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01.10.2014 | Therapy in Practice

Management of Fibromyalgia in Older Adults

verfasst von: Mary-Ann Fitzcharles, Peter A. Ste-Marie, Yoram Shir, David Lussier

Erschienen in: Drugs & Aging | Ausgabe 10/2014

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Abstract

Fibromyalgia (FM) is a pain syndrome characterized by dysregulation of pain-processing mechanisms. FM may arise de novo or evolve following nervous system sensitization after an identifiable triggering event or related to a peripheral pain generator such as osteoarthritis. Although the focus symptom of FM is generalized body pain, patients may also experience sleep and mood disturbance, fatigue, and other somatic symptoms leading to the concept of a polysymptomatic condition. In view of prevalent other comorbidities in older patients, FM may be overlooked and management may be neglected, thereby contributing to poor well-being. Pertinent to the older patient is to ensure that the diagnosis of FM is correct and that other conditions are not misdiagnosed as FM. Whereever possible, treatment strategies should emphasize non-pharmacologic interventions that encompass healthy lifestyle habits, with attention to adequate physical activity in particular. Drug treatments should be tailored to the individual needs of the patient, with knowledge that they may offer only a modest effect, but with caution to ensure that adverse effects do not overshadow therapeutic effects.

Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62(5):600–10.CrossRef

Wolfe F, Anderson J, Harkness D, Bennett RM, Caro XJ, Goldenberg DL, et al. Health status and disease severity in fibromyalgia: results of a six-center longitudinal study. Arthritis Rheum. 1997;40(9):1571–9.PubMedCrossRef

Walitt B, Fitzcharles MA, Hassett AL, Katz RS, Hauser W, Wolfe F. The longitudinal outcome of fibromyalgia: a study of 1555 patients. J Rheumatol. 2011;38(10):2238–46.PubMedCrossRef

Jacobson SA, Simpson RG, Lubahn C, Hu C, Belden CM, Davis KJ, et al. Characterization of fibromyalgia symptoms in patients 55–95 years old: a longitudinal study showing symptom persistence with suboptimal treatment. Aging Clin Exp Res. 2014 [Epub ahead of print].

Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33(2):160–72.PubMedCrossRef

Buskila D, Neumann L. Fibromyalgia syndrome (FM) and nonarticular tenderness in relatives of patients with FM. J Rheumatol. 1997;24(5):941–4.PubMed

Buskila D, Neumann L, Hazanov I, Carmi R. Familial aggregation in the fibromyalgia syndrome. Semin Arthritis Rheum. 1996;26(3):605–11.PubMedCrossRef

McBeth J, Silman AJ, Gupta A, Chiu YH, Ray D, Morriss R, et al. Moderation of psychosocial risk factors through dysfunction of the hypothalamic-pituitary-adrenal stress axis in the onset of chronic widespread musculoskeletal pain: findings of a population-based prospective cohort study. Arthritis Rheum. 2007;56(1):360–71.PubMedCrossRef

Greenfield S, Fitzcharles MA, Esdaile JM. Reactive fibromyalgia syndrome. Arthritis Rheum. 1992;35(6):678–81.PubMedCrossRef

10.

Miranda VS, Decarvalho VB, Machado LA, Dias JM. Prevalence of chronic musculoskeletal disorders in elderly Brazilians: a systematic review of the literature. BMC Musculoskelet Disord. 2012;13:82.PubMedCrossRefPubMedCentral

11.

Jordan KP, Kadam UT, Hayward R, Porcheret M, Young C, Croft P. Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskelet Disord. 2010;11:144.PubMedCrossRefPubMedCentral

12.

Thomas E, Peat G, Harris L, Wilkie R, Croft PR. The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP). Pain. 2004;110(1–2):361–8.PubMedCrossRef

13.

Wolfe F, Brahler E, Hinz A, Hauser W. Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: results from a survey of the general population. Arthritis Care Res (Hoboken). 2013;65(5):777–85. doi:10.1002/acr.21931.CrossRef

14.

Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken). 2013;65(5):786–92. doi:10.1002/acr.21896.CrossRef

15.

