Современные подходы к терапии фибромиалгии

Фибромиалгия (ФМ) встречается у 5–12% пациентов, но относительно редко диагностируется, поэтому большинство пациентов не получают эффективного лечения. В обзоре анализируются лекарственные и нелекарственные методы терапии ФМ. Отмечается, что в качестве лекарственных средств наиболее эффективны антидепрессанты (дулоксетин, милнаципран, амитриптилин) и противоэпилептические средства (прегабалин, габапентин). Из нелекарственных методов терапии показана эффективность когнитивно-поведенческой терапии, майндфулнесс (терапии осознанности), кинезитерапии и биологической обратной связи. При ведении пациентов с ФМ комбинация немедикаментозных методов и лекарственных средств позволяет уменьшить боль и повысить качество жизни.

1. Arnold LM, Bennett RM, Crofford LJ, et al. AAPT Diagnostic Criteria for Fibromyalgia. J Pain. 2019;20(6):611-28. doi: 10.1016/j.jpain.2018.10.008

2. Häuser W, Kosseva M, Üceyler N, et al. Emotional, physical, and sexual abuse in fibromyalgia syndrome: A systematic review with meta-analysis. Arthritis Care Res. 2011;63(6):808-20. doi: 10.1002/acr.20328

3. Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in the general population: Sex, pain threshold, and fibromyalgia symptoms. J Rheumatol. 1995;22(1):151-6. doi: 10.1002/art.1780380104

4. Стороженко ОН. Распространенность и факторы риска синдромов фибромиалгии и хронической генерализованной боли в популяции г. Екатеринбурга: Дисс. … канд. мед. наук. Москва; 2004. 171 c. Доступно по ссылке: https://rusneb.ru/catalog/000199_000009_004060836/

5. Jones GT, Atzeni F, Beasley M, et al. The prevalence of fibromyalgia in the general population: A comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheum. 2015;67(2):568-75. doi: 10.1002/art.38905

6. Sawaddiruk P, Paiboonworachat S, Chattipakorn N, et al. Alterations of brain activity in fibromyalgia patients. J Clin Neurosci. 2017 Apr;38:13-22. doi: 10.1016/j.jocn.2016.12.014. Epub 2017 Jan 10.

7. Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2016;76(2):318-28. doi: 10.1136/annrheumdis-2016-209724

8. Clauw DJ. Fibromyalgia: A clinical review. JAMA. 2014 Apr 16;311(15):1547-55. doi: 10.1001/jama.2014.3266

9. 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. doi: 10.1002/art.1780291110

10. Carette S, McCain GA, Bell DA, et al. Evaluation of amitriptyline in primary fibrositis. A double-blind, placebo-controlled study. Arthritis Rheum. 1986;29(5):655-9. doi: 10.1002/art.1780290510

11. Bennett RM, Gatter RA, Campbell SM, et al. A comparison of cyclobenzaprine and placebo in the management of fibrositis. A double-blind controlled study. Arthritis Rheum. 1988;31(12):1535-42. doi: 10.1002/art.1780311210

12. Tofferi JK, Jackson JL, O'Malley PG. Treatment of fibromyalgia with cyclobenzaprine: A meta-analysis. Arthritis Rheum. 2004;51(1):9-13. doi: 10.1002/art.20076

13. Arnold LM, Keck PE, Welge JA. Antidepressant treatment of fibromyalgia. A meta-analysis and review. Psychosomatics. 2000;41(2):104-13. doi: 10.1176/appi.psy.41.2.104

14. O'Malley PG, Balden E, Tomkins G, et al. Treatment of fibromyalgia with antidepressants: a meta-analysis. J Gen Intern Med. 2000;15(9):659-66. doi: 10.1046/j.15251497.2000.06279.x

15. Üceyler N, Häuser W, Sommer C. A systematic review on the effectiveness of treatment with antidepressants in fibromyalgia syndrome. Arthritis Rheum. 2008 Sep 15;59(9):1279-98. doi: 10.1002/art.24000

16. Häuser W, Petzke F, Üceyler N, et al. Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: a systematic review with meta-analysis. Rheumatology (Oxford). 2011 Mar;50(3):532-43. doi: 10.1093/rheumatology/keq354. Epub 2010 Nov 14.

