Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Oct 20;2015(10):CD008244.
doi: 10.1002/14651858.CD008244.pub3.

Milnacipran for pain in fibromyalgia in adults

Malene Cording  1 , Sheena Derry, Tudor Phillips, R Andrew Moore, Philip J Wiffen
Affiliations

Milnacipran for pain in fibromyalgia in adults

Malene Cording et al. Cochrane Database Syst Rev. .

Abstract

Background: This is an updated version of the original Cochrane review published in Issue 3, 2012. That review considered both fibromyalgia and neuropathic pain, but the efficacy of milnacipran for neuropathic pain is now dealt with in a separate review.Milnacipran is a serotonin-norepinephrine (noradrenaline) reuptake inhibitor (SNRI) that is licensed for the treatment of fibromyalgia in some countries, including Canada, Russia, and the United States.

Objectives: To assess the analgesic efficacy of milnacipran for pain in fibromyalgia in adults and the adverse events associated with its use in clinical trials.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE to 18 May 2015, together with reference lists of retrieved papers and reviews, and two clinical trial registries. For the earlier review, we also contacted the manufacturer.

Selection criteria: We included randomised, double-blind studies of eight weeks' duration or longer, comparing milnacipran with placebo or another active treatment in fibromyalgia in adults.

Data collection and analysis: We extracted efficacy and adverse event data, and two review authors examined issues of study quality independently.

Main results: We identified one new study with 100 participants for the pooled analysis. We identified two additional reports of a study using an enriched enrolment randomised withdrawal (EERW) design that included participants from earlier randomised controlled trials and an open-label study. Because this study used the same participants already included in our main analysis, and a different design, we dealt with it separately.The main analysis included six studies (five from the earlier review; 4238 participants in total), all of which were placebo-controlled, and used titration to a target dose of milnacipran 100 or 200 mg, with assessment after 8 to 24 weeks of stable treatment. There were no studies with active comparators. Study quality was generally good, although the imputation method used in analyses of the primary outcomes could overestimate treatment effect.Both doses of milnacipran provided moderate levels of pain relief (at least 30% pain intensity reduction) to about 40% of participants treated, compared to 30% with placebo, giving a number needed to treat for an additional beneficial outcome (NNT) of 6 to 10 (high quality evidence). Using a stricter definition for responder and a more conservative method of analysis gave lower levels of response (while maintaining a 10% difference between milnacipran and placebo) and increased the NNT to 11 (high quality evidence). One EERW study was broadly supportive.Adverse events were common in both milnacipran (86%) and placebo (78%) groups (high quality evidence), but serious adverse events did not differ between groups (less than 2%) (low quality evidence). Nausea, constipation, and headache were the most common events showing the greatest difference between groups (number needed to treat for an additional harmful outcome (NNH) of 5.7 for nausea, 13 for constipation, and 29 for headache) (moderate quality evidence).Withdrawals for any reason were more common with milnacipran than placebo, and more common with 200 mg (NNH 9) than 100 mg (NNH 23), compared with placebo. This was largely driven by adverse event withdrawals, where the NNH compared with placebo was 14 for 100 mg and 7.0 for 200 mg (high quality evidence). Withdrawals due to lack of efficacy were less common with milnacipran than placebo but did not differ between doses (number needed to treat to prevent an additional unwanted outcome (NNTp) of 41) (moderate quality evidence).

Authors' conclusions: The evidence available indicates that milnacipran 100 mg or 200 mg is effective for a minority in the treatment of pain due to fibromyalgia, providing moderate levels of pain relief (at least 30%) to about 40% of participants, compared with about 30% with placebo. There were insufficient data to assess substantial levels of pain relief (at least 50%), and the use of last observation carried forward imputation may overestimate drug efficacy. Using stricter criteria for 'responder' and a more conservative method of analysis gave lower response rates (about 26% with milnacipran versus 17% with placebo). Milnacipran was associated with increased adverse events and adverse event withdrawals, which were significantly greater for the higher dose.

PubMed Disclaimer

Conflict of interest statement

MC has no conflicts relating to this review or any similar product.

SD has no conflicts relating to this review or any similar product.

TP has no conflicts relating to this review or any similar product.

RAM has no conflicts relating to this review or any similar product.

PW has no conflicts relating to this review or any similar product.

We are funded by the National Institute for Health Research (NIHR) for work on a series of reviews informing the unmet need of chronic pain and providing the evidence for treatments of pain.