McBeth J, Lacey RJ, Wilkie R. Predictors of new-onset widespread pain in older adults: results from a population-based prospective cohort study in the UK. Arthritis Rheumatol (Hoboken, NJ). 2014;66(3):757–67.CrossRef

16.

Campos RP, Vazquez MI. The impact of fibromyalgia on health-related quality of life in patients according to age. Rheumatol Int. 2013;33(6):1419–24.PubMedCrossRef

17.

Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–7.PubMedCrossRefPubMedCentral

18.

Goldenberg DL. Diagnosis and differential diagnosis of fibromyalgia. Am J Med. 2009;122(12 Suppl):S14–21.PubMedCrossRef

19.

Fitzcharles MA, Ste-Marie PA, Goldenberg DL, Pereira JX, Abbey S, Choiniere M, et al. 2012 Canadian Guidelines for the diagnosis and management of fibromyalgia syndrome: executive summary. Pain Res Manag. 2013;18(3):119–26.PubMedPubMedCentral

20.

Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology. 2003;42(2):263–7.PubMedCrossRef

21.

Fitzcharles MA, Esdaile JM. The overdiagnosis of fibromyalgia syndrome. Am J Med. 1997;103(1):44–50.PubMedCrossRef

22.

Fassbender K, Samborsky W, Kellner M, Muller W, Lautenbacher S. Tender points, depressive and functional symptoms: comparison between fibromyalgia and major depression. Clin Rheumatol. 1997;16(1):76–9.PubMedCrossRef

23.

Abd TT, Jacobson TA. Statin-induced myopathy: a review and update. Expert Opin Drug Saf. 2011;10(3):373–87.PubMedCrossRef

24.

Henry NL, Jacobson JA, Banerjee M, Hayden J, Smerage JB, Van Poznak C, et al. A prospective study of aromatase inhibitor-associated musculoskeletal symptoms and abnormalities on serial high-resolution wrist ultrasonography. Cancer. 2010;116(18):4360–7.PubMedCrossRefPubMedCentral

25.

Papapetrou PD. Bisphosphonate-associated adverse events. Hormones (Athens). 2009;8(2):96–110.CrossRef

26.

Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, Buskila D, et al. EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis. 2008;67(4):536–41.PubMedCrossRef

27.

Hauser W, Arnold B, Eich W, Felde E, Flugge C, Henningsen P, et al. Management of fibromyalgia syndrome: an interdisciplinary evidence-based guideline. Ger Med Sci. 2008;6:14.

28.

Nuesch E, Hauser W, Bernardy K, Barth J, Juni P. Comparative efficacy of pharmacological and non-pharmacological interventions in fibromyalgia syndrome: network meta-analysis. Ann Rheum Dis. 2013;72(6):955–62.PubMedCrossRef

29.

Gore M, Sadosky A, Zlateva G, Clauw D. Initial use of pregabalin, patterns of pain-related pharmacotherapy, and healthcare resource use among older patients with fibromyalgia. Am J Manag Care. 2010;16(5 Suppl):S144–53.PubMed

30.

Hauser W, Bernardy K, Arnold B, Offenbacher M, Schiltenwolf M. Efficacy of multicomponent treatment in fibromyalgia syndrome: a meta-analysis of randomized controlled clinical trials. Arthritis Rheum. 2009;61(2):216–24.PubMedCrossRef

31.

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

32.

Karsdorp PA, Vlaeyen JW. Active avoidance but not activity pacing is associated with disability in fibromyalgia. Pain. 2009;147(1–3):29–35.PubMedCrossRef

33.

Lynch ME. The pharmacotherapy of chronic pain. Rheum Dis Clin N Am. 2008;34(2):369–85.CrossRef

34.

Chandrasekharan NV, Dai H, Roos KL, Evanson NK, Tomsik J, Elton TS, et al. COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: cloning, structure, and expression. Proc Natl Acad Sci. 2002;99(21):13926–31.PubMedCrossRefPubMedCentral

35.

Hogestatt ED, Jonsson BA, Ermund A, Andersson DA, Bjork H, Alexander JP, et al. Conversion of acetaminophen to the bioactive N-acylphenolamine AM404 via fatty acid amide hydrolase-dependent arachidonic acid conjugation in the nervous system. J Biol Chem. 2005;280(36):31405–12.PubMedCrossRef

36.

