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Emerging Developments

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Fibromyalgia

Abstract

In recent years, there have been advancements in both pharmacologic and non-pharmacologic strategies to treat fibromyalgia. A greater understanding of the pathophysiology of this complex disease has spurred this progress. Investigation into pharmacologic strategies has primarily focused on various neural receptors including cannabinoid, opioid, N-methyl-d-aspartate (NMDA), and dopamine, in addition to various neurotransmitters. Non-pharmacologic strategies, which have been recently examined, include specific exercise programs, acupuncture, cognitive behavioral therapy (CBT), motion-controlled video game systems, and transcutaneous magnetic stimulation. Fibromyalgia remains a difficult-to-treat disorder; however, novel research has led to an increased understanding of how various drug targets, existing agents, and non-pharmacologic strategies may help manage the symptoms of this disease.

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References

  1. Ablin J, Fitzcharles MA, Buskila D, Shir Y, Sommer C, Häuser W. Treatment of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines with special emphasis on complementary and alternative therapies. Evid Based Complement Alternat Med. 2013;2013:485272.

    PubMed Central  PubMed  Google Scholar 

  2. Agarwal N, Pacher P, Tegeder I, Amaya F, Constantin CE, Brenner GJ, Rubino T, Michalski CW, Marsicano G, Monory K, Mackie K, Marian C, Batkai S, Parolaro D, Fischer MJ, Reeh P, Kunos G, Kress M, Lutz B, Woolf CJ, Kuner R. Cannabinoids mediate analgesia largely via peripheral type 1 cannabinoid receptors in nociceptors. Nat Neurosci. 2007;10(7):870–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Bateman L, Palmer RH, Trugman JM, Lin Y. Results of switching to milnacipran in fibromyalgia patients with an inadequate response to duloxetine: a phase IV pilot study. J Pain Res. 2013;6:311–8

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Beltrán-Carrillo VJ, Tortosa-Martínez J, Jennings G, Sánchez ES. Contributions of a group-based exercise program for coping with fibromyalgia: a qualitative study giving voice to female patients. Women Health. 2013;53(6):612–29.

    Article  PubMed  Google Scholar 

  5. Bennett RM, Kamin M, Karim R, Rosenthal N. Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. Am J Med. 2003;114(7):537–45.

    Article  CAS  PubMed  Google Scholar 

  6. Bote ME, Garcia JJ, Hinchado MD, Ortega E. Fibromyalgia: anti-inflammatory and stress responses after acute moderate exercise. PLoS ONE. 2013;8(9):e74524.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Burstein SH, Zurier RB. Cannabinoids, endocannabinoids, and related analogs in inflammation. AAPS J. 2009;11(1):109–19. doi:10.1208/s12248-009-9084-5. Epub 2009 Feb 6. Review.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Cao H, Li X, Han M, Liu J. Acupoint stimulation for fibromyalgia: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med. 2013;2013:362831. Epub 2013 Dec 17. Review.

    PubMed Central  PubMed  Google Scholar 

  9. Casanueva B, Rodero B, Quintial C, Llorca J, González-Gay MA. Short-term efficacy of topical capsaicin therapy in severely affected fibromyalgia patients. Rheumatol Int. 2013;33(10):2665–70.

    Article  CAS  PubMed  Google Scholar 

  10. Casanueva B, Rivas P, Rodero B, Quintial C, Llorca J, González-Gay MA. Short-term improvement following dry needle stimulation of tender points in fibromyalgia. Rheumatol Int. 2014;34:861–6.

    Google Scholar 

  11. Castel A, Cascón R, Padrol A, Sala J, Rull M. Multicomponent cognitive-behavioral group therapy with hypnosis for the treatment of fibromyalgia: long-term outcome. J Pain. 2012;13(3):255–65.

    Article  PubMed  Google Scholar 

  12. Clauw DJ. Fibromyalgia: update on mechanisms and management. J Clin Rheumatol. 2007;13(2):102–9.

    Article  PubMed  Google Scholar 

  13. Clauw DJ, Mease PJ, Palmer RH, Trugman JM, Wang Y. Continuing efficacy of milnacipran following long-term treatment in fibromyalgia: a randomized trial. Arthritis Res Ther. 2013;15(4):R88.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Cohen SP, Verdolin MH, Chang AS, Kurihara C, Morlando BJ, Mao J. The intravenous ketamine test predicts subsequent response to an oral dextromethorphan treatment regimen in fibromyalgia patients. J Pain. 2006;7(6):391–8.

    Article  CAS  PubMed  Google Scholar 

  15. Deare JC, Zheng Z, Xue CC, Liu JP, Shang J, Scott SW, Littlejohn G. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev. 2013;5:CD007070.

