Year 2019, Volume 58 , Issue , Pages 43 - 47 2019-10-25

Fibromiyaljide güncel ilaç tedavisi
Current drug treatment in fibromyalgia

Seval Pehlevan [1]


Fibromiyalji (FM); kronik ağrı, yorgunluk ve fonksiyon bozukluğu ile karakterize bir hastalıktır. Genetik yatkınlık beraber çevresel ve psikolojik faktörlerde hastalığın oluşumda etkili olabilir. Serotonin ve katekolaminlerin ileti bozukluğu FM’de ağrı mekanizmasında rol oynar. İlaç tedavisi ağrıyı azaltmaya ve diğer semptomların iyileşmesine odaklanır. Hastalığın tedavisinde eğitim, bilişsel davranışçı terapi, egzersiz gibi ilaç dışı tedaviler ve farmakolojik tedavilerin yer aldığı çok yönlü yaklaşım gereklidir. FM’de tedavi, hastanın semptomlarının sayısına ve çeşitliliğine göre, tek bir uzman veya bir takım (romatoloji uzmanı, nöroloji uzmanı, psikiyatri uzmanı) tarafından yapılır. Farmakolojik tedavide en sık antidepresanlar (amitriptilin, siklobenzaprin, duloksetin, milnasipran) ve antikonvülsanlar (pregabalin, gabapentin) kullanılır. Uluslararası FM tedavi önerileri temel olarak aerobik egzersiz, bilişsel-davranışçı terapi ve amitriptilin gibi ilaç tedavisi yapılmasına odaklanmaktadır.

Fibromyalgia (FM), a disorder characterized by widespread chronic musculoskeletal pain, fatigue and dysfunction. Together with the genetic predisposition, it may be effective in the emergence of the disease in environmental and psychological factors. The aim of drug therapy in fibromyalgia is to reduce pain and improve other symptoms. Non-pharmacological therapies like cognitive behavioral therapies, training, exercise and pharmacologic therapies need versatile approach. Fibromyalgia treatment is performed by a single specialist or a team (rheumatologist, neurologist, and psychiatrist) according to the number and variety of the patient's symptoms. In pharmacological treatment, antidepressants (amitriptyline, cyclobenzaprine, duloxetine, milnacipran) and anticonvulsants (pregabalin, gabapentin) are most commonly used. International fibromyalgia treatment recommendations focus mainly on aerobic exercise, cognitive-behavioral therapy and drug therapy such as amitriptyline

  • Kia S, Choy E. Uptodate on treatment guideline in fibromyalgia syndrome with focus on pharmacology. Biomedicines 2017,5(2). pii: E20. doi: 10.3390/biomedicines5020020.
  • Clauw D. Fibromyalgia a clinical review. JAMA 2014;311(15):1547-55.
  • Liu Y, Qian C,Yang M, Treatment Patterns Associated with ACR-Recommended Medications in the Management of Fibromyalgia in the United States. J Manag Care Spec Pharm 2016;22(3):263-71.
  • Theoharides TC, Tsilioni I, Arbetman L, et al. Fibromyalgia syndrome in need of effective treatments. J Pharmacol Exp Ther 2015;355(2):255-63.
  • Hauser W, Abline J, Perrot S, Fitzcharless MA. Management of fibromyalgia: key messaes from evidence-based guidelines. Pol Arch Intern Med 2017;127(1):47-56.
  • Borchers AT, Gershwin ME. Fibromyalgia: a critical and comprehensive review. Clinic Rev Allerg Immunol 2015;49(2):100-51.
  • Walitt B, Urruita G, Nishishinya MB, Cantrell SE, Hauser W. Selective serotonin reuptake inhibitors for fibromyalgia syndrome. Cochrane Database of Systematic Reviews, 2015 Jun 5;(6): CD011735. doi: 10.1002/14651858.CD011735.
  • Moldofsky H, Harris HW, Archambault WT, Kwong T, Lederman S. Effects of bedtime very low dose cyclobenzaprine on symptoms and sleep physiology in patients with fibromyalgia syndrome: a double-blind randomized placebo-controlled study. J Rheumatol. 2011;38(12):2653-63.
  • Walitt B, Urrútia G, Nishishinya MB, Cantrell SE, Häuser W. Selective serotonin reuptake inhibitors for fibromyalgia syndrome. Cochrane Database Syst Rev 2015 Jun 5;(6):CD011735.
  • Lunn MPT. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev 2014 Jan 3;(1)
  • Cording M, Derry S, Phillips T, Moore RA, Wiffen PJ. Milnacipran for pain in fibromyalgia in adults. Cochrane Database Syst Rev 2015 Oct 20;(10):CD008244.
  • Arnold LM, Gendreau MR, Palmer RH, Gendreau JF, Wang Y. Efficacy and safety of milnacipran 100 mg/day in patients with fibromyalgia results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2010;62(9):2745-56.
  • Mease PJ, Dundon K, Sarzi-Puttini P. Pharmacotherapy of fibromyalgia. Best Pract Res Clin Rheumatol 2011;25(2):285-97.
  • Crofford LJ, Rowbotham MC, Mease PJ, et al. Pregabalin for the treatment of fibromyalgia syndrome: results of a randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2005;52(4):1264-73.
  • Arnold LM, Russell IJ, Diri EW, et al. A 14-week, randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia. J Pain 2008;9(9):792-805.
  • Pauer L, Winkelmann A, Arsenault P, et al. An international, randomized, double-blind, placebo-controlled, phase III trial of pregabalin monotherapy in treatment of patients with fibromyalgia. J Rheumatol 2011;38(12):2643-52.
  • Crofford LJ, Mease PJ, Susan L, et al. Fibromyalgia relapse evaluation and efficacy for durability of meaningful relief (FREEDOM): A 6-month, double-blind, placebo-controlled trial with pregabalin. Pain 2008;136(3):419-31.
  • Rose MA, Kam PC. Gabapentin: pharmacology and its use in pain management. Anaesthesia 2002;57(5):451-62.
  • Arnold LM, Goldenberg DL, Stanford SB, et al. Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum 2007;56(4):1336-44.
  • Clauw DJ. Fibromyalgia: a clinical review. JAMA 2014;311(15):1547-55.
  • Goldenberg DL, Felson DT, Dinerman H. A randomized, controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia. Arthritis Rheum 1986;29(11):1371-7.
  • MacLean AJ, Schwartz TL. Tramadol for the treatment of fibromyalgia. Expert Rev Neurother 2015;15(5):469-75.
  • 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 May;114(7):537-45.
  • Aşkın A, Özkan A. Pharmacological treatment in fibromyalgia. Archives Medical Review Journal 2017;26(1):124-41.
  • Tort S, Urrútia G, Nishishinya MB, Walitt B. Monoamine oxidase inhibitors (MAOIs) for fibromyalgia syndrome. Cochrane Database Syst Rev 2012 Apr18;(4):CD009807.
  • Lee YH, Song GG. Comparative efficacy and tolerability of duloxetine, pregabalin, and milnacipran for the treatment of fibromyalgia: a Bayesian network meta‑analysis of randomized controlled trials Rheumatol Int 2016;36(5):663-72.
  • Kim SC, Landon JE, Solomon DH. Clinical characteristics and medication uses among fibromyalgia patients newly prescribed amitriptyline, duloxetine, gabapentin, or pregabalin. Arthritis Care Res (Hoboken) 2013;65(11):1813-9.
  • Gilron I, Chaparro LE, Tu D, et al. Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial. Pain 2016;157(7):1532-40.
  • Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2017;76(2):318-28.
  • Talotta R, Bazzichi L, Di Franco M, et al. One year in review 2017: fibromyalgia. Clin Exp Rheumatol 2017;35 (Suppl.105):6-12.
Primary Language tr
Journal Section Supplement
Authors