Guggenheimer J, Moore PA. The therapeutic applications of and risks associated with acetaminophen use: a review and update. J Am Dent Assoc. 2011;142(1):38–44.PubMedCrossRef

37.

Lynch ME, Watson CP. The pharmacotherapy of chronic pain: a review. Pain Res Manag. 2006;11(1):11–38.PubMedPubMedCentral

38.

Launay-Vacher V, Karie S, Fau JB, Izzedine H, Deray G. Treatment of pain in patients with renal insufficiency: the World Health Organization three-step ladder adapted. J Pain. 2005;6(3):137–48.PubMedCrossRef

39.

Wolfe F, Zhao S, Lane N. Preference for nonsteroidal antiinflammatory drugs over acetaminophen by rheumatic disease patients: a survey of 1,799 patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Arthritis Rheum. 2000;43(2):378–85.PubMedCrossRef

40.

Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC Musculoskelet Disord. 2007;8:27.PubMedCrossRefPubMedCentral

41.

American Geriatrics Society Panel on Pharmacological Management of Persistent Pain in Older Persons. J Am Geriatr Soc 2009;57(8):1331–46. doi:10.1111/j.1532-5415.2009.02376.x

42.

Tannenbaum H, Bombardier C, Davis P, Russell AS. An evidence-based approach to prescribing nonsteroidal antiinflammatory drugs: Third Canadian Consensus Conference. J Rheumatol. 2006;33(1):140–57.PubMed

43.

Manchikanti L, Fellows B, Ailinani H, Pampati V. Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective. Pain Phys. 2010;13(5):401–35.

44.

Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med. 2010;363(21):1981–5.PubMedCrossRef

45.

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.PubMedCrossRef

46.

Biasi G, Manca S, Manganelli S, Marcolongo R. Tramadol in the fibromyalgia syndrome: a controlled clinical trial versus placebo. Int J Clin Pharmacol Res. 1998;18(1):13–9.PubMed

47.

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

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.PubMedCrossRef

49.

Fiz J, Duran M, Capella D, Carbonell J, Farre M. Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life. PLoS One. 2011;6(4):e18440.PubMedCrossRefPubMedCentral

50.

Siler AC, Gardner H, Yanit K, Cushman T, McDonagh M. Systematic review of the comparative effectiveness of antiepileptic drugs for fibromyalgia. J Pain. 2011;12(4):407–15.PubMedCrossRef

51.

Holtedahl R. Questionable documentation of the effect of pregabalin in fibromyalgia. Tidsskr Nor Laegeforen. 2010;130(10):1032–6.PubMedCrossRef

52.

Tzellos TG, Toulis KA, Goulis DG, Papazisis G, Zampeli VA, Vakfari A, et al. Gabapentin and pregabalin in the treatment of fibromyalgia: a systematic review and a meta-analysis. J Clin Pharm Ther. 2010;35(6):639–56.PubMedCrossRef

53.

Rogawski MA, Loscher W. The neurobiology of antiepileptic drugs for the treatment of nonepileptic conditions. Nat Med. 2004;10(15229516):685–92.PubMedCrossRef

54.

Hauser W, Bernardy K, Uceyler N, Sommer C. Treatment of fibromyalgia syndrome with gabapentin and pregabalin: a meta-analysis of randomized controlled trials. Pain. 2009;145(1–2):69–81.PubMedCrossRef

55.

Goldenberg DL, Clauw DJ, Fitzcharles MA. New concepts in pain research and pain management of the rheumatic diseases. Semin Arthritis Rheum. 2011;41(3):319–34.PubMedCrossRef

56.

Boomershine CS, Crofford LJ. A symptom-based approach to pharmacologic management of fibromyalgia. Nat Rev Rheumatol. 2009;5(4):191–9.PubMedCrossRef

57.

Moore RA, Straube S, Wiffen PJ, Derry S, McQuay HJ. Pregabalin for acute and chronic pain in adults. Cochrane Database Syst Rev. 2009 (3):CD007076.

58.

Randinitis EJ, Posvar EL, Alvey CW, Sedman AJ, Cook JA, Bockbrader HN. Pharmacokinetics of pregabalin in subjects with various degrees of renal function. J Clin Pharmacol. 2003;43(3):277–83.PubMedCrossRef

59.