Figures

1
1
Study flow diagram. EERW: enriched enrolment randomised withdrawal; RCT: randomised controlled trial.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Forest plot of comparison: 1 Milnacipran 100 mg/day versus placebo, outcome: 1.1 At least 30% pain relief.
5
5
Forest plot of comparison: 1 Milnacipran 100 mg/day versus placebo, outcome: 1.8 Individual adverse events.
1.1
1.1. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 1 At least 30% pain relief.
1.2
1.2. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 2 PGIC 'much improved' or 'very much improved'.
1.3
1.3. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 3 At least 50% pain relief.
1.4
1.4. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 4 Composite 1.
1.5
1.5. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 5 Composite 2.
1.6
1.6. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 6 At least one adverse event.
1.7
1.7. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 7 Serious adverse events.
1.8
1.8. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 8 Individual adverse events.
1.9
1.9. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 9 All‐cause withdrawals.
1.10
1.10. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 10 Lack of efficacy withdrawals.
1.11
1.11. Analysis
Comparison 1 Milnacipran 100 mg/day versus placebo, Outcome 11 Adverse event withdrawals.
2.1
2.1. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 1 At least 30% pain relief.
2.2
2.2. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 2 PGIC 'much improved' or 'very much improved'.
2.3
2.3. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 3 Composite 1.
2.4
2.4. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 4 Composite 2.
2.5
2.5. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 5 At least one adverse event.
2.6
2.6. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 6 Serious adverse events.
2.7
2.7. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 7 Individual adverse events.
2.8
2.8. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 8 All‐cause withdrawals.
2.9
2.9. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 9 Lack of efficacy withdrawals.
2.10
2.10. Analysis
Comparison 2 Milnacipran 200 mg/day versus placebo, Outcome 10 Adverse event withdrawals.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Arnold 2010 {published data only}
    1. Arnold LM, Gendreau RM, Palmer RH, Gendreau JF, Wang Y. Efficacy and safety of milnacipran 100mg/day in patients with fibromyalgia. Arthritis and Rheumatism 2010;62(9):2745‐56. [DOI: 10.1002/art.27559] - DOI - PubMed
    1. Arnold LM, Palmer RH, Gendreau RM, Chen W. Relationships among pain, depressed mood, and global status in fibromyalgia patients: post hoc analyses of a randomized, placebo‐controlled trial of milnacipran. Psychosomatics 2012;53(4):371‐9. [DOI: 10.1016/j.psym.2012.02.005] - DOI - PubMed
    1. Saxe PA, Arnold LM, Palmer RH, Gendreau RM, Chen W. Short‐term (2‐week) effects of discontinuing milnacipran in patients with fibromyalgia. Current Medical Research and Opinion 2012;28(5):815‐21. [DOI: 10.1185/03007995.2012.677418] - DOI - PubMed
Bateman 2013 {published data only}
    1. Study of milnacipran in patients with inadequate response to duloxetine for the treatment of fibromyalgia, 2011. www.clinicaltrials.gov/ct2/show/study/NCT01077375 (accessed 22 September 2015). [CTG: NCT01077375]
    1. Bateman L, Palmer RH, Trugman JM, Lin Y. Results of switching to milnacipran in fibromyalgia patients with an inadequate response to duloxetine: a phase IV pilot study. Journal of Pain Research 2013;6:311‐8. [DOI: 10.2147/JPR.S43395] - DOI - PMC - PubMed
Branco 2010 {published data only}
    1. Branco JC, Cherin P, Montagne A, Bouroubi A. Longterm therapeutic response to milnacipran treatment for fibromyalgia. A European 1‐year extension study following a 3‐month study. Journal of Rheumatology 2011;38(7):1403‐12. [DOI: 10.3899/jrheum.101025] - DOI - PubMed
    1. Branco JC, Zachrisson O, Perrot S, Mainguy Y. A European multicenter randomized double‐blind placebo‐controlled monotherapy clinical trial of milnacipran in treatment of fibromyalgia. Journal of Rheumatology 2010;37(4):851‐9. [DOI: 10.3899/jrheum.090884] - DOI - PubMed
Clauw 2008 {published data only}
    1. Clauw DJ, Mease P, Palmer RH, Gendreau RM, Wang Y. Milnacipran for the treatment of fibromyalgia in adults: a 15‐week, multicenter, randomized, double‐blind, placebo‐controlled, multiple‐dose clinical trial. Clinical Therapeutics 2008;30(11):1988‐2004. [DOI: 10.1016/j.clinthera.2008.11.009] - DOI - PubMed
Clauw 2013 {published data only}
    1. Clauw DJ, Mease PJ, Palmer RH, Trugman JM, Wang Y. Continuing efficacy of milnacipran following long‐term treatment in fibromyalgia: a randomized trial. Arthritis Research and Therapy 2013;15(4):R88. [DOI: 10.1186/ar4268] - DOI - PMC - PubMed
    1. Mease PJ, Clauw DJ, Trugman JM, Palmer RH, Wang Y. Efficacy of long‐term milnacipran treatment in patients meeting different thresholds of clinically relevant pain relief: subgroup analysis of a randomized, double‐blind, placebo‐controlled withdrawal study. Journal of Pain Research 2014;7:679‐87. [DOI: 10.2147/JPR.S70200] - DOI - PMC - PubMed
Mease 2009 {published data only}
    1. Mease PJ, Clauw DJ, Gendreau RM, Rao SG, Kranzler J, Chen W, et al. The efficacy and safety or milnacipran for treatment of fibromyalgia. A randomized, double‐blind, placebo‐controlled trial. Journal of Rheumatology 2009;36(2):398‐409. [DOI: 10.3899/jrheum.080734] - DOI - PubMed
Vitton 2004 {published data only}
    1. Gendreau RM, Thorn MD, Gendreau JF, Kranzler JD, Ribeiro S, Gracely RH, et al. Efficacy of milnacipran in patients with fibromyalgia. Journal of Rheumatology 2005;32:1975‐85. [PUBMED: 16206355] - PubMed
    1. Vitton O, Gendreau M, Gendreau J, Kranzler J, Rao SG. A double‐blind placebo‐controlled trial of milnacipran in the treatment of fibromyalgia. Human Psychopharmacology 2004;19:S27‐35. [DOI: 10.1002/hup.622] - DOI - PubMed

