Fibromialgia – Rokowania, prognozy i postęp choroby

Fibromialgia
Rokowania, prognozy i postęp choroby

Fibromialgia jest przewlekłym zespołem bólowym charakteryzującym się rozlanym bólem, zmęczeniem, zaburzeniami snu i funkcji poznawczych, z przewlekłym przebiegiem i brakiem skutecznego leczenia przyczynowego. Badania na 1555 pacjentach wykazały, że 5-letni wskaźnik poprawy bólu i zmęczenia wynosił około 0,4 (95% CI 0,2–0,5), natomiast ogólny stan zdrowia pozostawał bez zmian (0,0; 95% CI -0,1–0,1). Około 25% pacjentów doświadczyło umiarkowanej poprawy bólu, jednak u 35,9% nastąpiło pogorszenie ogólnego stanu, a u 38,6% wzrost nasilenia bólu. Fibromialgia nie zwiększa śmiertelności, ale wiąże się ze zwiększonym ryzykiem samobójstwa, szczególnie u kobiet. Współistniejące schorzenia, takie jak migrena, zespół jelita drażliwego, depresja i stany lękowe, pogarszają przebieg choroby i jakość życia pacjentów.

Wprowadzenie do prognozy w fibromyalgii

Przebieg naturalny fibromialgii
Czynniki wpływające na progresję choroby

Wyniki długoterminowe w fibromialgii

Wskaźniki poprawy i pogorszenia
Śmiertelność i ryzyko samobójstwa

Predyktory wyników leczenia fibromialgii

Modulacja bólu jako biomarker fibromialgii
Algorytmy predykcyjne w fibromialgii

Badania kliniczne i ich wpływ na prognozę

Wyniki badań klinicznych i ich interpretacja
Znaczenie przestrzegania leczenia dla prognozy

Podsumowanie prognozy w fibromialgii

Kolejne rozdziały

Wprowadzenie do prognozy w fibromyalgii

Fibromialgia to przewlekły zespół bólowy, charakteryzujący się rozlanym bólem, któremu towarzyszą inne objawy, takie jak zmęczenie, zaburzenia snu i funkcji poznawczych. Prognoza tego schorzenia jest złożona i wymaga uwzględnienia wielu aspektów klinicznych. Fibromialgia nie ma obecnie skutecznego leczenia przyczynowego, a większość pacjentów doświadcza objawów przez całe życie.¹ Badania naukowe wskazują, że różne formy fibromialgii mogą postępować z różnym nasileniem, co wpływa na rokowanie.²

Przebieg naturalny fibromialgii

Według badań, przebieg fibromialgii jest zazwyczaj definiowany jako kontinuum lub postępujący proces. Większość pacjentów doświadcza utrzymujących się na wysokim poziomie objawów i cierpienia, choć można zaobserwować nieznaczną tendencję do poprawy w perspektywie długoterminowej.³⁴ Badanie prowadzone na grupie 1555 pacjentów z fibromialgią przez amerykańskich reumatologów wykazało, że 5-letni wskaźnik poprawy wynosił dla bólu 0,4 (95% CI 0,2, 0,5), dla zmęczenia 0,4 (95% CI 0,2, 0,05), zaś dla ogólnego stanu zdrowia 0,0 (95% CI -0,1, 0,1).⁵

Czynniki wpływające na progresję choroby

Badania pokazują, że zwiększone spożycie leków oraz współistniejące schorzenia zdrowia fizycznego i psychicznego, takie jak migrena, zespół jelita drażliwego, depresja i stany lękowe, prowadzą do postępującego wzrostu dolegliwości fizycznych i subiektywnych zaburzeń.⁶ Istnieje silny konsensus z badań, że fibromialgia typowo wpływa na jakość życia ze względu na jej objawy, jednak nie zwiększa śmiertelności ani ryzyka zgonu.⁷⁸

Wyniki długoterminowe w fibromialgii

Długoterminowa obserwacja pacjentów z fibromialgią wskazuje na zróżnicowane wyniki leczenia. W badaniu 1555 pacjentów zaobserwowano, że około 10% pacjentów doświadczyło znacznej poprawy, a około 15% umiarkowanej poprawy bólu. Jednakże ogólne nasilenie fibromialgii pogorszyło się u 35,9% pacjentów, a ból u 38,6%.⁹

Wskaźniki poprawy i pogorszenia

Choć nie stwierdzono średniej, klinicznie znaczącej poprawy w nasileniu objawów ogółem, około 25% pacjentów doświadczyło co najmniej umiarkowanej poprawy bólu w miarę upływu czasu.¹⁰ Wynik z tego długoterminowego badania wskazywał generalnie na utrzymujące się wysokie poziomy objawów zgłaszanych przez pacjentów i cierpienia dla większości pacjentów, ale z niewielką tendencją do poprawy.¹¹

Śmiertelność i ryzyko samobójstwa

Duże badania porównujące pacjentów z fibromialgią z innymi przewlekłymi stanami bólowymi, takimi jak choroba zwyrodnieniowa stawów, wykazują, że wskaźnik śmiertelności nie jest podwyższony w fibromialgii.¹² Jednak raporty wskazują, że standaryzowane ryzyko samobójstwa w fibromialgii jest zwiększone w porównaniu z populacją USA.¹³ Niektóre badania wykazały również, że pacjentki z fibromialgią są bardziej skłonne do popełnienia samobójstwa niż mężczyźni z fibromialgią.¹⁴