Arnold LM, Keck PE Jr, Welge JA. Antidepressant treatment of fibromyalgia: a meta-analysis and review. Psychosomatics. 2000;41(2):104–13.PubMedCrossRef

60.

Crofford LJ. Meta-analysis of antidepressants in fibromyalgia. Curr Rheumatol Rep. 2001;3(2):115.PubMed

61.

O’Malley PG, Balden E, Tomkins G, Santoro J, Kroenke K, Jackson JL. Treatment of fibromyalgia with antidepressants: a meta-analysis. J Gen Intern Med. 2000;15(9):659–66.PubMedCrossRefPubMedCentral

62.

Hauser W, Bernardy K, Uceyler N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants: a meta-analysis. JAMA. 2009;301(2):198–209.PubMedCrossRef

63.

Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy or chronic pain. Cochrane Database Syst Rev. 2009 (4):CD007115.

64.

Nishishinya B, Urrutia G, Walitt B, Rodriguez A, Bonfill X, Alegre C, et al. Amitriptyline in the treatment of fibromyalgia: a systematic review of its efficacy. Rheumatology. 2008;47(12):1741–6.PubMedCrossRef

65.

Perrot S, Javier RM, Marty M, Le Jeunne C, Laroche F, Cedr FRSPSS. Is there any evidence to support the use of anti-depressants in painful rheumatological conditions? Systematic review of pharmacological and clinical studies. Rheumatology. 2008;47(8):1117–23.PubMedCrossRef

66.

Sultan A, Gaskell H, Derry S, Moore RA. Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials. BMC Neurol. 2008;8(29):29.PubMedCrossRefPubMedCentral

67.

Uceyler N, Hauser W, Sommer C. A systematic review on the effectiveness of treatment with antidepressants in fibromyalgia syndrome. Arthritis Care Res. 2008;59(9):1279–98.CrossRef

68.

Chan HN, Fam J, Ng BY. Use of antidepressants in the treatment of chronic pain. Ann Acad Med Singap. 2009;38(11):974–9.PubMed

69.

Heymann RE, Helfenstein M, Feldman D. A double-blind, randomized, controlled study of amitriptyline, nortriptyline and placebo in patients with fibromyalgia: an analysis of outcome measures. Clin Exp Rheumatol. 2001;19(6):697–702.PubMed

70.

Tofferi JK, Jackson JL, O’Malley PG. Treatment of fibromyalgia with cyclobenzaprine: a meta-analysis. Arthritis Rheum. 2004;51(1):9–13.PubMedCrossRef

71.

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.PubMedCrossRef

72.

Jung AC, Staiger T, Sullivan M. The efficacy of selective serotonin reuptake inhibitors for the management of chronic pain. J Gen Intern Med. 1997;12(6):384–9.PubMedCrossRefPubMedCentral

73.

Chappell AS, Littlejohn G, Kajdasz DK, Scheinberg M, D’Souza DN, Moldofsky H. A 1-year safety and efficacy study of duloxetine in patients with fibromyalgia. Clin J Pain. 2009;25(5):365–75.PubMedCrossRef

74.

Chwieduk CM, McCormack PL. Milnacipran: in fibromyalgia. Drugs. 2010;70(1):99–108.PubMedCrossRef

75.

Arnold LM, Lu Y, Crofford LJ, Wohlreich M, Detke MJ, Iyengar S, et al. A double-blind, multicenter trial comparing duloxetine with placebo in the treatment of fibromyalgia patients with or without major depressive disorder. Arthritis Rheum. 2004;50(9):2974–84.PubMedCrossRef

76.

Arnold LM, Rosen A, Pritchett YL, D’Souza DN, Goldstein DJ, Iyengar S, et al. A randomized, double-blind, placebo-controlled trial of duloxetine in the treatment of women with fibromyalgia with or without major depressive disorder. Pain. 2005;119(1–3):5–15.PubMedCrossRef

77.

