[Note: To read the full text of this article free, click here. It was a small trial but indicated some patients may benefit from perseverance in seeking help for FM pain.]
Context: Fibromyalgia is a chronic musculoskeletal pain disorder. The pain can be intractable and may not respond to commonly-used treatments, such as tricyclic antidepressants and opioids.
Objectives: To evaluate pregabalin [trade name Lyrica] response in the subset of patients with fibromyalgia whose pain had been judged refractory to other treatments.
Methods: Patients had previously participated in a controlled trial of pregabalin and had moderate to severe pain despite treatment with gabapentin, a tricyclic antidepressant, and a third medication (e.g., other anticonvulsants, opioid, selective serotonin reuptake inhibitors, tramadol). Flexible-dose pregabalin 150-600 mg/day was added for 3-month treatment cycles, each followed by 3- to 28-day pregabalin “drug holiday” that lasted until a relapse occurred. Pain intensity was measured using the visual analogue scale of the Short-Form McGill Pain Questionnaire completed at baseline, the end of each 3-month treatment period and at the relapse visit. Analysis was at 15 months (after 5 cycles).
Results: In total, 25 patients were included and 19 completed the 15-month analysis period. At baseline, 88% were receiving 1 or more pain medications. Pregabalin 150-600 mg/day was associated with statistically significant, clinically meaningful pain reduction during each treatment cycle. Pain quickly returned to baseline levels during the “drug holidays” in a median time of 2-4 days. Somnolence (n=5) and dizziness (n=4) were the most common adverse events.
Conclusions: These results suggest that pregabalin may be beneficial in patients with fibromyalgia who have had an unsatisfactory response to treatment with other medications.
Source: Open Rhematology Journal, Oct 2010. Stacey BR, Emir B, Petersel D, Murphy K. Comprehensive Pain Center, Department of Anesthesiology and Peri-Operative Medicine, Oregon Health & Science University, Portland, Oregon; Pfizer Pharmaceuticals Group, New York, New York, USA. [E-mail: firstname.lastname@example.org]