Monotherapy or Combination Therapy for Fibromyalgia Treatment?
Current Rheumatology Reports, 07/27/2012
Calandre EP et al. – When polytherapy is considered, therapeutic decisions must be based on data from monotherapy trials and a sound knowledge of the pharmacological profile of each drug. Well–designed clinical trials exploring specific drug combinations selected on the basis of potential additive or synergistic effects should be performed.
- Fibromyalgia is a chronic pain disease whose clinical symptomatology also includes different symptom domains: fatigue, sleep disturbances, morning stiffness, dyscognition, and psychological distress.
- These associated symptoms usually vary in frequency and intensity from patient to patient.
- Because the efficacy of monotherapy is limited, more severely affected patients frequently require drug combinations.
- There is, however, scarce scientific information concerning the benefits and risks of such combinations.
- To date, only ten studies investigating the efficacy and tolerability of two–drug combinations have been published; some of these studies are old and/or studied drugs that are now known to be of little or no interest in fibromyalgia management.