SynthesisBMJ medicine2026
Drug treatments for fibromyalgia: systematic review and network meta-analysis of randomised trials.
Synthesis in BMJ medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To compare the effectiveness of drug treatments for the management of fibromyalgia. Design: Systematic review and network meta-analysis of randomised trials. Data sources: Medline, Embase, AMED (Allied and Complementary Medicine Database), PsycInfo, CINAHL, and Cochrane CENTRAL (Cochrane Central Register of Controlled Trials), from inception to 13 January 2025. Eligibility criteria for selecting studies: Parallel, crossover, and cluster randomised trials that enrolled adults (aged ≥18 years) with fibromyalgia, according to any published diagnostic criteria or as diagnosed by a physician. Trials compared commercially available, investigational, or discontinued drug treatments with another drug, the same drug at a different dose or regimen, placebo, or standard care. Treatments also included select vitamins and supplements, such as melatonin, vitamin D, vitamin B6, and omega 3 fatty acids. Results: 151 eligible trials (32 592 participants) were included in this systematic review. Compared with placebo or usual care, low certainty evidence suggested that sodium oxybate, selective noradrenaline (norepinephrine) reuptake inhibitors (NRIs), serotonin-noradrenaline reuptake inhibitors (SNRIs), and gabapentinoids may increase the likelihood of patient reported meaningful improvement or recovery (risk difference 105 to 283 more per 1000 patients). Based on scores from the fibromyalgia impact questionnaire, low certainty evidence further suggested that sodium oxybate (mean difference -8.81, 95% confidence interval (CI) -11.78 to -5.84) and selective serotonin reuptake inhibitors (SSRIs) (mean difference -8.02, 95% CI -13.40 to -2.64) may reduce fibromyalgia symptoms, whereas tricyclic antidepressants, sodium oxybate, and gabapentinoids may improve sleep quality. No drug showed pooled effects on pain, physical health or mental health that met or exceeded a threshold for clinical importance. For sodium oxybate, selective NRIs, SNRIs, and cyclobenzaprine, responder analyses indicated that a potentially important proportion of patients achieved a reduction in pain of at least 30% (risk difference 111 to 202 more per 1000 patients). In addition, no drug increased the risk of discontinuing treatment or serious adverse events. Conclusions: This systematic review and network meta-analysis provides low certainty evidence that sodium oxybate, selective NRIs, SNRIs, gabapentinoids, tricyclic antidepressants, and SSRIs may provide typically small benefits in select outcomes for people with fibromyalgia. Systematic review registration: PROSPERO CRD42012003291.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.