Update to Chronic Pain – Fibromyalgia

31 May Update to Chronic Pain – Fibromyalgia

All TreatGx users now have access to the updated treatment algorithm for Chronic Pain – Fibromyalgia. This update incorporates information from the most recent clinical guidelines and literature, including the American College of Physicians[1], the European League Against Rheumatism[2], and the Cochrane Database of Systematic Reviews[3-6].  

The algorithm has been simplified for ease of use to give all medication options at a glance, and three new medication options (cyclobenzaprine, gabapentin, and milnacipran) have been added based on the latest evidence for efficacy and safety. Side effect profiles have been added for all medications.  

As always, this update includes the TreatGx standard of providing personalized dosing based on pharmacogenetics, kidney function, liver function, and drug interactions. 

References 

1. Bair MJ, Krebs EE:Fibromyalgia.Ann Intern Med 2020, 172(5):Itc33-itc48. 
2. Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Hauser W, Fluss E, Choy E, Kosek E, Amris K, Branco Jet al:EULAR revised recommendations for the management of fibromyalgia. Annals of the rheumatic diseases 2016. 
3. Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ:Amitriptyline for fibromyalgia in adults.Cochrane Database of Systematic Reviews 2015(7). 
4. Lunn MP, Hughes RA, Wiffen PJ:Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia.The Cochrane database of systematic reviews 2014, 1:CD007115. 
5. Wiffen PJ, Derry S, Moore RA, Aldington D, Cole P, Rice AS, Lunn MP, Hamunen K, Haanpaa M, Kalso EA:Antiepileptic drugs for neuropathic pain and fibromyalgia – an overview of Cochrane reviews.The Cochrane database of systematic reviews 2013, 11:CD010567. 
6. Uceyler N, Sommer C, Walitt B, Hauser W:Anticonvulsants for fibromyalgia.The Cochrane database of systematic reviews 2013(10):CD010782.