Clauw DJ, Mease P, Palmer RH, Gendreau RM, Wang Y. Milnacipran for the treatment of fibromyalgia in adults: a 15-week, multicenter, randomized, double-blind, placebo-controlled, multiple-dose clinical trial. [Erratum appears in Clin Ther. 2009 Jul; 31(7):1617]. [Erratum appears in Clin Ther. 2009 Feb; 31(2):446]. Clin Ther. 2008;30(11):1988–2004.PubMedCrossRef

78.

Gendreau RM, Thorn MD, Gendreau JF, Kranzler JD, Ribeiro S, Gracely RH, et al. Efficacy of milnacipran in patients with fibromyalgia. J Rheumatol. 2005;32(10):1975–85.PubMed

79.

Goldenberg DL, Clauw DJ, Palmer RH, Mease P, Chen W, Gendreau RM. Durability of therapeutic response to milnacipran treatment for fibromyalgia: results of a randomized, double-blind, monotherapy 6-month extension study. Pain Med. 2010;11(2):180–94.PubMedCrossRef

80.

Choy EHS, Mease PJ, Kajdasz DK, Wohlreich MM, Crits-Christoph P, Walker DJ, et al. Safety and tolerability of duloxetine in the treatment of patients with fibromyalgia: pooled analysis of data from five clinical trials. Clin Rheumatol. 2009;28(9):1035–44.PubMedCrossRefPubMedCentral

81.

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.PubMedCrossRef

82.

Drewes AM, Andreasen A, Jennum P, Nielsen KD. Zopiclone in the treatment of sleep abnormalities in fibromyalgia. Scand J Rheumatol. 1991;20(4):288–93.PubMedCrossRef

83.

Gronblad M, Nykanen J, Konttinen Y, Jarvinen E, Helve T. Effect of zopiclone on sleep quality, morning stiffness, widespread tenderness and pain and general discomfort in primary fibromyalgia patients: a double-blind randomized trial. Clin Rheumatol. 1993;12(2):186–91.PubMedCrossRef

84.

Potvin S, Morin M, Cloutier C, Gendron A, Bissonnette A, Marchand S. Add-on treatment of quetiapine for fibromyalgia: a pilot, randomized, double-blind, placebo-controlled 12-week trial. J Clin Psychopharmacol. 2012;32(5):684–7.PubMedCrossRef

85.

Calandre EP, Rico-Villademoros F, Galan J, Molina-Barea R, Vilchez JS, Rodriguez-Lopez CM, et al. Quetiapine extended-release (Seroquel-XR) versus amitriptyline monotherapy for treating patients with fibromyalgia: a 16-week, randomized, flexible-dose, open-label trial. Psychopharmacology. 2014;231(12):2525–31.PubMedCrossRef

86.

Hidalgo J, Rico-Villademoros F, Calandre EP. An open-label study of quetiapine in the treatment of fibromyalgia. Prog Neuro Psychopharmacol Biol Psychiatry. 2007;31(1):71–7.CrossRef

87.

McIntyre A, Paisley D, Kouassi E, Gendron A. Quetiapine fumarate extended-release for the treatment of major depression with comorbid fibromyalgia syndrome: a double-blind, randomized, placebo-controlled study. Arthritis Rheumatol (Hoboken, NJ). 2014;66(2):451–61.CrossRef

88.

Citera G, Arias MA, Maldonado-Cocco JA, Lazaro MA, Rosemffet MG, Brusco LI, et al. The effect of melatonin in patients with fibromyalgia: a pilot study. Clin Rheumatol. 2000;19(1):9–13.PubMedCrossRef

89.

Vergne-Salle P, Dufauret-Lombard C, Bonnet C, Simon A, Trèves R, Bonnabau H, et al. A randomised, double-blind, placebo-controlled trial of dolasetron, a 5-hydroxytryptamine 3 receptor antagonist, in patients with fibromyalgia. Eur J Pain. 2011;15(5):509–14.

Titel: Management of Fibromyalgia in Older Adults
verfasst von: Mary-Ann Fitzcharles
Peter A. Ste-Marie
Yoram Shir
David Lussier
Publikationsdatum: 01.10.2014
Verlag: Springer International Publishing
Erschienen in: Drugs & Aging / Ausgabe 10/2014
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI: https://doi.org/10.1007/s40266-014-0210-4

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