Presented by Dr. Tofferi in partial fulfillment of the requirements for a Masters of Public Health degree, Uniformed Services University of the Health Sciences, Bethesda, MD.
Treatment of fibromyalgia with cyclobenzaprine: A meta-analysis
Article first published online: 5 FEB 2004
Copyright © 2004 by the American College of Rheumatology
Arthritis Care & Research
Volume 51, Issue 1, pages 9–13, 15 February 2004
How to Cite
Tofferi, J. K., Jackson, J. L. and O'Malley, P. G. (2004), Treatment of fibromyalgia with cyclobenzaprine: A meta-analysis. Arthritis & Rheumatism, 51: 9–13. doi: 10.1002/art.20076
- Issue published online: 5 FEB 2004
- Article first published online: 5 FEB 2004
To systematically review the effectiveness of cyclobenzaprine in the treatment of fibromyalgia.
Articles describing randomized, placebo-controlled trials of cyclobenzaprine in people with fibromyalgia were obtained from Medline, EMBase, Psyclit, the Cochrane Library, and Federal Research in Progress Database. Unpublished literature and bibliographies were also reviewed. Outcomes, including global improvement, treatment effects on pain, fatigue, sleep, and tender points over time, were abstracted.
Five randomized, placebo-controlled trials were identified. The odds ratio for global improvement with therapy was 3.0 (95% confidence interval [95% CI] 1.6–5.6) with a pooled risk difference of 0.21 (95% CI 0.09–0.34), which calculates to 4.8 (95% CI 3.0–11) individuals needing treatment for 1 patient to experience symptom improvement. Pain improved early on, but there was no improvement in fatigue or tender points at any time.
Cyclobenzaprine-treated patients were 3 times as likely to report overall improvement and to report moderate reductions in individual symptoms, particularly sleep.