Predyktory wyników leczenia fibromialgii

Identyfikacja wiarygodnych biomarkerów i predyktorów klinicznych wyników leczenia fibromialgii jest aktywnym obszarem badań. Około 3% globalnej populacji cierpi na fibromialgię, a średnie opóźnienie diagnostyczne wynosi sześć lat.¹⁵ Klasyfikacja wyników oparta na objawach zgłaszanych przez pacjentów mogłaby przynieść korzyści pacjentom, umożliwiając wcześniejsze skierowanie do specjalistów.¹⁶

Modulacja bólu jako biomarker fibromialgii

Fibromialgia jest prawdopodobnie związana z obecnością centralnej dysfunkcji w zstępujących szlakach hamowania bólu.¹⁷ W celu wyjaśnienia ważności kondycjonowanej modulacji bólu (CPM) jako biomarkera fibromialgii, testowano dwa paradygmaty CPM (równoległy i sekwencyjny) na próbie 23 pacjentek i 23 zdrowych kobiet.¹⁸ Zaobserwowano, że tylko równoległe testowanie CPM prawidłowo klasyfikowało około 70% pacjentów z fibromialgią.¹⁹

Jednakże wyniki te również budzą wątpliwości co do czułości CPM jako markera ciężkości bólu w fibromialgii.²⁰ CPM była sugerowana jako potencjalny biomarker do rozróżniania profili klinicznych o różnym rokowaniu choroby i nasileniu objawów w przewlekłych chorobach bólowych.²¹ Jednak niedawny przegląd kwestionuje ważność CPM jako biomarkera bólu klinicznego, biorąc pod uwagę, że deficyty w CPM nie zawsze korelują z klinicznymi objawami bólu.²²

Algorytmy predykcyjne w fibromialgii

Badania nad algorytmami predykcyjnymi w fibromialgii wykazują obiecujące wyniki. Algorytm oparty na objawach zgłaszanych przez pacjentów wykazuje dobrą skuteczność w przewidywaniu diagnozy fibromialgii we wszystkich punktach obserwacji, z ogólnymi wartościami AUROC nigdy nie spadającymi poniżej 0,79.²³ Taki algorytm może być przydatny dla klinicystów, umożliwiając szybszą diagnozę na podstawie odpowiedzi pacjentów z kwestionariuszy objawów.²⁴

Badania kliniczne i ich wpływ na prognozę

Rozwój nowych metod terapeutycznych może potencjalnie wpłynąć na poprawę rokowania u pacjentów z fibromialgią. Przykładem jest badanie FORTRESS oceniające skuteczność IMC-1 w leczeniu fibromialgii.²⁵

Wyniki badań klinicznych i ich interpretacja

W badaniu FORTRESS ogólnie nie osiągnięto statystycznie istotnej różnicy w predefiniowanym pierwszorzędowym punkcie końcowym skuteczności, jakim była zmiana od wartości wyjściowej do 14 tygodnia w tygodniowej średniej codziennych samodzielnie zgłaszanych wyników nasilenia bólu, porównując IMC-1 z placebo (p=0,302).²⁶

Jednakże w drugiej połowie badania (listopad 2021 do kwietnia 2022), dla pacjentów, którzy zostali włączeni (n=214), gdy wskaźniki szczepień poprawiły się, a mniej ciężki wariant Omicron COVID-19 stał się dominującym szczepem w USA, pacjenci leczeni IMC-1 wykazali statystycznie istotną poprawę w pierwszorzędowym punkcie końcowym redukcji bólu (p=0,03) w 14. tygodniu, a także statystycznie istotną poprawę w kluczowej drugorzędowej ocenie zmęczenia PROMIS (p=0,006) i wyniku domeny objawów Kwestionariusza Wpływu Fibromialgii-Zrewidowanego (FIQR) (p=0,015).²⁷

Znaczenie przestrzegania leczenia dla prognozy

Istotne jest, aby każdy przewlekle cierpiący pacjent przestrzegał leczenia dla jego maksymalnej skuteczności.²⁸ Badania pokazują, że pacjenci z większym bólem i lepszym zdrowiem emocjonalnym lepiej przestrzegają terapii ćwiczeniowej i innych metod leczenia w porównaniu do tych z depresją i innymi powiązanymi zaburzeniami zdrowia psychicznego.²⁹

Podsumowanie prognozy w fibromialgii

Rokowanie w fibromialgii jest zróżnicowane i zależy od wielu czynników. Ogólnie rzecz biorąc, pacjenci doświadczają przewlekłych objawów, które mogą utrzymywać się przez całe życie, choć indywidualne trajektorie choroby mogą się znacznie różnić. Około 25% pacjentów doświadcza umiarkowanej poprawy bólu w czasie, podczas gdy u znacznego odsetka stan może się pogorszyć.³⁰³¹

Rozwój biomarkerów, takich jak CPM, oraz algorytmów predykcyjnych może pomóc w lepszym prognozowaniu przebiegu choroby i optymalizacji strategii leczenia dla poszczególnych pacjentów.³²³³ Przestrzeganie leczenia przez pacjentów oraz zarządzanie współistniejącymi schorzeniami ma kluczowe znaczenie dla optymalnych wyników.³⁴

