Treatment data from the Brazilian fibromyalgia registry (EpiFibro)

• Main Authors: Marcos Renato de Assis, Eduardo dos Santos Paiva, Milton Helfenstein, Roberto Ezequiel Heymann, Daniel Feldman Pollak, Jose Roberto Provenza, Aline Ranzolin, Marcelo Cruz Rezende, Luiz Severiano Ribeiro, Eduardo José R. Souza, José Eduardo Martinez
• Format: Article
• Language: English
• Published: BMC 2020-01-01
• Series: Advances in Rheumatology
• Subjects: Fibromyalgia; Treatment; Registries; Chronic pain
• Online Access: https://doi.org/10.1186/s42358-019-0108-2

Abstract Background EpiFibro (Brazilian Epidemiological Study of Fibromyalgia) was created to study patients with fibromyalgia (FM). Patients were included since 2011 according to the classification criteria for FM of the American College of Rheumatology of 1990 (ACR1990). Objective To analyze the therapeutic measures prescribed by Brazilian physicians. Materials and methods Cross-sectional study of a multicenter cohort. The therapeutic measures were described using descriptive statistics. Results We analyzed 456 patients who had complete data in the registry. The mean age was 54.0 ± 11.9 years; 448 were women (98.2%). Almost all patients (98.4%) used medications, 62.7% received health education, and less than half reported practicing physical exercise; these modalities were often used in combination. Most patients who practiced exercises practiced aerobic exercise only, and a significant portion of patients combined it with flexibility exercises. The most commonly used medication was amitriptyline, followed by cyclobenzaprine, and a minority used medication specifically approved for FM, such as duloxetine and pregabalin, either alone or in combination. Combinations of two or three medications were observed, with the combination of fluoxetine and amitriptyline being the most frequent (18.8%). Conclusion In this evaluation of the care of patients with FM in Brazil, it was found that the majority of patients are treated with a combination of pharmacological measures. Non-pharmacological methods are underused, with aerobic exercise being the most commonly practiced exercise type. The most commonly prescribed single drug was amitriptyline, and the most commonly prescribed combination was fluoxetine and amitriptyline. Drugs specifically approved for FM are seldom prescribed.