An Effective Drug for Fibromyalgia?

The title of this piece may seem a little surprising – most fibromyalgia patients will tell you that nothing works well, though lots of treatments work a bit. Many drugs show short-term benefit, but their effects usually don’t last long. Patients have to find, by trial and error, the treatment that works best for them. Now a study has been reported that describes long-term pain relief for fibromyalgia; it was presented at the American College of Rheumatology meeting this month.

A six-month, two-phase study in more than 1000 patients – chiefly women – was done at Northwestern, Chicago. In the first phase all of them took the drug, pregabalin (Lyrica®), for 6 weeks, increasing the dose as they felt comfortable, to a maximum of 600 mg daily. About two-thirds of them had a 50% reduction in their pain score, and were classified as ‘responders’. These patients were then invited to take part in a double-blind 6-month comparison of pregabalin with matching dummy tablets (placebo).

One in 4 placebo patients’ pain worsened within a week, compared to 34 days for those on pregabalin. At the end of six months the drug was no longer effective in a third of the patients on it, compared with two-thirds of those taking the placebo. Side effects were mild to moderate – dizziness, sleepiness, and anxiety.

Pregabalin is not approved for use in fibromyalgia, but then no prescription drug is approved. Its effectiveness in this study offer hope that it, or another drug of the same type, will prove to be a reliable treatment for this distressing complaint.