Pomimo braku wyraźnej poprawy w nasileniu objawów ogółem, indywidualne wyniki mogą być korzystniejsze u niektórych pacjentów. Fibromialgia, choć nie zwiększa śmiertelności, wiąże się z podwyższonym ryzykiem samobójstwa, co podkreśla znaczenie kompleksowej opieki, obejmującej także wsparcie zdrowia psychicznego.³⁵

Badania kliniczne, takie jak badanie FORTRESS, dostarczają cennych informacji na temat skuteczności nowych terapii, które mogą potencjalnie zmienić przebieg choroby i poprawić długoterminowe prognozy u pacjentów z fibromialgią.³⁶

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Materiały źródłowe

#1 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Fibromyalgia is a condition with widespread debilitating pain. […] The condition has no cure and most often patients continue to have symptoms throughout life. […] There is scientific evidence that different forms of fibromyalgia progress differently with varying severity. […] Most studies define the progression as a continuum or a continuing ongoing process. […] Studies have shown that increased drug consumption and physical and mental health associated conditions like migraine, irritable bowel syndrome and depression and anxiety lead to a progressive increase in physical distress and subjective disturbances. […] There is a strong consensus from studies that fibromyalgia typically affects the quality of life due to its symptoms. […] Studies also show that mortality or risk of death does not rise with fibromyalgia.
#2 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Fibromyalgia is a condition with widespread debilitating pain. […] The condition has no cure and most often patients continue to have symptoms throughout life. […] There is scientific evidence that different forms of fibromyalgia progress differently with varying severity. […] Most studies define the progression as a continuum or a continuing ongoing process. […] Studies have shown that increased drug consumption and physical and mental health associated conditions like migraine, irritable bowel syndrome and depression and anxiety lead to a progressive increase in physical distress and subjective disturbances. […] There is a strong consensus from studies that fibromyalgia typically affects the quality of life due to its symptoms. […] Studies also show that mortality or risk of death does not rise with fibromyalgia.
#3 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Fibromyalgia is a condition with widespread debilitating pain. […] The condition has no cure and most often patients continue to have symptoms throughout life. […] There is scientific evidence that different forms of fibromyalgia progress differently with varying severity. […] Most studies define the progression as a continuum or a continuing ongoing process. […] Studies have shown that increased drug consumption and physical and mental health associated conditions like migraine, irritable bowel syndrome and depression and anxiety lead to a progressive increase in physical distress and subjective disturbances. […] There is a strong consensus from studies that fibromyalgia typically affects the quality of life due to its symptoms. […] Studies also show that mortality or risk of death does not rise with fibromyalgia.
#4 The longitudinal outcome of fibromyalgia: a study of 1555 patients – PubMed
https://pubmed.ncbi.nlm.nih.gov/21765102/
Objective: To describe the diagnosis status and outcome of patients diagnosed with fibromyalgia (FM) by US rheumatologists. […] The 5-year improvement rates were pain 0.4 (95% CI 0.2, 0.5), fatigue 0.4 (95% CI 0.2, 0.05), and global 0.0 (95% CI -0.1, 0.1). […] About 10% of patients had substantial improvement and about 15% had moderate improvement of pain. Overall, FM severity worsened in 35.9% and pain in 38.6%. […] Although we found no average clinically meaningful improvement in symptom severity overall, 25% had at least moderate improvement of pain over time. The result that emerged from this longitudinal study was one of generally continuing high levels of self-reported symptoms and distress for most patients, but a slight trend toward improvement.
#5 The longitudinal outcome of fibromyalgia: a study of 1555 patients – PubMed
https://pubmed.ncbi.nlm.nih.gov/21765102/
Objective: To describe the diagnosis status and outcome of patients diagnosed with fibromyalgia (FM) by US rheumatologists. […] The 5-year improvement rates were pain 0.4 (95% CI 0.2, 0.5), fatigue 0.4 (95% CI 0.2, 0.05), and global 0.0 (95% CI -0.1, 0.1). […] About 10% of patients had substantial improvement and about 15% had moderate improvement of pain. Overall, FM severity worsened in 35.9% and pain in 38.6%. […] Although we found no average clinically meaningful improvement in symptom severity overall, 25% had at least moderate improvement of pain over time. The result that emerged from this longitudinal study was one of generally continuing high levels of self-reported symptoms and distress for most patients, but a slight trend toward improvement.
#6 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Fibromyalgia is a condition with widespread debilitating pain. […] The condition has no cure and most often patients continue to have symptoms throughout life. […] There is scientific evidence that different forms of fibromyalgia progress differently with varying severity. […] Most studies define the progression as a continuum or a continuing ongoing process. […] Studies have shown that increased drug consumption and physical and mental health associated conditions like migraine, irritable bowel syndrome and depression and anxiety lead to a progressive increase in physical distress and subjective disturbances. […] There is a strong consensus from studies that fibromyalgia typically affects the quality of life due to its symptoms. […] Studies also show that mortality or risk of death does not rise with fibromyalgia.