17. Rico-Villademoros F, Slim M, Calandre EP. Amitriptyline for the treatment of fibromyalgia: a comprehensive review. Exp Rev Neurother. 2015;15(10):1123-50. doi: 10.1586/14737175.2015.1091726. Epub 2015 Sep 22.

18. Häuser W, Petzke F, Sommer C. Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome. J Pain. 2010;11(6):505-21. doi: 10.1016/j.jpain.2010.01.002. Epub 2010 Apr 24.

19. Häuser W, Urrutia G, Tort S, et al. Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD010292. doi: 10.1002/14651858.cd010292

20. Welsch P, Üceyler N, Klose P, et al. Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia. Cochrane Database Syst Rev. 2018 Feb 28;2(2):CD010292. doi: 10.1002/14651858.cd010292.pub2

21. Arnold LM, Lu Y, Crofford LJ, et al. A double-blind, multicenter trial comparing duloxetine with placebo in the treatment o f fibromyalgia patients with or without major depressive disorder. Arthritis Rheum. 2004;50(9):2974-84. doi: 10.1002/art.20485

22. Arnold LM, Rosen A, Pritchett YL, 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. doi: 10.1016/j.pain.2005.06.031

23. Russell IJ, Mease PJ, Smith TR, et al. Efficacy and safety of duloxetine for treatment of fibromyalgia in patients with or without major depressive disorder: Results from a 6-month, randomized, double-blind, placebo-controlled, fixed-dose trial. Pain. 2008;136(3):432-44. doi: 10.1016/j.pain.2008.02.024

24. Vitton O, Gendreau M, Gendreau J, et al. A double-blind placebo-controlled trial of milnacipran in the treatment of fibromyalgia. Hum Psychopharmacol. 2004;19(S1):S27-S35. doi: 10.1002/hup.622

25. Gendreau RM, Thorn MD, Gendreau JF, et al. Efficacy of milnacipran in patients with fibromyalgia. J Rheumatol. 2005;32(10):1975-85.

26. Branco JC, Zachrisson O, Perrot S, et al. A European multicenter randomized double-blind placebo-controlled monotherapy clinical trial of milnacipran in treatment of fibromyalgia. J Rheumatol. 2010 Apr;37(4):851-9. doi: 10.3899/jrheum.090884. Epub 2010 Feb 15.

27. Arnold LM, Gendreau RM, Palmer RH, et al. Efficacy and safety of milnacipran 100 mg/day in patients with fibromyalgia: results of a randomized, double-blind, placebocontrolled trial. Arthritis Rheum. 2010;62(9):2745-56. doi: 10.1002/art.27559

28. Arnold LM, Zhang S, Pangallo BA. Efficacy and safety of duloxetine 30 mg/d in patients with fibromyalgia: a randomized, double-blind, placebo-controlled study. Clin J Pain. Nov-Dec 2012;28(9):775-81. doi: 10.1097/ajp.0b013e3182510295

29. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014 Jan 3;(1):CD007115. doi: 10.1002/14651858.cd007115.pub3

30. Murakami M, Osada K, Ichibayashi H, et al. An open-label, long-term, phase III extension trial of duloxetine in Japanese patients with fibromyalgia. Mod Rheumatol. 2017;27(4):688-95. doi: 10.1080/14397595.2016.1245237. Epub 2016 Oct 31..

