Placebo effect in pharmacological management of fibromyalgia: a meta-analysis

Author:

Migliorini Filippo1,Maffulli Nicola234,Eschweiler Jörg1,Betsch Marcel5,Tingart Markus1,Colarossi Giorgia1

Affiliation:

1. Departement of Orthopedic Surgery, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074 Aachen, Germany

2. Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, Baronissi (Salerno) 84081, Italy

3. School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, ST5 5BG Stoke on Trent, UK

4. Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK

5. Department of Orthopedics and Trauma Surgery, University Medical Center Mannheim of the University Heidelberg, Ludolf-Krehl-Straße 13-17, 68167 Mannheim, Germany

Abstract

Abstract Introduction The management of fibromyalgia involves a combination of pharmacological and non-pharmacological treatments. Source of data Recently published literature in PubMed, Google Scholar and Embase databases. Areas of agreement Several pharmacological and non-pharmacological strategies have been proposed for the management of fibromyalgia. However, the management of fibromyalgia remains controversial. The administration of placebo has proved to be more effective than no treatment in many clinical settings and evidence supports the ‘therapeutic’ effects of placebo on a wide range of symptoms. Areas of controversy The placebo effect is believed to impact the clinical outcomes, but its actual magnitude is controversial. Growing points A meta-analysis comparing pharmacological management versus placebo administration for fibromyalgia was conducted. Areas timely for developing research Drug treatment resulted to be more effective than placebo administration for the management of fibromyalgia. Nevertheless, placebo showed a beneficial effect in patients with fibromyalgia. Treatment-related adverse events occurred more frequently in the drug treatment. Level of evidence I, Bayesian network meta-analysis of double-blind randomized clinical trials.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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