Background/Purpose: The Brazilian registry on fibromyalgia syndrome (EpiFibro) included 810 patients who satisfied the American College of Rheumatology Classification Criteria for Fibromyalgia (ACR1990) at the time of diagnosis. Objectives – 1. Describe treatment modalities for Brazilian Patients; 2. Describe treatment measures in each of the modalities.

Methods: – A transversal study on a multicenter cohort of Brazilian Fibromyalgia patients. All patients fulfilled at the data entry the American College of Rheumatology Classification Criteria for Fibromyalgia. The analysis was made through descriptive statistical technique (frequency and standard deviation).  

Results: Three hundred and forty two (342) entries were excluded for having incomplete forms at the treatment modalities. In relation of the therapeutic modalities, it was observed: sixty-six (66) patients are taking only medications and no non-pharmacological therapy; four hundred and fifty five (455) patients are taking some medicines; three hundred and three (303) patients are receiving some kind of health education; two hundred and six (206) patients are practicing exercises and ninety seven (97) are getting some kind of other non-pharmacological measures. The most frequent combination of modalities is medicine, health education and exercises (89). The only 2 drugs approved for fibromyalgia in Brazil are duloxetine (57 patients in use) and pregabalin (11 patients in use). Other medications with proved efficacy by literature have also being prescribed off label, such as amitriptyline (115), venlafaxine (17), fluoxetine (49), cyclobenzaprine (77), tramadol (30) and gabapentin (11). The most used medication associations are: fluoxetine and amitriptyline (88), fluoxetine and cyclobenzaprine (14), amitriptyline and cyclobenzaprine (7), tramadol and paracetamol (23). Other associations were also reported: pregabalin and duloxetine (2), pregabalin and amitriptyline (3), pregabalin and fluoxetine (5), gabapentin and duloxetine (1), gabapentin and amitriptyline (1). There were also prescribed triple associations. In relation to exercises, 108 patients practice aerobics, 26 stretching exercises and 2 strengthening exercises. The most frequent combination is aerobics and stretching exercises (48). The non-pharmacological measures most used are heated swimming pool exercises (17), relaxing techniques (10), acupuncture (10), psychotherapy (9), massage (6) and tender point infiltration (6). It has been also mentioned hypnosis, homeopathy and biofeedback.

Conclusion: The majority of Brazilian fibromyalgia patients are treated by a combination of pharmacological and non-pharmacological measures. It is prescribed approved medications for fibromyalgia, but the most prescribed drug is amitriptyline off label, probably for economic reasons. The most prescribed medicine combination is fluoxetine and amitriptyline. The most practiced exercises are the aerobics modalities and the most non-pharmacological measures are health education and exercises in heated swimming pool.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/data-on-treatment-from-brazilian-fibromyalgia-patients-registry-epifibro/