References to studies excluded from this review

Ang 2013 {published data only}
    1. Ang DC, Jensen MP, Steiner JL, Hilligoss J, Gracely RH, Saha C. Combining cognitive‐behavioral therapy and milnacipran for fibromyalgia: a feasibility randomized‐controlled trial. Clinical Journal of Pain 2013;29(9):747‐54. [DOI: 10.1097/AJP.0b013e31827a784e] - DOI - PMC - PubMed
Arnold 2012 {published data only}
    1. Arnold LM, Palmer RH, Hufford MR, Chen W. Effect of milnacipran on body weight in patients with fibromyalgia. International Journal of General Medicine 2012;5:879‐87. [DOI: 10.2147/IJGM.S36444] - DOI - PMC - PubMed
Branco 2011 {published data only}
    1. Branco JC, Cherin P, Montagne A, Bouroubi A, on behalf of the Multinational Coordinator Study Group. Longterm therapeutic response to milnacipran treatment for fibromyalgia. A European 1‐year extension study following a 3‐month study. Journal of Rheumatology 2011;38(7):1403‐12. [DOI: 10.3899/jrheum.101025] - DOI - PubMed
Goldenberg 2010 {published data only}
    1. Goldenberg DL, Clauw DJ, Palmer RH, Mease P, Chen W, Gendreau RM. Durability of therapeutic response to milnacipran treatment for fibromyalgia. Results of a randomized, double‐blind, monotherapy 6‐month extension study. Pain Medicine 2010;11(2):180‐94. [DOI: 10.1111/j.1526-4637.2009.00755.x] - DOI - PubMed
Häuser 2014 {published data only}
    1. Häuser W, Sarzi‐Puttini P, Töle TR, Wolfe F. Placebo and nocebo responses in randomised controlled trials of drugs applying for approval for fibromyalgia syndrome treatment: systematic review and meta‐analysis. Clinical and Experimental Rheumatology 2014;30(6 (Suppl 74)):78‐87. [PUBMED: 23137770] - PubMed
Kim 2013 {published data only}
    1. Kim JL, Rele S, Marks DM, Masand PS, Yerramsetty P, Millet RA, et al. Effects of milnacipran on neurocognition, pain, and fatigue in fibromyalgia: a 13‐week, randomized, placebo‐controlled, crossover trial. Primary Care Companion for CNS Disorders 2013;15(6):PCC.13m01555. [DOI: 10.4088/PCC.13m01555] - DOI - PMC - PubMed
Matthey 2013 {published data only}
    1. Matthey A, Cedraschi C, Piguet V, Besson M, Chabert J, Daali Y, et al. Dual reuptake inhibitor milnacipran and spinal pain pathways in fibromyalgia patients: a randomized, double‐blind, placebo‐controlled trial. Pain Physician 2013;16(5):E553‐62. [PUBMED: 24077206] - PubMed
Mease 2014 {published data only}
    1. Mease PJ, Palmer RH, Wang Y. Effects of milnacipran on the multidimensional aspects of fatigue and the relationship of fatigue to pain and function: pooled analysis of 3 fibromyalgia trials. Journal of Clinical Rheumatology 2014;20(4):195‐202. [DOI: 10.1097/RHU.0000000000000103] - DOI - PubMed
NCT00797797 {unpublished data only}
    1. A multicenter, randomized, open‐label, controlled study to evaluate the safety, tolerability, and efficacy of milnacipran when added to pregabalin in the treatment of fibromyalgia, 2011. clinicaltrials.gov/ct2/show/NCT00797797 (accessed 12 August 2011).
Spera 2012 {published data only}
    1. Spera A, Clauw DJ, Arnold LM, Ma Y. Long‐term efficacy and tolerability of milnacipran for the management of fibromyalgia: results from an open‐label, flexible‐dosing study followed by a randomized, double‐blind, placebo‐controlled discontinuation study. Journal of General Internal Medicine. Conference: 35th Annual Meeting of the Society of General Internal Medicine, SGIM. 2012.

