Background/Purpose:   A wide variety of medications are used to treat FMS, with an equally wide variety of opinions about their efficacy. We asked FMS patients which medications they had tried for treating their disease, and how effective these medications were.

Methods: 150 office patients with FMS (130 women and 20 men; mean age 51 + 12) completed a questionnaire about the FMS medications they had taken and the effectiveness of these medications (rated as 1 = not helpful, 2 = mildly helpful, 3 = moderately helpful, and 4 = very helpful). The two-sided Friedman test was used to compare pairs of medications with respect to the ratings given by patients who had tried both medications, using a 0.05 significance level.

 Results: The following medications were tried by at least 40% of patients: NSAIDs (93%), prednisone (72%), Flexeril (64%), amitriptyline (64%), Norco/Vicodin (56%), Tramadol (50%), Lyrica (47%), Cymbalta (45%), and Ritalin (44%). The two least frequently tried medications were Vyvanse (9%) and nortriptyline (12%). Based on the percentage of patients who rated the medication as moderately or very helpful, the most helpful medications were Norco/Vicodin (75%), prednisone (70%), Ritalin (65%), Tizanidine (58%), NSAIDs (56%), phentermine (56%), amitriptyline (52%), Tramadol (50%), and Nuvigil/Provgil (50%). The least helpful medications were Savella (12%) and Lunesta (19%). Norco/Vicodin was significantly more helpful than Lyrica (median 4 vs. 1, p < 0.001), Cymbalta (median 4 vs. 1, p < 0.001), Flexeril (median 4 vs. 2, p < 0.001), Tramadol (median 4 vs. 2, p < 0.001), prednisone (median 4 vs. 3, p = 0.004), NSAIDS (median 3.5 vs. 2, p = 0.001), and amitriptyline (median 4 vs. 3, p = 0.041). Prednisone was significantly more helpful than Cymbalta (median 3 vs. 1, p < 0.001), Lyrica (median 3 vs. 1, p = 0.019), Flexeril (median 3 vs. 2, p = 0.028), and Tramadol (median 3 vs. 2, p = 0.009). Tramadol was significantly more helpful than Cymbalta (median 2 vs. 1, p = 0.018). Ritalin was significantly more helpful than Lyrica (median 3 vs. 1, p = 0.008), Cymbalta (median 3 vs. 1, p = 0.003), NSAIDs (median 3 vs. 2, p = 0.028), and Flexeril (median 3 vs. 2, p = 0.034). NSAIDs were significantly more helpful than Cymbalta (median 2 vs. 1, p = 0.001) and Lyrica (median 2 vs. 1, p = 0.020). Amitriptyline was significantly more helpful than Cymbalta (median 2 vs. 1, p = 0.005) and Lyrica (median 2 vs. 1, p = 0.033).

 Conclusion: Older medications were significantly more helpful for treating FMS than some newer medications. However, a wide variety of FMS medications may still be needed because different patients often respond to different medications.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/new-and-not-improved-the-efficacy-of-fms-medications/