#7 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Fibromyalgia is a condition with widespread debilitating pain. […] The condition has no cure and most often patients continue to have symptoms throughout life. […] There is scientific evidence that different forms of fibromyalgia progress differently with varying severity. […] Most studies define the progression as a continuum or a continuing ongoing process. […] Studies have shown that increased drug consumption and physical and mental health associated conditions like migraine, irritable bowel syndrome and depression and anxiety lead to a progressive increase in physical distress and subjective disturbances. […] There is a strong consensus from studies that fibromyalgia typically affects the quality of life due to its symptoms. […] Studies also show that mortality or risk of death does not rise with fibromyalgia.
#8 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Large studies comparing fibromyalgia patients with other chronic pain conditions like osteoarthritis show that the death rate was not elevated in fibromyalgia. […] Reports find that the standardized risk of suicide with fibromyalgia is increased when compared to the US population. […] Some studies have also shown that female patients with fibromyalgia are more likely to commit suicide than males with fibromyalgia. […] It is important that any chronic sufferer be adherent to treatment for its maximum efficacy. […] Patients with greater pain and better emotional health are more compliant to exercise therapy and other treatment modalities compared to those with depression and other associated mental health disturbances.
#9 The longitudinal outcome of fibromyalgia: a study of 1555 patients – PubMed
https://pubmed.ncbi.nlm.nih.gov/21765102/
Objective: To describe the diagnosis status and outcome of patients diagnosed with fibromyalgia (FM) by US rheumatologists. […] The 5-year improvement rates were pain 0.4 (95% CI 0.2, 0.5), fatigue 0.4 (95% CI 0.2, 0.05), and global 0.0 (95% CI -0.1, 0.1). […] About 10% of patients had substantial improvement and about 15% had moderate improvement of pain. Overall, FM severity worsened in 35.9% and pain in 38.6%. […] Although we found no average clinically meaningful improvement in symptom severity overall, 25% had at least moderate improvement of pain over time. The result that emerged from this longitudinal study was one of generally continuing high levels of self-reported symptoms and distress for most patients, but a slight trend toward improvement.
#10 The longitudinal outcome of fibromyalgia: a study of 1555 patients – PubMed
https://pubmed.ncbi.nlm.nih.gov/21765102/
Objective: To describe the diagnosis status and outcome of patients diagnosed with fibromyalgia (FM) by US rheumatologists. […] The 5-year improvement rates were pain 0.4 (95% CI 0.2, 0.5), fatigue 0.4 (95% CI 0.2, 0.05), and global 0.0 (95% CI -0.1, 0.1). […] About 10% of patients had substantial improvement and about 15% had moderate improvement of pain. Overall, FM severity worsened in 35.9% and pain in 38.6%. […] Although we found no average clinically meaningful improvement in symptom severity overall, 25% had at least moderate improvement of pain over time. The result that emerged from this longitudinal study was one of generally continuing high levels of self-reported symptoms and distress for most patients, but a slight trend toward improvement.
#11 The longitudinal outcome of fibromyalgia: a study of 1555 patients – PubMed
https://pubmed.ncbi.nlm.nih.gov/21765102/
Objective: To describe the diagnosis status and outcome of patients diagnosed with fibromyalgia (FM) by US rheumatologists. […] The 5-year improvement rates were pain 0.4 (95% CI 0.2, 0.5), fatigue 0.4 (95% CI 0.2, 0.05), and global 0.0 (95% CI -0.1, 0.1). […] About 10% of patients had substantial improvement and about 15% had moderate improvement of pain. Overall, FM severity worsened in 35.9% and pain in 38.6%. […] Although we found no average clinically meaningful improvement in symptom severity overall, 25% had at least moderate improvement of pain over time. The result that emerged from this longitudinal study was one of generally continuing high levels of self-reported symptoms and distress for most patients, but a slight trend toward improvement.
#12 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Large studies comparing fibromyalgia patients with other chronic pain conditions like osteoarthritis show that the death rate was not elevated in fibromyalgia. […] Reports find that the standardized risk of suicide with fibromyalgia is increased when compared to the US population. […] Some studies have also shown that female patients with fibromyalgia are more likely to commit suicide than males with fibromyalgia. […] It is important that any chronic sufferer be adherent to treatment for its maximum efficacy. […] Patients with greater pain and better emotional health are more compliant to exercise therapy and other treatment modalities compared to those with depression and other associated mental health disturbances.
#13 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Large studies comparing fibromyalgia patients with other chronic pain conditions like osteoarthritis show that the death rate was not elevated in fibromyalgia. […] Reports find that the standardized risk of suicide with fibromyalgia is increased when compared to the US population. […] Some studies have also shown that female patients with fibromyalgia are more likely to commit suicide than males with fibromyalgia. […] It is important that any chronic sufferer be adherent to treatment for its maximum efficacy. […] Patients with greater pain and better emotional health are more compliant to exercise therapy and other treatment modalities compared to those with depression and other associated mental health disturbances.