    PubMed Central  PubMed  Google Scholar 

  16. Dougherty PM, Palecek J, Paleckova V, Sorkin LS, Willis WD. The role of NMDA and non-NMDA excitatory amino acid receptors in the excitation of primate spinothalamic tract neurons by mechanical, chemical, thermal, and electrical stimuli. J Neurosci. 1992;12(8):3025–41.

    CAS  PubMed  Google Scholar 

  17. Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA. 2004;292(19):2388–95. Review.

    Article  CAS  PubMed  Google Scholar 

  18. Harris RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta JK. Decreased central mu-opioid receptor availability in fibromyalgia. J Neurosci. 2007;27(37):10000–6.

    Article  CAS  PubMed  Google Scholar 

  19. Häuser W, Urrútia G, Tort S, Uçeyler N, Walitt B. Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome. Cochrane Database Syst Rev. 2013;1:CD010292.

    PubMed  Google Scholar 

  20. Holman AJ. Ropinirole, open preliminary observations of a dopamine agonist for refractory fibromyalgia. J Clin Rheumatol. 2003;9(4):277–9.

    Article  PubMed  Google Scholar 

  21. Holman AJ, Myers RR. A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Arthritis Rheum. 2005;52(8):2495–505.

    Article  CAS  PubMed  Google Scholar 

  22. Jentoft ES, Kvalvik AG, Mengshoel AM. Effects of pool-based and land-based aerobic exercise on women with fibromyalgia/chronic widespread muscle pain. Arthritis Rheum. 2001;45(1):42–7.

    Article  CAS  PubMed  Google Scholar 

  23. Kaneko K, Umehara M, Homan T, Okamoto K, Oka M, Oyama T. The analgesic effect of tramadol in animal models of neuropathic pain and fibromyalgia. Neurosci Lett. 2014;562:28–33.

    Google Scholar 

  24. Lee SJ, Kim DY, Chun MH, Kim YG. The effect of repetitive transcranial magnetic stimulation on fibromyalgia: a randomized sham-controlled trial with 1-mo follow-up. Am J Phys Med Rehabil. 2012;91(12):1077–85.

    Article  PubMed  Google Scholar 

  25. Lima TB, Dias JM, Mazuquin BF, da Silva CT, Nogueira RM, Marques AP, Lavado EL, Cardoso JR. The effectiveness of aquatic physical therapy in the treatment of fibromyalgia: a systematic review with meta-analysis. Clin Rehabil. 2013;27(10):892–908.

    Article  PubMed  Google Scholar 

  26. Liu B, Du L, Hong JS. Naloxone protects rat dopaminergic neurons against inflammatory damage through inhibition of microglia activation and superoxide generation. J Pharmacol Exp Ther. 2000;293:607–617.

    CAS  PubMed  Google Scholar 

  27. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014;1:CD007115.

    PubMed  Google Scholar 

  28. Mahayana IT, Sari DC, Chen CY, Juan CH, Muggleton NG. The potential of transcranial magnetic stimulation for population-based application: a region-based illustrated brief overview. Int J Neurosci. 2014;124:717–23.

    Google Scholar 

  29. Marks DM, Shah MJ, Patkar AA, Masand PS, Park GY, Pae CU. Serotonin-norepinephrine reuptake inhibitors for pain control: premise and promise. Curr Neuropharmacol. 2009;7(4):331–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  30. Marlow NM, Bonilha HS, Short EB. Efficacy of transcranial direct current stimulation and repetitive transcranial magnetic stimulation for treating fibromyalgia syndrome: a systematic review. Pain Pract. 2013;13(2):131–45.

    Article  PubMed  Google Scholar 

  31. Martínez MP, Miró E, Sánchez AI, Díaz-Piedra C, Cáliz R, Vlaeyen JW, Buela-Casal G. Cognitive-behavioral therapy for insomnia and sleep hygiene in fibromyalgia: a randomized controlled trial. J Behav Med. 2014;34:683–97.

    Google Scholar 

  32. Mattioli TA, Milne B, Cahill CM. Ultra-low dose naltrexone attenuates chronic morphine-induced gliosis in rats. Mol Pain. 2010;6:22.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Mease PJ, Farmer MV, Palmer RH, Gendreau RM, Trugman JM, Wang Y. Milnacipran combined with pregabalin in fibromyalgia: a randomized, open-label study evaluating the safety and efficacy of adding milnacipran in patients with incomplete response to pregabalin. Ther Adv Musculoskelet Dis. 2013;5(3):113–26.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Moldofsky H, Inhaber NH, Guinta DR, Alvarez-Horine SB. Effects of sodium oxybate on sleep physiology and sleep/wake-related symptoms in patients with fibromyalgia syndrome: a double-blind, randomized, placebo-controlled study. J Rheumatol. 2010;37(10):2156–66.

