Mease Philip J, Choy Ernest H
Seattle Rheumatology Associates, Swedish Medical Center, Seattle, WA 98104,
Rheum Dis Clin North Am. 2009 May;35(2):359-72. doi: 10.1016/j.rdc.2009.06.007.
Advances have occurred in the pharmacotherapy of fibromyalgia (FM) and the methodology of clinical trial design in FM in parallel with improved understanding of the underlying pathophysiologic mechanisms. Several medications have been approved for the management of FM based on their clinically meaningful and durable effect on pain in monotherapy trials and their beneficial effect on patients'global impression of change, function, and other key symptom domains such as fatigue, sleep disturbance, and cognition. Adjunctive therapy with medicines targeted to specific symptom domains such as sleep as well as treatments aimed toward common comorbid conditions such as irritable bowel syndrome or disease states such as rheumatoid arthritis should be considered for the purpose of reducing the patient's overall symptom burden.
随着对纤维肌痛(FM)潜在病理生理机制的认识不断加深,FM的药物治疗和临床试验设计方法都取得了进展。基于在单药治疗试验中对疼痛具有临床意义且持久的疗效,以及对患者整体改善印象、功能和其他关键症状领域(如疲劳、睡眠障碍和认知)的有益影响,几种药物已被批准用于FM的治疗。为了减轻患者的整体症状负担,应考虑针对特定症状领域(如睡眠)的辅助治疗以及针对常见共病情况(如肠易激综合征)或疾病状态(如类风湿性关节炎)的治疗。