#14 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Large studies comparing fibromyalgia patients with other chronic pain conditions like osteoarthritis show that the death rate was not elevated in fibromyalgia. […] Reports find that the standardized risk of suicide with fibromyalgia is increased when compared to the US population. […] Some studies have also shown that female patients with fibromyalgia are more likely to commit suicide than males with fibromyalgia. […] It is important that any chronic sufferer be adherent to treatment for its maximum efficacy. […] Patients with greater pain and better emotional health are more compliant to exercise therapy and other treatment modalities compared to those with depression and other associated mental health disturbances.
#15 POS1052âPREDICTING FIBROMYALGIA OUTCOME FROM A RHEUMATIC-SPECIFIC SURVEY | Annals of the Rheumatic Diseases
https://ard.bmj.com/content/83/Suppl_1/573.1
Around 3% of the global population suffers from Fibromyalgia (FM) and the average diagnostic delay is six years. […] An outcome classification based on self-reported symptoms could benefit patients, by allowing patients to be referred to specialists sooner. […] Our algorithm performs well for predicting FM diagnosis at all follow-up timepoints with overall AUROCS never falling below 0.79. […] Our pipeline obtained a consistently high performance. Such a pipeline can be useful for clinicians by allowing faster diagnosis based on symptom checker responses from patients.
#16 POS1052âPREDICTING FIBROMYALGIA OUTCOME FROM A RHEUMATIC-SPECIFIC SURVEY | Annals of the Rheumatic Diseases
https://ard.bmj.com/content/83/Suppl_1/573.1
Around 3% of the global population suffers from Fibromyalgia (FM) and the average diagnostic delay is six years. […] An outcome classification based on self-reported symptoms could benefit patients, by allowing patients to be referred to specialists sooner. […] Our algorithm performs well for predicting FM diagnosis at all follow-up timepoints with overall AUROCS never falling below 0.79. […] Our pipeline obtained a consistently high performance. Such a pipeline can be useful for clinicians by allowing faster diagnosis based on symptom checker responses from patients.
#17 Conditioned pain modulation (CPM) paradigm type affects its sensitivity as a biomarker of fibromyalgia | Scientific Reports
https://www.nature.com/articles/s41598-024-58079-7
Fibromyalgia (FM) is a widespread chronic pain syndrome, possibly associated with the presence of central dysfunction in descending pain inhibition pathways. […] To clarify the validity of CPM as a biomarker of FM, we tested two CPM paradigms (parallel and sequential) in a sample of 23 female patients and 23 healthy women. […] We observed that only parallel CPM testing correctly classified about 70% of patients with FM. […] However, the findings also cast doubts on the sensitivity of CPM as a marker of pain severity in FM. […] Thus, CPM has been suggested as a potential biomarker to distinguish clinical profiles with different disease prognosis and symptom severity in chronic pain diseases. […] However, a recent review brings into question the validity of CPM as a biomarker of clinical pain, given that the deficits in CPM are not always correlated with clinical manifestations of pain. […] Our findings confirm the influence of some methodological factors on the magnitude of the CPM effect and suggest the usefulness of CPM (parallel paradigm) as a diagnostic tool for FM; however, they cast doubts on the sensitivity of CPM as a biomarker of disease severity.
#18 Conditioned pain modulation (CPM) paradigm type affects its sensitivity as a biomarker of fibromyalgia | Scientific Reports
https://www.nature.com/articles/s41598-024-58079-7
Fibromyalgia (FM) is a widespread chronic pain syndrome, possibly associated with the presence of central dysfunction in descending pain inhibition pathways. […] To clarify the validity of CPM as a biomarker of FM, we tested two CPM paradigms (parallel and sequential) in a sample of 23 female patients and 23 healthy women. […] We observed that only parallel CPM testing correctly classified about 70% of patients with FM. […] However, the findings also cast doubts on the sensitivity of CPM as a marker of pain severity in FM. […] Thus, CPM has been suggested as a potential biomarker to distinguish clinical profiles with different disease prognosis and symptom severity in chronic pain diseases. […] However, a recent review brings into question the validity of CPM as a biomarker of clinical pain, given that the deficits in CPM are not always correlated with clinical manifestations of pain. […] Our findings confirm the influence of some methodological factors on the magnitude of the CPM effect and suggest the usefulness of CPM (parallel paradigm) as a diagnostic tool for FM; however, they cast doubts on the sensitivity of CPM as a biomarker of disease severity.
#19 Conditioned pain modulation (CPM) paradigm type affects its sensitivity as a biomarker of fibromyalgia | Scientific Reports
https://www.nature.com/articles/s41598-024-58079-7
Fibromyalgia (FM) is a widespread chronic pain syndrome, possibly associated with the presence of central dysfunction in descending pain inhibition pathways. […] To clarify the validity of CPM as a biomarker of FM, we tested two CPM paradigms (parallel and sequential) in a sample of 23 female patients and 23 healthy women. […] We observed that only parallel CPM testing correctly classified about 70% of patients with FM. […] However, the findings also cast doubts on the sensitivity of CPM as a marker of pain severity in FM. […] Thus, CPM has been suggested as a potential biomarker to distinguish clinical profiles with different disease prognosis and symptom severity in chronic pain diseases. […] However, a recent review brings into question the validity of CPM as a biomarker of clinical pain, given that the deficits in CPM are not always correlated with clinical manifestations of pain. […] Our findings confirm the influence of some methodological factors on the magnitude of the CPM effect and suggest the usefulness of CPM (parallel paradigm) as a diagnostic tool for FM; however, they cast doubts on the sensitivity of CPM as a biomarker of disease severity.