Additional references

Arnold 2013
    1. Arnold LM, Palmer RH, Ma Y. A 3‐year, open‐label, flexible‐dosing study of milnacipran for the treatment of fibromyalgia. Clinical Journal of Pain 2013;29(12):1021‐8. [DOI: 10.1097/AJP.0b013e31828440ab] - DOI - PubMed
Bernstein 2013
    1. Bernstein CD, Albrecht KL, Marcus DA. Milnacipran for fibromyalgia: a useful addition to the treatment armamentarium. Expert Opinion on Pharmacotherapy 2013;14(7):905‐16. [DOI: 10.1517/14656566.2013.779670] - DOI - PubMed
Choy 2011
    1. Choy E, Marshall D, Gabriel ZL, Mitchell SA, Gylee E, Dakin HA. A systematic review and mixed treatment comparison of the efficacy of pharmacological treatments for fibromyalgia. Seminars in Arthritis and Rheumatism 2011;41(3):335‐45.e6. [DOI: 10.1016/j.semarthrit.2011.06.003] - DOI - PubMed
Dechartres 2013
    1. Dechartres A, Trinquart L, Boutron I, Ravaud P. Influence of trial sample size on treatment effect estimates: meta‐epidemiological study. BMJ 2013;346:f2304. [DOI: 10.1136/bmj.f2304] - DOI - PMC - PubMed
Derry 2015
    1. Derry S, Phillips T, Moore RA, Wiffen PJ. Milnacipran for neuropathic pain in adults. Cochrane Database of Systematic Reviews 2015, Issue 7. [DOI: 10.1002/14651858.CD011789] - DOI - PMC - PubMed
Dworkin 2008
    1. Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. Journal of Pain 2008;9(2):105‐21. [DOI: 10.1016/j.jpain.2007.09.005] - DOI - PubMed
Higgins 2011
    1. Higgins JPT, Green S. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Altman DG, Sterne JAC (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hoffman 2010
    1. Hoffman DL, Sadosky A, Dukes EM, Alvir J. How do changes in pain severity levels correspond to changes in health status and function in patients with painful diabetic peripheral neuropathy?. Pain 2010;149(2):194‐201. [DOI: 10.1016/j.pain.2009.09.017] - DOI - PubMed
Häuser 2011
    1. Häuser W, Petzke F, Üçeyler N, Sommer C. Comparative efficacy and acceptability of amitriptyline, duloxetine and milnacipran in fibromyalgia syndrome: a systematic review with meta‐analysis. Rheumatology (Oxford) 2011;50(3):532‐43. [DOI: 10.1093/rheumatology/keq354] - DOI - PubMed
Häuser 2013
    1. Häuser W, Urrútia G, Tort S, Uçeyler N, Walitt B. Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome. Cochrane Database of Systematic Reviews 2013, Issue 1. [DOI: 10.1002/14651858.CD010292] - DOI - PubMed
Jadad 1996
    1. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled Clinical Trials 1996;17(1):1‐12. [DOI: ] - PubMed
Kalso 2013
    1. Kalso E, Aldington DJ, Moore RA. Drugs for neuropathic pain. BMJ 2013;347:f7339. [DOI: 10.1136/bmj.f7339] - DOI - PubMed
Kjaergard 2001
    1. Kjaergard LL, Villumsen J, Gluud C. Reported methodologic quality and discrepancies between large and small randomized trials in meta‐analyses. Annals of Internal Medicine 2001;135(11):982‐9. [DOI: 10.7326/0003-4819-135-11-200112040-00010] - DOI - PubMed
Koroschetz 2011
    1. Koroschetz J, Rehm SE, Gockel U, Brosz M, Freynhagen R, Tölle TR, et al. Fibromyalgia and neuropathic pain ‐ differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia. BMC Neurology 2011;11:55. [DOI: 10.1186/1471-2377-11-55] - DOI - PMC - PubMed
Kyle 2010