31. Clauw DJ, Mease P, Palmer RH, et al. Milnacipran for the treatment of fibromyalgia in adults: a 15-week, multicenter, randomized, double-blind, placebo-controlled, multiple-dose clinical trial. Clin Ther. 2008;30(11):1988-2004. doi: 10.1016/j.clinthera.2008.11.009

32. Mease PJ, Clauw DJ, Gendreau RM, et al. The efficacy and safety of milnacipran for treatment of fibromyalgia. A randomized, double-blind, placebo-controlled trial. J Rheumatol. 2009 Feb;36(2):398-409. doi: 10.3899/jrheum.080734

33. Sayar K, Aksu G, Ak I, et al. Venlafaxine treatment of fibromyalgia. Ann Pharmacother. 2003;37(11):1561-5. doi: 10.1345/aph.1d112

34. Wiffen PJ, Derry S, Moore RA, et al. Antiepileptic drugs for neuropathic pain and fibromyalgia – an overview of Cochrane reviews. Cochrane Database Syst Rev. 2013 Nov 11;2013(11):CD010567. doi: 10.1002/14651858.cd010567

35. Moore A, Wiffen P, Kalso E. Antiepileptic drugs for neuropathic pain and fibromyalgia. JAMA. 2014;312(2):182. doi: 10.1001/jama.2014.6336

36. Puiu T, Kairys AE, Pauer L, et al. Association of Alterations in Gray Matter Volume With Reduced Evoked-Pain Connectivity Following Short-Term Administration of Pregabalin in Patients With Fibromyalgia. Arthritis Rheum. 2016;68(6):1511-21. doi: 10.1002/art.39600

37. Häuser W, Bernardy K, Üceyler N, et al. Treatment of fibromyalgia syndrome with gabapentin and pregabalin – a meta-analysis of randomized controlled trials. Pain. 2009;145(1):69-81. doi: 10.1016/j.pain.2009.05.014. Epub 2009 Jun 17.

38. 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. doi: 10.1002/art.22457

39. Cooper TE, Derry S, Wiffen PJ, et al. Gabapentin for fibromyalgia pain in adults. Cochrane Database Syst Rev. 2017 Jan 3;1(1):CD012188. doi: 10.1002/14651858.cd012188.pub2

40. Moore RA, Wiffen PJ, Derry S, Rice AS. Gabapentin for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev. 2014 Apr 27;2014(4):CD007938. doi: 10.1002/14651858.CD007938.pub3

41. Andrew R, Derry S, Taylor RS, et al. The Costs and Consequences of Adequately Managed Chronic Non-Cancer Pain and Chronic Neuropathic Pain. Pain Pract. 2014 Jan;14(1):79-94. doi: 10.1111/papr.12050. Epub 2013 Mar 6.

42. Üceyler N, Sommer C, Walitt B, et al. Anticonvulsants for fibromyalgia. Cochrane Database Syst Rev. 2013 Oct 16;(10):CD010782. doi: 10.1002/14651858.cd010782

43. Derry S, Cording M, Wiffen PJ, et al. Pregabalin for pain in fibromyalgia in adults. Cochrane Database Syst Rev. 2016 Sep 29;9(9):CD011790. doi: 10.1002/14651858.cd011790.pub2

44. Derry S, Wiffen PJ, Häuser W, et al. Oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults. Cochrane Database Syst Rev. 2017 Mar 27;3(3):CD012332. doi: 10.1002/14651858.cd012332.pub2

45. Goldenberg DL, Clauw DJ, Palmer RE, et al. Opioid Use in Fibromyalgia: A Cautionary Tale. Mayo Clinic Proc. 2016;91(5):640-8. doi: 10.1016/j.mayocp.2016.02.002. Epub 2016 Mar 11.