    Article  CAS  PubMed  Google Scholar 

  35. Mortensen J, Kristensen LQ, Brooks EP, Brooks AL. Women with fibromyalgia’s experience with three motion-controlled video game consoles and indicators of symptom severity and performance of activities of daily living. Disabil Rehabil Assist Technol. 2013 Sept 12.

    Google Scholar 

  36. Noppers I, Niesters M, Swartjes M, Bauer M, Aarts L, Geleijnse N, Mooren R, Dahan A, Sarton E. Absence of long-term analgesic effect from a short-term S-ketamine infusion on fibromyalgia pain: a randomized, prospective, double blind, active placebo-controlled trial. Eur J Pain. 2011;15(9):942–9.

    Article  CAS  PubMed  Google Scholar 

  37. Ortega E, García JJ, Bote ME, Martín-Cordero L, Escalante Y, Saavedra JM, Northoff H, Giraldo E. Exercise in fibromyalgia and related inflammatory disorders: known effects and unknown chances. Exerc Immunol Rev. 2009;15:42–65. Review.

    CAS  PubMed  Google Scholar 

  38. Painter JT, Crofford LJ. Chronic opioid use in fibromyalgia syndrome: a clinical review. J Clin Rheumatol. 2013;19(2):72–7.

    Article  PubMed  Google Scholar 

  39. R & D Focus Drug News. (2009). Neuropro UCB clinical data. [Press release]. http://business.highbeam.com/436989/article-1G1–203878561/neupro-ucb-clinical-data.

  40. Raffa RB, Buschmann H, Christoph T, Eichenbaum G, Englberger W, Flores CM, Hertrampf T, Kögel B, Schiene K, Straßburger W, Terlinden R, Tzschentke TM. Mechanistic and functional differentiation of tapentadol and tramadol. Expert Opin Pharmacother. 2012;13(10):1437–49.

    Article  CAS  PubMed  Google Scholar 

  41. Russell IJ, Holman AJ, Swick TJ, Alvarez-Horine S, Wang YG, Guinta D, Sodium Oxybate 06–008 FM Study Group. Sodium oxybate reduces pain, fatigue, and sleep disturbance and improves functionality in fibromyalgia: results from a 14-week, randomized, double-blind, placebo-controlled study. Pain. 2011;152(5):1007–17.

    Article  CAS  PubMed  Google Scholar 

  42. Schwartz TL, Rayancha S, Rashid A, Chlebowksi S, Chilton M, Morell M. Modafinil treatment for fatigue associated with fibromyalgia. J Clin Rheumatol. 2007;13(1):52.

    Article  PubMed  Google Scholar 

  43. Schwartz TL, Siddiqui UA, Raza S, Morell M. Armodafinil for fibromyalgia fatigue. Ann Pharmacother. 2010;44(7–8):1347–8.

    Article  PubMed  Google Scholar 

  44. Skrabek RQ, Galimova L, Ethans K, Perry D. Nabilone for the treatment of pain in fibromyalgia. J Pain. 2008;9(2):164–73.

    Article  CAS  PubMed  Google Scholar 

  45. Sörensen J, Bengtsson A, Bäckman E, Henriksson KG, Bengtsson M. Pain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine, and ketamine. Scand J Rheumatol. 1995;24(6):360–5.

    Article  PubMed  Google Scholar 

  46. Spaeth M, Bennett RM, Benson BA, Wang YG, Lai C, Choy EH. Sodium oxybate therapy provides multidimensional improvement in fibromyalgia: results of an international phase 3 trial. Ann Rheum Dis. 2012;71(6):935–42.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  47. Staud R, Vierck CJ, Robinson ME, Price DD. Effects of the N-methyl-D-aspartate receptor antagonist dextromethorphan on temporal summation of pain are similar in fibromyalgia patients and normal control subjects. J Pain. 2005;6(5):323–32.

    Article  CAS  PubMed  Google Scholar 

  48. Ware MA, Fitzcharles MA, Joseph L, Shir Y. The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesth Analg. 2010;110(2):604–10.

    Article  CAS  PubMed  Google Scholar 

  49. Weber J, Schley M, Casutt M, Gerber H, Schuepfer G, Rukwied R, Schleinzer W, Ueberall M, Konrad C. Tetrahydrocannabinol (Delta 9-THC) treatment in chronic central neuropathic pain and fibromyalgia patients: results of a multicenter survey. Anesthesiol Res Pract. 2009;2009.

    Google Scholar 

  50. Younger J, Mackey S. Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study. Pain Med. 2009;10(4):663–72.

    Article  PubMed Central  PubMed  Google Scholar 

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Correspondence to Marni G. Hillinger MD .

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Hillinger, M., Rosenquist, E. (2015). Emerging Developments. In: Lawson, MD, E., Wallace, MD, M. (eds) Fibromyalgia. Springer, Cham. https://doi.org/10.1007/978-3-319-15820-4_11

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  • DOI: https://doi.org/10.1007/978-3-319-15820-4_11

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