    1. Kyle JA, Dugan BD, Testerman KK. Milnacipran for treatment of fibromyalgia. Annals of Pharmacotherapy 2010;44(9):1422‐9. [DOI: 10.1345/aph.1P218] - DOI - PubMed
L'Abbé 1987
    1. L'Abbé KA, Detsky AS, O'Rourke K. Meta‐analysis in clinical research. Annals of Internal Medicine 1987;107:224‐33. [DOI: 10.7326/0003-4819-107-2-224] - DOI - PubMed
Lunn 2014
    1. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database of Systematic Reviews 2014, Issue 1. [DOI: 10.1002/14651858.CD007115.pub3] - DOI - PMC - PubMed
McQuay 1998
    1. McQuay H, Moore R. An Evidence‐based Resource for Pain Relief. Oxford: Oxford University Press, 1998. [ISBN: 0‐19‐263048‐2]
Moore 1998
    1. Moore RA, Gavaghan D, Tramèr MR, Collins SL, McQuay HJ. Size is everything ‐ large amounts of information are needed to overcome random effects in estimating direction and magnitude of treatment effects. Pain 1998;78(3):209‐16. [DOI: 10.1016/S0304-3959(98)00140-7] - DOI - PubMed
Moore 2008
    1. Moore RA, Barden J, Derry S, McQuay HJ. Managing potential publication bias. In: McQuay HJ, Kalso E, Moore RA editor(s). Systematic Reviews in Pain Research: Methodology Refined. Seattle: IASP Press, 2008:15‐24. [ISBN: 978‐0‐931092‐69‐5]
Moore 2009
    1. Moore RA, Straube S, Wiffen PJ, Derry S, McQuay HJ. Pregabalin for acute and chronic pain in adults. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD007076] - DOI - PMC - PubMed
Moore 2010a
    1. Moore RA, Eccleston C, Derry S, Wiffen P, Bell RF, Straube S, et al. ACTINPAIN Writing Group of the IASP Special Interest Group on Systematic Reviews in Pain Relief, Cochrane Pain, Palliative and Supportive Care Systematic Review Group Editors. "Evidence" in chronic pain‐establishing best practice in the reporting of systematic reviews. Pain 2010;150(3):386‐9. [DOI: 10.1016/j.pain.2010.05.011] - DOI - PubMed
Moore 2010b
    1. Moore RA, Moore OA, Derry S, Peloso PM, Gammaitoni AR, Wang H. Responder analysis for pain relief and numbers needed to treat in a meta‐analysis of etoricoxib osteoarthritis trials: bridging a gap between clinical trials and clinical practice. Annals of the Rheumatic Diseases 2010;69(2):374‐9. [DOI: 10.1136/ard.2009.107805] - PMC - PubMed
Moore 2010c
    1. Moore RA, Straube S, Paine J, Phillips CJ, Derry S, McQuay HJ. Fibromyalgia: moderate and substantial pain intensity reduction predicts improvement in other outcomes and substantial quality of life gain. Pain 2010;149(3):260‐4. [DOI: 10.1016/j.pain.2010.02.039] - DOI - PubMed
Moore 2010d
    1. Moore RA, Derry S, McQuay HJ, Straube S, Aldington D, Wiffen P, et al. Clinical effectiveness: an approach to clinical trial design more relevant to clinical practice, acknowledging the importance of individual differences. Pain 2010;149(2):173‐6. [DOI: 10.1016/j.pain.2009.08.007] - DOI - PubMed
Moore 2011a
    1. Moore RA, Straube S, Paine J, Derry S, McQuay HJ. Minimum efficacy criteria for comparisons between treatments using individual patient meta‐analysis of acute pain trials: examples of etoricoxib, paracetamol, ibuprofen, and ibuprofen/paracetamol combinations after third molar extraction. Pain 2011;152(5):982‐9. [DOI: 10.1016/j.pain.2010.11.030] - DOI - PubMed
Moore 2011b
