Imane El Binoune, Salma Bourjila, Samira Rostom, Hajar El Allagui, Salma Zemrani, Bouchra Amine, Rachid Bahiri
Department of Rheumatology A, Al Ayachi Hospital, University Hospital Center Rabat-Salé, Morocco.
Reumatologia. 2025 Jun 20;63(3):166-173. doi: 10.5114/reum/201416. eCollection 2025.
This study outlines the diagnostic and therapeutic approaches - both pharmacological and non-pharmacological - used by Moroccan rheumatologists in managing fibromyalgia (FM). It also addresses other key aspects, such as assessing the psychosocial context of patients and referring them to other medical specialties.
A descriptive cross-sectional study was conducted using a survey designed to assess the management approach of Moroccan rheumatologists towards FM. The survey was carried out anonymously.
Out of 275 rheumatologists, 140 responded to the questionnaire (with a total of approximately 450 rheumatologists in Morocco). Ninety-nine percent ( = 139) reported encountering FM patients in their practice. Diagnosis of FM was predominantly based on clinical assessment without a scoring system ( = 66; 47%), while 20.7% ( = 29) used the FIRST score. A substantial proportion (70%) of participants requested biological and imaging workups despite apparent FM, with 92% ( = 129) opting for an inflammatory workup. Regarding the treatment aspect, paracetamol was the first-line analgesic prescribed by 58% ( = 81), followed by tramadol ( = 43; 30.9%). Pregabalin was the most commonly prescribed first-line treatment ( = 37; 27.4%), with antidepressants being the second-line choice in 35.8% ( = 42). Non-pharmacological treatments such as physical therapy, therapeutic education, and psychotherapy were the most highly recommended. Nearly all rheumatologists ( = 131; 93.6%) emphasized the need for multidisciplinary management for FM patients, often referring them to psychiatrists either alone or in conjunction with other specialists.
Diagnosing and treating FM presents significant challenges. This survey sheds light on the diverse approaches adopted by Moroccan rheumatologists towards managing patients with FM, emphasizing the importance of multidisciplinary care in addressing the complex needs of these patients.
本研究概述了摩洛哥风湿病专家在管理纤维肌痛（FM）时所采用的诊断和治疗方法，包括药物治疗和非药物治疗。它还涉及其他关键方面，如评估患者的社会心理背景以及将他们转诊至其他医学专科。
采用一项旨在评估摩洛哥风湿病专家对FM管理方法的调查进行描述性横断面研究。该调查以匿名方式进行。
在275名风湿病专家中，140人回复了问卷（摩洛哥共有约450名风湿病专家）。99%（=139）报告在其临床实践中遇到过FM患者。FM的诊断主要基于临床评估，未使用评分系统（=66；47%），而20.7%（=29）使用了FIRST评分。尽管FM症状明显，仍有很大比例（70%）的参与者要求进行生物学和影像学检查，其中92%（=129）选择进行炎症检查。在治疗方面，58%（=81）的人将对乙酰氨基酚作为一线镇痛药开具，其次是曲马多（=43；30.9%）。普瑞巴林是最常用的一线治疗药物（=37；27.4%），35.8%（=42）的人将抗抑郁药作为二线选择。物理治疗、治疗性教育和心理治疗等非药物治疗是最常被推荐的。几乎所有的风湿病专家（=131；93.6%）都强调FM患者需要多学科管理，通常会将他们单独或与其他专科医生一起转诊给精神科医生。
诊断和治疗FM存在重大挑战。这项调查揭示了摩洛哥风湿病专家在管理FM患者时采用的多种方法，强调了多学科护理在满足这些患者复杂需求方面的重要性。
