PMID- 22513976
OWN - NLM
STAT- MEDLINE
DCOM- 20120723
LR  - 20181221
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
IP  - 4
DP  - 2012 Apr 18
TI  - Monoamine oxidase inhibitors (MAOIs) for fibromyalgia syndrome.
PG  - CD009807
LID - 10.1002/14651858.CD009807 [doi]
AB  - BACKGROUND: Fibromyalgia (FM) syndrome is a chronic condition of unknown 
      aetiology characterised by musculoskeletal pain that often co-exists with sleep 
      disturbance, cognitive dysfunction and fatigue. Patients often report high 
      disability levels and poor quality of life. Since there is no specific treatment 
      that alters the pathogenesis of FM, drug therapy focuses on pain reduction and 
      improvement of other bothersome symptoms. OBJECTIVES: The objective of this 
      review was to assess the effectiveness and safety of monoamine oxidase inhibitors 
      (MAOIs) in the treatment of FM syndrome. SEARCH METHODS: We searched the Cochrane 
      Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 
      10), MEDLINE (1966 to November 2010), EMBASE (1980 to November 2010) and the 
      reference lists of reviewed articles. SELECTION CRITERIA: We selected all 
      randomised, double-blind trials of MAOIs used for the treatment of FM pain in 
      adult participants. DATA COLLECTION AND ANALYSIS: Two authors assessed risk of 
      bias and extracted data independently onto a specially designed pro forma and a 
      third review author cross-checked them. MAIN RESULTS: We included two studies of 
      inconsistent risk of bias with a total of 230 patients diagnosed with FM. We 
      evaluated two MAOIs: pirlindole and moclobemide. Pirlindole showed statistically 
      significant results compared with placebo for several outcomes (pain, tender 
      points and overall assessment by the patient and the physician), whereas 
      moclobemide did not show statistically significant differences between groups. 
      Pooled results of the two studies displayed a modest effect size in pain (mean 
      difference (MD) -1.45 (121 patients; 95% confidence interval (CI) -2.71 to -0.20; 
      number needed to treat (NNT) 2 (95% CI 1 to 12); I(2) = 59%)), implying a minimal 
      clinically important difference (MCID) and a small effect on tender points 
      (standardised mean difference (SMD) -0.36 (121 patients; 95% CI -0.72 to -0.00; 
      I(2) = 31%)). No effect was seen on global assessment by patient. Physical 
      function and sleep disturbance were not measured. The most frequent adverse 
      events were nausea and vomiting, with statistically significant differences 
      between groups (risk ratio (RR) 7.82 (89 patients; 95% CI 1.02 to 59.97; NNT 7 
      (95% CI 4 to 33)). AUTHORS' CONCLUSIONS: Data suggest that the effectiveness of 
      MAOIs for the treatment of FM symptoms is limited. Although we observed a 
      moderate effect size on pain and a small one on tender points, these results 
      should be taken with caution as they are only based on two studies with a small 
      number of patients and inconsistent risk of bias among them.
FAU - Tort, Sera
AU  - Tort S
AD  - Iberoamerican Cochrane Centre, Institute of Biomedical Research (IIB Sant Pau), 
      Barcelona, Spain. sera.tort@cochrane.es
FAU - Urrutia, Gerard
AU  - Urrutia G
FAU - Nishishinya, Maria Betina
AU  - Nishishinya MB
FAU - Walitt, Brian
AU  - Walitt B
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20120418
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
RN  - 0 (Carbazoles)
RN  - 0 (Monoamine Oxidase Inhibitors)
RN  - PJ0Y7AZB63 (Moclobemide)
RN  - V39YPH45FZ (pirlindole)
SB  - IM
MH  - Adult
MH  - Carbazoles/*therapeutic use
MH  - Fibromyalgia/*drug therapy
MH  - Humans
MH  - Moclobemide/*therapeutic use
MH  - Monoamine Oxidase Inhibitors/*therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Syndrome
EDAT- 2012/04/20 06:00
MHDA- 2012/07/24 06:00
CRDT- 2012/04/20 06:00
PHST- 2012/04/20 06:00 [entrez]
PHST- 2012/04/20 06:00 [pubmed]
PHST- 2012/07/24 06:00 [medline]
AID - 10.1002/14651858.CD009807 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2012 Apr 18;(4):CD009807. doi: 
      10.1002/14651858.CD009807.