    1. Moore RA, Mhuircheartaigh RJ, Derry S, McQuay HJ. Mean analgesic consumption is inappropriate for testing analgesic efficacy in post‐operative pain: analysis and alternative suggestion. European Journal of Anaesthesiology 2011;28(6):427‐32. [DOI: 10.1097/EJA.0b013e328343c569] - DOI - PubMed
Moore 2012a
    1. Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ. Amitriptyline for neuropathic pain and fibromyalgia in adults. Cochrane Database of Systematic Reviews 2012, Issue 12. [DOI: 10.1002/14651858.CD008242.pub2] - DOI - PubMed
Moore 2012b
    1. Moore RA, Straube S, Eccleston C, Derry S, Aldington D, Wiffen P, et al. Estimate at your peril: imputation methods for patient withdrawal can bias efficacy outcomes in chronic pain trials using responder analyses. Pain 2012;153(2):265‐8. [DOI: 10.1016/j.pain.2011.10.00] - DOI - PubMed
Moore 2013a
    1. Moore RA, Straube S, Aldington D. Pain measures and cut‐offs ‐ 'no worse than mild pain' as a simple, universal outcome. Anaesthesia 2013;68(4):400‐12. [DOI: 10.1111/anae.12148] - DOI - PubMed
Moore 2013b
    1. Moore A, Derry S, Eccleston C, Kalso E. Expect analgesic failure; pursue analgesic success. BMJ 2013;346:f2690. [DOI: 10.1136/bmj.f2690] - DOI - PubMed
Moore 2014a
    1. Moore RA, Derry S, Taylor RS, Straube S, Phillips CJ. The costs and consequences of adequately managed chronic non‐cancer pain and chronic neuropathic pain. Pain Practice 2014;14(1):79‐94. [DOI: 10.1111/papr.12050] - DOI - PubMed
Moore 2014b
    1. Moore RA, Wiffen PJ, Derry S, Toelle T, Rice AS. Gabapentin for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database of Systematic Reviews 2014, Issue 4. [DOI: 10.1002/14651858.CD007938.pub3] - DOI - PMC - PubMed
Moore 2014c
    1. Moore RA, Cai N, Skljarevski V, Tölle TR. Duloxetine use in chronic painful conditions ‐ individual patient data responder analysis. European Journal of Pain 2014;18(1):67‐75. [DOI: 10.1002/j.1532-2149.2013.00341.x] - DOI - PMC - PubMed
Nüesch 2010
    1. Nüesch E, Trelle S, Reichenbach S, Rutjes AW, Tschannen B, Altman DG, et al. Small study effects in meta‐analyses of osteoarthritis trials: meta‐epidemiological study. BMJ 2010;341:c3515. [DOI: 10.1136/bmj.c3515] - DOI - PMC - PubMed
Ormseth 2010
    1. Ormseth MJ, Eyler AE, Hammonds CL, Boomershine CS. Milnacipran for the management of fibromyalgia syndrome. Journal of Pain Research 2010;1(3):15‐24. [DOI: 10.2147/JPR.S7883] - DOI - PMC - PubMed
PaPaS 2012
    1. PaPaS author and referee guidance. papas.cochrane.org/papas‐documents (accessed 11 August 2015).
Queiroz 2013
    1. Queiroz LP. Worldwide epidemiology of fibromyalgia. Current Pain and Headache Reports 2013;17(8):356. [DOI: 10.1007/s11916-013-0356-5] - DOI - PubMed
Recla 2010
    1. Recla JM. New and emerging therapeutic agents for the treatment of fibromyalgia: an update. Journal of Pain Research 2010;22(3):89‐103. [DOI: 10.2147/JPR.S6792] - DOI - PMC - PubMed
RevMan 2014 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
Roskell 2011
    1. Roskell NS, Beard SM, Zhao Y, Le TK. A meta‐analysis of pain response in the treatment of fibromyalgia. Pain Practice 2011;11(6):516‐27. [DOI: 10.1111/j.1533-2500.2010.00441.x] - DOI - PubMed
Saarto 2007
