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Erkilic B, Dalgic GS. The preventive role of vitamin D in the prevention and management of Fibromyalgia syndrome. Nutr Health 2023; 29:223-229. [PMID: 36591895 DOI: 10.1177/02601060221144801] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Aim: Vitamin D deficiency is a prevalent condition among the general population, all around the world. Vitamin D deficiency is defined as serum levels of 25-hydroxy vitamin D lower than 20 ng/ml (50 nmol/ml). It is a known actor in the skeletal system through the regulation of calcium and phosphate metabolism and bone mineralization. Still, the role of vitamin D as an immunomodulator is yet to be acknowledged by healthcare practitioners as a cause, precipitating factor, and contributor to a variety of diseases. Vitamin D is shown to be an actor in multiple sclerosis, rheumatoid arthritis, insulin-dependent diabetes mellitus, and irritable bowel syndrome. Fibromyalgia syndrome (FMS) is a chronic disorder associated with a severe pain that can affect a patient's musculoskeletal system, daily routine, and mood. The clinical presentation encapsulates other disorders such as lethargy and sleep problems, brain fog and other cognitive issues, and physical and psychiatric symptoms. Methods: We have used PubMed and ResearchGate in the reviewing process of our paper. We tried to address as many topics as we judged to be adequate and relevant for the practicing clinicians. Results: Management of fibromyalgia syndrome is both nonpharmacologic and pharmacologic, which are provided in a stepwise fashion. Yet, the management of FMS remains a challenge, heeding a multidisciplinary approach. Among the dietary interventions, we chose vitamin D and its effects on FMS. Literature shows that supplementation improves pain caused by fibromyalgia syndrome, yet specific recommendations are still to be created. Conclusions: We call on all the relevant governmental bodies, public health experts and health policy makers, healthcare practitioners, and the civil society to use novel data related to fibromyalgia syndrome, and in a broader perspective, the integral role of vitamin D.
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Affiliation(s)
| | - Gunay Sahin Dalgic
- Department of Rheumatology, 63994Faculty of Medicine, Baskent University, Ankara, Turkey
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Martins YA, Cardinali CAEF, Ravanelli MI, Brunaldi K. Is hypovitaminosis D associated with fibromyalgia? A systematic review. Nutr Rev 2020; 78:115-133. [PMID: 31397485 DOI: 10.1093/nutrit/nuz033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
CONTEXT Recent findings have suggested a high prevalence of vitamin D deficiency or insufficiency in fibromyalgia (FM) patients despite the lack of clinical and pathophysiological evidence. OBJECTIVE A systematic review was conducted to examine the association between vitamin D status and FM, including the effect of vitamin D supplementation. DATA SOURCE PubMed, LILACS, Scopus, SciELO, Cochrane, and EMBASE were searched, from January 2000 to July 2018, using the descriptors "Fibromyalgia" and "Vitamin D." STUDY SELECTION Trials including FM patients in whom vitamin D levels were assessed were eligible for inclusion. DATA EXTRACTION Data comprised age, gender, country, aims, bias, diagnosis criteria, cutoff point, and status of vitamin D, together with FM symptoms and vitamin D supplementation protocol. RESULTS A total of 26 articles were selected. Most of the studies were found to present unreliable control groups and small samples. Experimental data on vitamin D supplementation indicated improvement in certain FM symptoms. CONCLUSION Prevalence of hypovitaminosis D in the FM population and the cause-effect relationship were inconclusive. Nevertheless, vitamin D supplementation may be considered as a co-adjuvant in FM therapy.
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Affiliation(s)
- Yandara A Martins
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Camila A E F Cardinali
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Maria Ida Ravanelli
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Kellen Brunaldi
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
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Silverman SL, Backonja M, Pauer L, Landen J, Bhadra Brown P, Scavone JM, Vissing R, Clair A. Effect of Baseline Characteristics on the Pain Response to Pregabalin in Fibromyalgia Patients with Comorbid Depression. PAIN MEDICINE 2019; 19:419-428. [PMID: 28525632 DOI: 10.1093/pm/pnx091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective To evaluate the effect of baseline characteristics on the treatment response to pregabalin in fibromyalgia (FM) patients with depression. Design Post hoc analysis from a randomized, double-blind, placebo-controlled, two-way crossover study of pregabalin (300 or 450 mg/day, twice daily). Subjects A total of 193 FM patients taking an antidepressant for comorbid depression. Methods The effect of patient baseline characteristics on the treatment response to pregabalin vs placebo was assessed for the primary efficacy end point (mean pain score on an 11-point numeric rating scale). Variables were analyzed using a linear mixed effects model with sequence, period, and treatment as fixed factors, and subject within sequence and within subject error as random factors. Results Pregabalin significantly improved mean pain scores vs placebo irrespective of age, duration of FM, number of prior FM medications, depression diagnosis, shorter-term depression (<10 years), prior or no prior opioid use, pain severity, anxiety severity, and sleep disruption severity (all P < 0.05). Compared with placebo, pregabalin did not significantly affect mean pain scores in patients with comorbid insomnia, irritable bowel syndrome, or gastroesophageal reflux disease; severe FM; a diagnosis of depression before FM, longer-term depression (≥ 10 years), more severe depression, or who were taking a high dose of antidepressant. Conclusions Pregabalin significantly improved mean pain scores when compared with placebo for the majority of baseline characteristics assessed in FM patients taking an antidepressant for comorbid depression.
