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Evidence for the efficacy of complementary and alternative medicines in the management of fibromyalgia: a systematic review

Evidence for the efficacy of complementary and alternative medicines in the management of fibromyalgia: a systematic review
Evidence for the efficacy of complementary and alternative medicines in the management of fibromyalgia: a systematic review
Objective: to critically evaluate the evidence regarding complementary and alternative medicines (CAMs) taken orally or applied topically for the treatment of FM.

Methods: randomized controlled trials of FM using CAMs, in comparison with other treatments or placebo, published in English up to March 2009, were eligible for inclusion. They were identified using systematic searches of bibliographic databases and manual searching of reference lists. Information was extracted on outcomes, and statistical significance, in comparison with alternative treatment or placebo, and side effects were reported. The methodological quality of the primary studies was determined.

Results: single studies on four CAMs, and three on different approaches to homeopathic care were identified. Their methodological quality was moderate. The homeopathy studies were small, but each reported an improvement in pain. The effects of anthocyanidins, capsaicin and S-adenosylmethionine each showed at least one statistically significant improved outcome compared with placebo. However, the studies of anthocyanidins and capsaicin only demonstrated an improvement in a single outcome, sleep disturbance and tenderness, respectively, of several outcomes considered. No evidence of efficacy was found regarding Soy in a single study. Most of these CAMs were free of major adverse effects and usually associated with only minor adverse effects such as dizziness, nausea and stomach upsets.

Conclusion: there is insufficient evidence on any CAM, taken orally or applied topically, for FM. The small number of positive studies lack replication. Further high-quality trials are necessary to determine whether these initial findings can be supported by a larger evidence base
fibromyalgia, complementary and alternative medicine, anthocyanidins, capsaicin, soy, s-adenosylmethionine, homeopathy
1462-0324
1063-1068
De Silva, Vijitha
a39cba69-36e6-4465-bb86-c2e2ea45cfb6
El-Metwally, Ashraf
94b0b3c0-613d-46d2-87fb-fb5306ccbe6e
Ernst, Edzard
28f82437-609a-4cd7-8d0c-aa5cc37ad1b8
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Macfarlane, Gary J.
e17bbdb7-9d82-42ac-8a0a-09bf10885e3c
De Silva, Vijitha
a39cba69-36e6-4465-bb86-c2e2ea45cfb6
El-Metwally, Ashraf
94b0b3c0-613d-46d2-87fb-fb5306ccbe6e
Ernst, Edzard
28f82437-609a-4cd7-8d0c-aa5cc37ad1b8
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Macfarlane, Gary J.
e17bbdb7-9d82-42ac-8a0a-09bf10885e3c

De Silva, Vijitha, El-Metwally, Ashraf, Ernst, Edzard, Lewith, George and Macfarlane, Gary J. (2010) Evidence for the efficacy of complementary and alternative medicines in the management of fibromyalgia: a systematic review. Rheumatology, 49 (6), 1063-1068. (doi:10.1093/rheumatology/keq025).

Record type: Article

Abstract

Objective: to critically evaluate the evidence regarding complementary and alternative medicines (CAMs) taken orally or applied topically for the treatment of FM.

Methods: randomized controlled trials of FM using CAMs, in comparison with other treatments or placebo, published in English up to March 2009, were eligible for inclusion. They were identified using systematic searches of bibliographic databases and manual searching of reference lists. Information was extracted on outcomes, and statistical significance, in comparison with alternative treatment or placebo, and side effects were reported. The methodological quality of the primary studies was determined.

Results: single studies on four CAMs, and three on different approaches to homeopathic care were identified. Their methodological quality was moderate. The homeopathy studies were small, but each reported an improvement in pain. The effects of anthocyanidins, capsaicin and S-adenosylmethionine each showed at least one statistically significant improved outcome compared with placebo. However, the studies of anthocyanidins and capsaicin only demonstrated an improvement in a single outcome, sleep disturbance and tenderness, respectively, of several outcomes considered. No evidence of efficacy was found regarding Soy in a single study. Most of these CAMs were free of major adverse effects and usually associated with only minor adverse effects such as dizziness, nausea and stomach upsets.

Conclusion: there is insufficient evidence on any CAM, taken orally or applied topically, for FM. The small number of positive studies lack replication. Further high-quality trials are necessary to determine whether these initial findings can be supported by a larger evidence base

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More information

Published date: 3 March 2010
Keywords: fibromyalgia, complementary and alternative medicine, anthocyanidins, capsaicin, soy, s-adenosylmethionine, homeopathy

Identifiers

Local EPrints ID: 73659
URI: http://eprints.soton.ac.uk/id/eprint/73659
ISSN: 1462-0324
PURE UUID: 957fb825-6be8-4bda-93f6-7c029f34f20a

Catalogue record

Date deposited: 15 Mar 2010
Last modified: 08 Jan 2022 14:26

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Contributors

Author: Vijitha De Silva
Author: Ashraf El-Metwally
Author: Edzard Ernst
Author: George Lewith
Author: Gary J. Macfarlane

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