567 No evidence of benefits from oral NSAIDs for fibromyalgia

April 15, 2018

written by Brian McAvoy

Clinical question

How effective are oral nonsteroidal anti-inflammatory drugs (NSAIDs) for fibromyalgia in adults?

Bottom line

There was no evidence NSAIDs had any efficacy in relieving pain or other symptoms in people with fibromyalgia. Pain reduction by half or better was experienced by 1 in 10 with NSAID and 2 in 10 with placebo. Pain reduction by one-third or better was experienced by about 2 in 10 with both NSAID and placebo. There was limited evidence to indicate NSAIDs were without any effect. Side effects were experienced by 3 in 10 with NSAID and 2 in 10 with placebo. There were no serious adverse effects or deaths. NSAIDs tested were etoricoxib 90mg daily, ibuprofen 2400mg daily, naproxen 1000mg daily and tenoxicam 20mg daily. The duration of treatment in the double-blind phase varied between 3 and 8 weeks.

Caveat

There were only a small number of studies, and these were largely inadequate, with potential risk of bias.

Context

Fibromyalgia is characterised by persistent, widespread pain, sleep problems and fatigue. NSAIDs are frequently used to treat rheumatic diseases.

Cochrane Systematic Review

Derry S et al. Oral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults. Cochrane Reviews, 2017, Issue 3. Art. No.: CD012332.DOI: 10.1002/14651858. CD012332.pub2. This review contains 6 studies involving 292 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.