Clinical question
How effective are oral nonsteroidal anti-inflammatory drugs (NSAIDs) for fibromyalgia in adults?
Bottom line
There was no evidence NSAIDs had any efficacy in relieving pain or other symptoms in people with fibromyalgia. Pain reduction by half or better was experienced by 1 in 10 with NSAID and 2 in 10 with placebo. Pain reduction by one-third or better was experienced by about 2 in 10 with both NSAID and placebo. There was limited evidence to indicate NSAIDs were without any effect. Side effects were experienced by 3 in 10 with NSAID and 2 in 10 with placebo. There were no serious adverse effects or deaths. NSAIDs tested were etoricoxib 90mg daily, ibuprofen 2400mg daily, naproxen 1000mg daily and tenoxicam 20mg daily. The duration of treatment in the double-blind phase varied between 3 and 8 weeks.
Caveat
There were only a small number of studies, and these were largely inadequate, with potential risk of bias.
Context
Fibromyalgia is characterised by persistent, widespread pain, sleep problems and fatigue. NSAIDs are frequently used to treat rheumatic diseases.
Cochrane Systematic Review
Derry S et al. Oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults. Cochrane Reviews, 2017, Issue 3. Art. No.: CD012332.DOI: 10.1002/14651858. CD012332.pub2. This review contains 6 studies involving 292 participants.
Cochrane Systematic Reviews for primary care practitioners – developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health. Brian McAvoy is an honorary/adjunct professor of general practice at the Universities of Auckland, Melbourne, Monash and Queensland. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
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