Orcid: 0000-0003-3800-7868
Author: Seval Pehlevan (Primary Author)
Institution: Özel Medical Park Gebze Hastanesi, İç Hastalıkları Romatoloji Kliniği, Kocaeli
Country: Turkey


Dates

Publication Date : October 25, 2019

Bibtex @other { etd649156, journal = {Ege Tıp Dergisi}, issn = {1016-9113}, eissn = {2147-6500}, address = {}, publisher = {Ege University}, year = {2019}, volume = {58}, pages = {43 - 47}, doi = {10.19161/etd.649156}, title = {Fibromiyaljide güncel ilaç tedavisi}, key = {cite}, author = {Pehlevan, Seval} }
APA Pehlevan, S . (2019). Fibromiyaljide güncel ilaç tedavisi. Ege Tıp Dergisi , 58 () , 43-47 . DOI: 10.19161/etd.649156
MLA Pehlevan, S . "Fibromiyaljide güncel ilaç tedavisi". Ege Tıp Dergisi 58 (2019 ): 43-47 <http://egetipdergisi.com.tr/en/issue/50237/649156>
Chicago Pehlevan, S . "Fibromiyaljide güncel ilaç tedavisi". Ege Tıp Dergisi 58 (2019 ): 43-47
RIS TY - JOUR T1 - Fibromiyaljide güncel ilaç tedavisi AU - Seval Pehlevan Y1 - 2019 PY - 2019 N1 - doi: 10.19161/etd.649156 DO - 10.19161/etd.649156 T2 - Ege Tıp Dergisi JF - Journal JO - JOR SP - 43 EP - 47 VL - 58 IS - SN - 1016-9113-2147-6500 M3 - doi: 10.19161/etd.649156 UR - https://doi.org/10.19161/etd.649156 Y2 - 2019 ER -
EndNote %0 Ege Tıp Dergisi Fibromiyaljide güncel ilaç tedavisi %A Seval Pehlevan %T Fibromiyaljide güncel ilaç tedavisi %D 2019 %J Ege Tıp Dergisi %P 1016-9113-2147-6500 %V 58 %N %R doi: 10.19161/etd.649156 %U 10.19161/etd.649156
ISNAD Pehlevan, Seval . "Fibromiyaljide güncel ilaç tedavisi". Ege Tıp Dergisi 58 / (October 2019): 43-47 . https://doi.org/10.19161/etd.649156
AMA Pehlevan S . Fibromiyaljide güncel ilaç tedavisi. Ege Tıp Dergisi. 2019; 58: 43-47.
Vancouver Pehlevan S . Fibromiyaljide güncel ilaç tedavisi. Ege Tıp Dergisi. 2019; 58: 47-43.