    1. Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane Database of Systematic Reviews 2007, Issue 4. [DOI: 10.1002/14651858.CD005454.pub2] - DOI - PMC - PubMed
Schmidt‐Wilcke 2014
    1. Schmidt‐Wilcke T, Ichesco E, Hampson JP, Kairys A, Peltier S, Harte S, et al. Resting state connectivity correlates with drug and placebo response in fibromyalgia patients. Neuroimage Clinical 2014;6:252‐61. [DOI: 10.1016/j.nicl.2014.09.007] - DOI - PMC - PubMed
Straube 2008
    1. Straube S, Derry S, McQuay HJ, Moore RA. Enriched enrollment: definition and effects of enrichment and dose in trials of pregabalin and gabapentin in neuropathic pain. A systematic review. British Journal Clinical Pharmacology 2008;66(2):266‐75. [DOI: 10.1111/j.1365-2125.2008.03200.x] - DOI - PMC - PubMed
Straube 2010
    1. Straube S, Derry S, Moore RA, Paine J, McQuay HJ. Pregabalin in fibromyalgia ‐ responder analysis from individual patient data. BMC Musculoskeletal Disorders 2010;11:150. [DOI: 10.1186/1471-2474-11-150] - DOI - PMC - PubMed
Straube 2011
    1. Straube S, Moore RA, Paine J, Derry S, Phillips CJ, Hallier E, et al. Interference with work in fibromyalgia: effect of treatment with pregabalin and relation to pain response. BMC Musculoskeletal Disorders 2011;12:125. [DOI: 10.1186/1471-2474-12-125] - DOI - PMC - PubMed
Sultan 2008
    1. Sultan A, Gaskell H, Derry S, Moore RA. Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials. BMC Neurology 2008;8:29. [DOI: 10.1186/1471-2377-8-29] - DOI - PMC - PubMed
Suzuki 2004
    1. Suzuki R, Rygh LJ, Dickenson AH. Bad news from the brain: descending 5‐HT pathways that control spinal pain processing. Trends in the Pharmacological Sciences 2004;2512:613‐7. [DOI: 10.1016/j.tips.2004.10.002] - DOI - PubMed
Vos 2012
    1. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859):2163‐96. [DOI: 10.1016/S0140-6736(12)61729-2] - DOI - PMC - PubMed
Wiffen 2013
    1. Wiffen PJ, Derry S, Moore RA, Aldington D, Cole P, Rice ASC, et al. Antiepileptic drugs for neuropathic pain and fibromyalgia ‐ an overview of Cochrane reviews. Cochrane Database of Systematic Reviews 2013, Issue 11. [DOI: 10.1002/14651858.CD010567.pub2] - DOI - PMC - PubMed
Wolfe 1990
    1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis and Rheumatism 1990;33:160‐72. [PUBMED: 2306288] - PubMed
Wolfe 2010
    1. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care and Research 2010;62(5):600‐10. [DOI: 10.1002/acr.20140] - DOI - PubMed
Wolfe 2013a
    1. Wolfe F, Brähler E, Hinz A, Häuser W. Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: results from a survey of the general population. Arthritis Care and Research 2013;645(5):777‐85. [DOI: 10.1002/acr.21931] - DOI - PubMed
Wolfe 2014
    1. Wolfe F, Walitt BT, Häuser W. What is fibromyalgia, how is it diagnosed and what does it really mean?. Arthritis Care and Research 2014;66(7):969‐71. [DOI: 10.1002/acr.22207] - DOI - PubMed

References to other published versions of this review

Derry 2012
    1. Derry S, Gill D, Phillips T, Moore RA. Milnacipran for neuropathic pain and fibromyalgia in adults. Cochrane Database of Systematic Reviews 2012, Issue 3. [DOI: 10.1002/14651858.CD008244.pub2] - DOI - PMC - PubMed

Publication types

MeSH terms