#20 Conditioned pain modulation (CPM) paradigm type affects its sensitivity as a biomarker of fibromyalgia | Scientific Reports
https://www.nature.com/articles/s41598-024-58079-7
Fibromyalgia (FM) is a widespread chronic pain syndrome, possibly associated with the presence of central dysfunction in descending pain inhibition pathways. […] To clarify the validity of CPM as a biomarker of FM, we tested two CPM paradigms (parallel and sequential) in a sample of 23 female patients and 23 healthy women. […] We observed that only parallel CPM testing correctly classified about 70% of patients with FM. […] However, the findings also cast doubts on the sensitivity of CPM as a marker of pain severity in FM. […] Thus, CPM has been suggested as a potential biomarker to distinguish clinical profiles with different disease prognosis and symptom severity in chronic pain diseases. […] However, a recent review brings into question the validity of CPM as a biomarker of clinical pain, given that the deficits in CPM are not always correlated with clinical manifestations of pain. […] Our findings confirm the influence of some methodological factors on the magnitude of the CPM effect and suggest the usefulness of CPM (parallel paradigm) as a diagnostic tool for FM; however, they cast doubts on the sensitivity of CPM as a biomarker of disease severity.
#21 Conditioned pain modulation (CPM) paradigm type affects its sensitivity as a biomarker of fibromyalgia | Scientific Reports
https://www.nature.com/articles/s41598-024-58079-7
Fibromyalgia (FM) is a widespread chronic pain syndrome, possibly associated with the presence of central dysfunction in descending pain inhibition pathways. […] To clarify the validity of CPM as a biomarker of FM, we tested two CPM paradigms (parallel and sequential) in a sample of 23 female patients and 23 healthy women. […] We observed that only parallel CPM testing correctly classified about 70% of patients with FM. […] However, the findings also cast doubts on the sensitivity of CPM as a marker of pain severity in FM. […] Thus, CPM has been suggested as a potential biomarker to distinguish clinical profiles with different disease prognosis and symptom severity in chronic pain diseases. […] However, a recent review brings into question the validity of CPM as a biomarker of clinical pain, given that the deficits in CPM are not always correlated with clinical manifestations of pain. […] Our findings confirm the influence of some methodological factors on the magnitude of the CPM effect and suggest the usefulness of CPM (parallel paradigm) as a diagnostic tool for FM; however, they cast doubts on the sensitivity of CPM as a biomarker of disease severity.
#22 Conditioned pain modulation (CPM) paradigm type affects its sensitivity as a biomarker of fibromyalgia | Scientific Reports
https://www.nature.com/articles/s41598-024-58079-7
Fibromyalgia (FM) is a widespread chronic pain syndrome, possibly associated with the presence of central dysfunction in descending pain inhibition pathways. […] To clarify the validity of CPM as a biomarker of FM, we tested two CPM paradigms (parallel and sequential) in a sample of 23 female patients and 23 healthy women. […] We observed that only parallel CPM testing correctly classified about 70% of patients with FM. […] However, the findings also cast doubts on the sensitivity of CPM as a marker of pain severity in FM. […] Thus, CPM has been suggested as a potential biomarker to distinguish clinical profiles with different disease prognosis and symptom severity in chronic pain diseases. […] However, a recent review brings into question the validity of CPM as a biomarker of clinical pain, given that the deficits in CPM are not always correlated with clinical manifestations of pain. […] Our findings confirm the influence of some methodological factors on the magnitude of the CPM effect and suggest the usefulness of CPM (parallel paradigm) as a diagnostic tool for FM; however, they cast doubts on the sensitivity of CPM as a biomarker of disease severity.
#23 POS1052âPREDICTING FIBROMYALGIA OUTCOME FROM A RHEUMATIC-SPECIFIC SURVEY | Annals of the Rheumatic Diseases
https://ard.bmj.com/content/83/Suppl_1/573.1
Around 3% of the global population suffers from Fibromyalgia (FM) and the average diagnostic delay is six years. […] An outcome classification based on self-reported symptoms could benefit patients, by allowing patients to be referred to specialists sooner. […] Our algorithm performs well for predicting FM diagnosis at all follow-up timepoints with overall AUROCS never falling below 0.79. […] Our pipeline obtained a consistently high performance. Such a pipeline can be useful for clinicians by allowing faster diagnosis based on symptom checker responses from patients.
#24 POS1052âPREDICTING FIBROMYALGIA OUTCOME FROM A RHEUMATIC-SPECIFIC SURVEY | Annals of the Rheumatic Diseases
https://ard.bmj.com/content/83/Suppl_1/573.1
Around 3% of the global population suffers from Fibromyalgia (FM) and the average diagnostic delay is six years. […] An outcome classification based on self-reported symptoms could benefit patients, by allowing patients to be referred to specialists sooner. […] Our algorithm performs well for predicting FM diagnosis at all follow-up timepoints with overall AUROCS never falling below 0.79. […] Our pipeline obtained a consistently high performance. Such a pipeline can be useful for clinicians by allowing faster diagnosis based on symptom checker responses from patients.
#25 Virios Therapeutics Announces Top-Line Results from Phase 2b Study of IMC-1 in Fibromyalgia :: Dogwood Therapeutics, Inc. (DWTX)
https://ir.dwtx.com/news/press-releases/detail/84/virios-therapeutics-announces-top-line-results-from-phase
