Combination Therapy Reduces Fibromyalgia Symptoms

Fibromyalgia does not only cause chronic widespread pain, it also impacts patients’ physical abilities, quality of sleep, and daily life. A new study found that combining two well-known medications for fibromyalgia is better than either therapy on its own.

The majority of studies on reducing fibromyalgia pain focus on monotherapy. However, a combination of medication may be the ticket to increased analgesic outcome. Ian Gilron, MD, MSc, FRCPC, a professor of anesthesiology and biomedical sciences at Queen’s University, and colleagues compared several monotherapy options to a pregabalin-duloxetine combination.

Thirty-nine patients with fibromyalgia were randomly assigned to receive placebo, pregabalin, duloxetine, or pregabalin-duloxetine combination at the maximally tolerated dosages for six weeks. The primary goal was to assess daily pain on a scale of one to 10. The participants also reported using the Fibromyalgia Impact Questionnaire (FIQ), SF-36 survey, MOS sleep scale, and Beck Depression Inventory (BDI-II), as well as adverse effects.

During the trial, the average pain levels were as follows: placebo (5.1), pregabalin (5.0), duloxetine (4.1), and pregabalin-duloxetine combination (3.7). Furthermore, patients reported global pain relief as follows: placebo (18%), pregabalin (39%), duloxetine (42%), and pregabalin-duloxetine combination (68%).

In addition, FIQ and MOS sleep scale scores were all the best in the combination group. The most common side effect with the pregabalin-duloxetine was moderate to severe drowsiness.

“Combining pregabalin and duloxetine for fibromyalgia improves multiple clinical outcomes versus monotherapy,” the authors summarized in the journal PAIN.

Although these are promising results, more research is needed to compare the combination treatment with other monotherapies. The team said that other drug combination should be explored as well.