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Affiliation(s)
- Stuart L Silverman
- OMC Clinical Research Center, UCLA School of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Miroslav Backonja
- University of Wisconsin, Madison, Wisconsin.,WorldWide Clinical Trials, Morrisville, North Carolina
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Arnold LM, Choy E, Clauw DJ, Oka H, Whalen E, Semel D, Pauer L, Knapp L. An evidence-based review of pregabalin for the treatment of fibromyalgia. Curr Med Res Opin 2018. [PMID: 29519159 DOI: 10.1080/03007995.2018.1450743] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Pregabalin, an α2-δ agonist, is approved for the treatment of fibromyalgia (FM) in the United States, Japan, and 37 other countries. The purpose of this article was to provide an in-depth, evidence-based summary of pregabalin for FM as demonstrated in randomized, placebo-controlled clinical studies, including open-label extensions, meta-analyses, combination studies and post-hoc analyses of clinical study data. METHODS PubMed was searched using the term "pregabalin AND fibromyalgia" and the Cochrane Library with the term "pregabalin". Both searches were conducted on 2 March 2017 with no other date limits set. RESULTS Eleven randomized, double-blind, placebo-controlled clinical studies were identified including parallel group, two-way crossover and randomized withdrawal designs. One was a neuroimaging study. Five open-label extensions were also identified. Evidence of efficacy was demonstrated across the studies identified with significant and clinically relevant improvements in pain, sleep quality and patient status. The safety and tolerability profile of pregabalin is consistent across all the studies identified, including in adolescents, with dizziness and somnolence the most common adverse events reported. These efficacy and safety data are supported by meta-analyses (13 studies). Pregabalin in combination with other pharmacotherapies (7 studies) is also efficacious. Post-hoc analyses have demonstrated the onset of pregabalin efficacy as early as 1-2 days after starting treatment, examined the effect of pregabalin on other aspects of sleep beyond quality, and shown it is effective irrespective of the presence of a wide variety of patient demographic and clinical characteristics. CONCLUSIONS Pregabalin is a treatment option for FM; its clinical utility has been comprehensively demonstrated.
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Affiliation(s)
- Lesley M Arnold
- a Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine , Cincinnati , OH , USA
| | - Ernest Choy
- b Institute of Infection and Immunity, Cardiff University School of Medicine , Cardiff , UK
| | - Daniel J Clauw
- c Department of Anesthesiology , University of Michigan , Ann Arbor , MI , USA
| | - Hiroshi Oka
- d Tokyo Rheumatism Pain Clinic , Tokyo , Japan
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Chambers J, Gleason RM, Kirsh KL, Twillman R, Webster L, Berner J, Fudin J, Passik SD. An Online Survey of Patients' Experiences Since the Rescheduling of Hydrocodone: The First 100 Days. PAIN MEDICINE 2015; 17:1686-93. [PMID: 26814291 DOI: 10.1093/pm/pnv064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 10/18/2015] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To conduct an Internet patient survey through the National Fibromyalgia & Chronic Pain Association on reactions to the first 100 days following the rescheduling of hydrocodone. METHODS Face-valid survey questions were created with expert consensus along with repurposed questions used on previous NFMCPA surveys covering domains such as demographics and symptoms. The questionnaire was designed to be administered over the Internet. RESULTS 6,420 responders met screening criteria and completed the survey. Most (5,181, or 82.5%) had been prescribed hydrocodone for more than 1 year. 2,296, (39.0%) reported no changes in access to hydrocodone, while the majority experienced some barriers. Of those who could no longer get hydrocodone, 1,067 (18.1%) borrowed pain medications, 1,007 (17.1%) turned to marijuana, 773 (13.1%) used alcohol, and 135 (2.3%) used illicit drugs. Most respondents had to visit their healthcare providers more often (N = 3,699, 64.2%) and 1,735 (30.3%) reported some type of issue interacting with their pharmacy. Most felt that the rescheduling was neither a fair nor appropriate solution to the abuse of hydrocodone (N = 4,938, 88.3%). For those still working, 801 (46.2%) reported that they had missed work because of the stricter regulations. 1,462 (27.2%) reported having thoughts of suicide since the rescheduling. SIGNIFICANCE The unintended consequences for people with chronic pain that have been caused by the rescheduling effort to impede hydrocodone abuse are negatively impacting thousands. These consequences include suffering from being placed on less effective drugs, increased cost, inconvenience, and negative influence on physician-patient and pharmacist-patient relationships.
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Affiliation(s)
- Jan Chambers
- *National Fibromyalgia & Chronic Pain Association, Logan, UT
| | - Rae M Gleason
- *National Fibromyalgia & Chronic Pain Association, Logan, UT
| | | | | | | | - Jon Berner
- Woodinville Psychiatric, Woodinville, WA
| | - Jeff Fudin
- Remitigate, LLC, Delmar, New York Western New England University College of Pharmacy, Springfield, Massachusetts **University of Connecticut School of Pharmacy, Storrs, Connecticut, USA
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