Overall, the FORTRESS study did not achieve statistical significance on the prespecified primary efficacy endpoint of change from baseline to Week 14 in the weekly average of daily self-reported average pain severity scores comparing IMC-1 to placebo (p=0.302). […] Conversely, during the second half of the trial (November 2021 to April 2022), for the patients who were enrolled (n=214) when vaccination rates improved and the less severe Omicron variant of COVID-19 became the dominant U.S. strain, IMC-1-treated patients demonstrated a statistically significant improvement on the primary pain reduction endpoint (p=0.03) at Week 14, as well as a statistically significant improvement in the key secondary PROMIS Fatigue assessment (p=0.006) and the Fibromyalgia Impact Questionnaire-Revised (FIQR) symptoms domain score (p=0.015). […] Overall, the efficacy data from this trial were not what we had expected, said R. Michael Gendreau, M.D., Ph.D., Chief Medical Officer of Virios Therapeutics. We will continue to explore IMC-1s potential as a viable FM treatment option.
#26 Virios Therapeutics Announces Top-Line Results from Phase 2b Study of IMC-1 in Fibromyalgia :: Dogwood Therapeutics, Inc. (DWTX)
https://ir.dwtx.com/news/press-releases/detail/84/virios-therapeutics-announces-top-line-results-from-phase
Overall, the FORTRESS study did not achieve statistical significance on the prespecified primary efficacy endpoint of change from baseline to Week 14 in the weekly average of daily self-reported average pain severity scores comparing IMC-1 to placebo (p=0.302). […] Conversely, during the second half of the trial (November 2021 to April 2022), for the patients who were enrolled (n=214) when vaccination rates improved and the less severe Omicron variant of COVID-19 became the dominant U.S. strain, IMC-1-treated patients demonstrated a statistically significant improvement on the primary pain reduction endpoint (p=0.03) at Week 14, as well as a statistically significant improvement in the key secondary PROMIS Fatigue assessment (p=0.006) and the Fibromyalgia Impact Questionnaire-Revised (FIQR) symptoms domain score (p=0.015). […] Overall, the efficacy data from this trial were not what we had expected, said R. Michael Gendreau, M.D., Ph.D., Chief Medical Officer of Virios Therapeutics. We will continue to explore IMC-1s potential as a viable FM treatment option.
#27 Virios Therapeutics Announces Top-Line Results from Phase 2b Study of IMC-1 in Fibromyalgia :: Dogwood Therapeutics, Inc. (DWTX)
https://ir.dwtx.com/news/press-releases/detail/84/virios-therapeutics-announces-top-line-results-from-phase
Overall, the FORTRESS study did not achieve statistical significance on the prespecified primary efficacy endpoint of change from baseline to Week 14 in the weekly average of daily self-reported average pain severity scores comparing IMC-1 to placebo (p=0.302). […] Conversely, during the second half of the trial (November 2021 to April 2022), for the patients who were enrolled (n=214) when vaccination rates improved and the less severe Omicron variant of COVID-19 became the dominant U.S. strain, IMC-1-treated patients demonstrated a statistically significant improvement on the primary pain reduction endpoint (p=0.03) at Week 14, as well as a statistically significant improvement in the key secondary PROMIS Fatigue assessment (p=0.006) and the Fibromyalgia Impact Questionnaire-Revised (FIQR) symptoms domain score (p=0.015). […] Overall, the efficacy data from this trial were not what we had expected, said R. Michael Gendreau, M.D., Ph.D., Chief Medical Officer of Virios Therapeutics. We will continue to explore IMC-1s potential as a viable FM treatment option.
#28 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Large studies comparing fibromyalgia patients with other chronic pain conditions like osteoarthritis show that the death rate was not elevated in fibromyalgia. […] Reports find that the standardized risk of suicide with fibromyalgia is increased when compared to the US population. […] Some studies have also shown that female patients with fibromyalgia are more likely to commit suicide than males with fibromyalgia. […] It is important that any chronic sufferer be adherent to treatment for its maximum efficacy. […] Patients with greater pain and better emotional health are more compliant to exercise therapy and other treatment modalities compared to those with depression and other associated mental health disturbances.
#29 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Large studies comparing fibromyalgia patients with other chronic pain conditions like osteoarthritis show that the death rate was not elevated in fibromyalgia. […] Reports find that the standardized risk of suicide with fibromyalgia is increased when compared to the US population. […] Some studies have also shown that female patients with fibromyalgia are more likely to commit suicide than males with fibromyalgia. […] It is important that any chronic sufferer be adherent to treatment for its maximum efficacy. […] Patients with greater pain and better emotional health are more compliant to exercise therapy and other treatment modalities compared to those with depression and other associated mental health disturbances.
#30 The longitudinal outcome of fibromyalgia: a study of 1555 patients – PubMed
https://pubmed.ncbi.nlm.nih.gov/21765102/
Objective: To describe the diagnosis status and outcome of patients diagnosed with fibromyalgia (FM) by US rheumatologists. […] The 5-year improvement rates were pain 0.4 (95% CI 0.2, 0.5), fatigue 0.4 (95% CI 0.2, 0.05), and global 0.0 (95% CI -0.1, 0.1). […] About 10% of patients had substantial improvement and about 15% had moderate improvement of pain. Overall, FM severity worsened in 35.9% and pain in 38.6%. […] Although we found no average clinically meaningful improvement in symptom severity overall, 25% had at least moderate improvement of pain over time. The result that emerged from this longitudinal study was one of generally continuing high levels of self-reported symptoms and distress for most patients, but a slight trend toward improvement.
