 10 patients with a follow-up longer than four weeks. The study further extracted the data from the fibromyalgia impact questionnaire (FIQ) and the physical and mental subscales short form 36 (SF36) at the last follow-up. Additionally, it recognized the number of adverse events leading to the studys discontinuation. 

The study investigated the compounds like duloxetine, pregabalin, fluoxetine, gabapentin, milnacipran, trazodone, placebo, nortriptyline, IGF-I, amitriptyline, and the combination of fluoxetine and amitriptyline, pregabalin, and trazodone, which are commonly employed for the management of fibromyalgia.

The published evidence showed that pregabalin and duloxetine cause the most significant improvement in the FIQ and SF36 Physical and Mental subscales. Further, they are also associated with the lowest rate of adverse events leading to study discontinuation. 

However, clinicians must interpret these results considering the adverse events related to the use of these drugs.

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