Treatment of fibromyalgia with cyclobenzaprine: A meta-analysis

Authors

  • Jeanne K. Tofferi,

    1. Walter Reed Army Medical Center, Washington, DC and Uniformed Services University of the Health Sciences, Bethesda, MD
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    • 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.

    • The opinions expressed in this article are those of the authors and should not be construed in any way to reflect those of the U.S. Army or the Department of Defense.

  • Jeffrey L. Jackson,

    Corresponding author
    1. Uniformed Services University of the Health Sciences, Bethesda, MD
    • Uniformed Services University of the Health Sciences, Department of Medicine (EDP), 4301 Jones Bridge Road, Bethesda, MD 20814–4799===

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    • The opinions expressed in this article are those of the authors and should not be construed in any way to reflect those of the U.S. Army or the Department of Defense.

  • Patrick G. O'Malley

    1. Walter Reed Army Medical Center, Washington, DC and Uniformed Services University of the Health Sciences, Bethesda, MD
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    • The opinions expressed in this article are those of the authors and should not be construed in any way to reflect those of the U.S. Army or the Department of Defense.


Abstract

Objective

To systematically review the effectiveness of cyclobenzaprine in the treatment of fibromyalgia.

Methods

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 Unpublished literature and bibliographies were also reviewed.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.

Results

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.

Conclusion

Cyclobenzaprine-treated patients were 3 times as likely to report overall improvement and to report moderate reductions in individual symptoms, particularly sleep.

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