#31 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Fibromyalgia is a condition with widespread debilitating pain. […] The condition has no cure and most often patients continue to have symptoms throughout life. […] There is scientific evidence that different forms of fibromyalgia progress differently with varying severity. […] Most studies define the progression as a continuum or a continuing ongoing process. […] Studies have shown that increased drug consumption and physical and mental health associated conditions like migraine, irritable bowel syndrome and depression and anxiety lead to a progressive increase in physical distress and subjective disturbances. […] There is a strong consensus from studies that fibromyalgia typically affects the quality of life due to its symptoms. […] Studies also show that mortality or risk of death does not rise with fibromyalgia.
#32 Conditioned pain modulation (CPM) paradigm type affects its sensitivity as a biomarker of fibromyalgia | Scientific Reports
https://www.nature.com/articles/s41598-024-58079-7
Fibromyalgia (FM) is a widespread chronic pain syndrome, possibly associated with the presence of central dysfunction in descending pain inhibition pathways. […] To clarify the validity of CPM as a biomarker of FM, we tested two CPM paradigms (parallel and sequential) in a sample of 23 female patients and 23 healthy women. […] We observed that only parallel CPM testing correctly classified about 70% of patients with FM. […] However, the findings also cast doubts on the sensitivity of CPM as a marker of pain severity in FM. […] Thus, CPM has been suggested as a potential biomarker to distinguish clinical profiles with different disease prognosis and symptom severity in chronic pain diseases. […] However, a recent review brings into question the validity of CPM as a biomarker of clinical pain, given that the deficits in CPM are not always correlated with clinical manifestations of pain. […] Our findings confirm the influence of some methodological factors on the magnitude of the CPM effect and suggest the usefulness of CPM (parallel paradigm) as a diagnostic tool for FM; however, they cast doubts on the sensitivity of CPM as a biomarker of disease severity.
#33 POS1052âPREDICTING FIBROMYALGIA OUTCOME FROM A RHEUMATIC-SPECIFIC SURVEY | Annals of the Rheumatic Diseases
https://ard.bmj.com/content/83/Suppl_1/573.1
Around 3% of the global population suffers from Fibromyalgia (FM) and the average diagnostic delay is six years. […] An outcome classification based on self-reported symptoms could benefit patients, by allowing patients to be referred to specialists sooner. […] Our algorithm performs well for predicting FM diagnosis at all follow-up timepoints with overall AUROCS never falling below 0.79. […] Our pipeline obtained a consistently high performance. Such a pipeline can be useful for clinicians by allowing faster diagnosis based on symptom checker responses from patients.
#34 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Large studies comparing fibromyalgia patients with other chronic pain conditions like osteoarthritis show that the death rate was not elevated in fibromyalgia. […] Reports find that the standardized risk of suicide with fibromyalgia is increased when compared to the US population. […] Some studies have also shown that female patients with fibromyalgia are more likely to commit suicide than males with fibromyalgia. […] It is important that any chronic sufferer be adherent to treatment for its maximum efficacy. […] Patients with greater pain and better emotional health are more compliant to exercise therapy and other treatment modalities compared to those with depression and other associated mental health disturbances.
#35 Azthena logo with the word Azthena
https://www.news-medical.net/health/Fibromyalgia-Expectations-(Prognosis).aspx
Large studies comparing fibromyalgia patients with other chronic pain conditions like osteoarthritis show that the death rate was not elevated in fibromyalgia. […] Reports find that the standardized risk of suicide with fibromyalgia is increased when compared to the US population. […] Some studies have also shown that female patients with fibromyalgia are more likely to commit suicide than males with fibromyalgia. […] It is important that any chronic sufferer be adherent to treatment for its maximum efficacy. […] Patients with greater pain and better emotional health are more compliant to exercise therapy and other treatment modalities compared to those with depression and other associated mental health disturbances.
#36 Virios Therapeutics Announces Top-Line Results from Phase 2b Study of IMC-1 in Fibromyalgia :: Dogwood Therapeutics, Inc. (DWTX)
https://ir.dwtx.com/news/press-releases/detail/84/virios-therapeutics-announces-top-line-results-from-phase
Overall, the FORTRESS study did not achieve statistical significance on the prespecified primary efficacy endpoint of change from baseline to Week 14 in the weekly average of daily self-reported average pain severity scores comparing IMC-1 to placebo (p=0.302). […] Conversely, during the second half of the trial (November 2021 to April 2022), for the patients who were enrolled (n=214) when vaccination rates improved and the less severe Omicron variant of COVID-19 became the dominant U.S. strain, IMC-1-treated patients demonstrated a statistically significant improvement on the primary pain reduction endpoint (p=0.03) at Week 14, as well as a statistically significant improvement in the key secondary PROMIS Fatigue assessment (p=0.006) and the Fibromyalgia Impact Questionnaire-Revised (FIQR) symptoms domain score (p=0.015). […] Overall, the efficacy data from this trial were not what we had expected, said R. Michael Gendreau, M.D., Ph.D., Chief Medical Officer of Virios Therapeutics. We will continue to explore IMC-1s potential as a viable FM treatment option.