46. Häuser W, Jones G. Psychological therapies for chronic widespread pain and fibromyalgia syndrome. Best Pract Res Clin Rheumatol. 2019;33(3):101416. doi: 10.1016/j.berh.2019.05.001

47. Köllner V, Bernardy K, Greiner W, et al. Psychotherapy and psychological procedures: updated guidelines 2017 and overview of systematic review articles. Schmerz. 2017;31(3):266-73. doi: 10.1007/s00482-017-0204-3

48. Beck JS. Cognitive behavior therapy: basics and beyond. 2 nd ed. New York: The Guilford Press; 2011.

49. Bernardy K, Klose P, Welsch P, et al. Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta-analysis of randomized controlled trials. Eur J Pain. 2018;22(2):242-60. doi: 10.1002/ejp.1121

50. Haugmark T, Hagen KB, Smedslund G, Zangi HA. Mindfulness- and acceptance-based interventions for patients with fibromyalgia A systematic review and meta-analyses. PLoS One. 2019 Sep 3;14(9):e0221897. doi: 10.1371/journal.pone.0221897. eCollection 2019.

51. Greeson J, Eisenlohr-Moul T. Chapter 12. Mindfulness-Based Stress Reduction for Chronic Pain. In: Baer RA, ed. Practical Resources for the Mental Health Professional, Mind-fulness-Based Treatment Approaches. 2nd ed. Academic Press; 2014. P. 269-92. doi: 10.1016/b978-0-12-416031-6.00012-8

52. Lauche R, Cramer H, Dobos G, et al. A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome (Provisional abstract). J Psychosom Res. 2013 Dec;75(6):500-10. doi: 10.1016/j.jpsychores.2013.10.010. Epub 2013 Oct 26.

53. Perez-Aranda A, D'Amico F, Feliu-Soler A, et al. Cost-Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study). J Clin Med. 2019;8(7):1068. doi: 10.3390/jcm8071068

54. Sosa-Reina MD, Nunez-Nagy S, Gallego-Izquierdo T, et al. Effectiveness of Therapeutic Exercise in Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. BioMed Res Int. 2017;2017:1-14. doi: 10.1155/2017/2356346

55. Estevez-Lopez F, Maestre-Cascales C, Russell D, et al. Effectiveness of exercise on fatigue and sleep quality in fibromyalgia: a systematic review and meta-analysis of randomised trials. Arch Phys Med Rehabil. 2021 Apr;102(4):752-61. doi: 10.1016/j.apmr.2020.06.019. Epub 2020 Jul 25.

56. Glombiewski JA, Bernardy K, Häuser W. Efficacy of EMG- and EEG-Biofeedback in Fibromyalgia Syndrome: A Meta-Analysis and a Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:962741. doi: 10.1155/2013/962741. Epub 2013 Sep 3.

57. Baumueller E, Winkelmann A, Irnich D, et al. Electromyogram biofeedback in patients with fibromyalgia: a randomized controlled trial. Complement Med Res. 2017;24(1):33-9. doi: 10.1159/000454692

58. Kim J, Kim SR, Lee H, Nam DH. Comparing Verum and Sham Acupuncture in Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2019 Aug 25;2019:8757685. doi: 10.1155/2019/8757685. eCollection 2019.

59. Galvez-Sanchez CM, Duschek S, Reyes Del Paso GA. Psychological impact of fibromyalgia: current perspectives. Psychol Res Behav Manag. 2019 Feb 13;12:117-127. doi: 10.2147/PRBM.S178240. eCollection 2019.

60. Шилов ВВ. Открытое, рандомизированное, перекрестное исследование сравнительной фармакокинетики и биоэквивалентности препаратов Дулоксетин Канон, капсулы 60 мг (ЗАО «Канонфарма продакшн», Россия) и Симбалта® , капсулы 60 мг («Лилли С.А.», Испания»). 2012. Доступно по ссылке: https://clinline.ru/reestr-klinicheskih-issledovanij/897-19.04.2012.html

61. Сардарян ИС. Открытое, рандомизированное, перекрестное исследование сравнительной фармакокинетики и биоэквивалентности препаратов Прегабалин Канон, капсулы, 300 мг (ЗАО Канонфарма Продакшн, Россия) и Лирика® , капсулы 300 мг (Пфайзер ГмбХ, Германия). 2013. Доступно по ссылке: https://clinline.ru/reestr-klinicheskih-issledovanij/286-30.04.2013.html