OP0100 THE EFFECT OF COMBINED PREGABALIN AND DULOXETINE IN FUNCTIONAL STATUS, QUALITY OF LIFE AND PSYCHOLOGICAL STATUS IN FIBROMYALGIA
Authors: Samar Abd Alhamed Tabra, Mohammed Hassan Abu-Zaid, Marwa Aboelhawa, Salwa Elmorsy
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Fibromyalgia syndrome (FMS) is a chronic pain syndrome that characterized by chronic widespread pain, muscle tenderness and is often accompanied by fatigue, sleep disturbance, and depressive moods<sup>1</sup>. Pregabalin and duloxetine are thought to reduce pain by different pharmacological actions, and the studies for combining different treatments in FMS are limited<sup>2</sup>. <h3>Objectives</h3> Assessment of the effectiveness of combined pregabalin and duloxetine in functional status, quality of life and psychological status in fibromyalgia <h3>Methods</h3> One hundred and twenty adult patients of primary FMS (according to the 2010 ACR criteria for FMS) participated in this study. Patients with other source of chronic pain as inflammatory or degenerative rheumatic diseases, severe debilitating systemic diseases were excluded; also we excluded patients with any previous psychiatric disorders and patients who had any contraindications for the used treatments. After written consent; the patients were randomly divided into 4 equal groups; group I were given pregabaline (200 mg divided twice daily) for 6 months, group II were given duloxetine (60 mg divided twice daily) for 6 months, group III were given combined therapy (200 mg divided twice daily of pregabaline plus 30 mg daily single dose of duloxetine) for 6 months, group IV were given placebo treatment, any other previous treatments were stopped before starting this study. The patients were assessed at baseline, after 3 and 6 months of treatment by Fibromyalgia Impact Questionnaire (FIQ), Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36), Hospital Anxiety and Depression Scale (HADS) and serum beta endorphin. <h3>Results</h3> In this study 115 patients completed the study. There was no significant difference between all groups in demographic data or educational status. At baseline there were no significant differences between all groups regarding FIQ, SF-36, HADS. Patients in all groups had low levels of β-Endorphin at baseline (82.7±14.8, 84.1±12.7, 83.9±11.4, and 82.3±16.6 respectively). There was significant improvement(P&lt;0.05) in FIQ, SF-36 and HADS in groups I, II and III after 3 and 6 months of treatment, while there was no significant improvement(P&gt;0.05) in group IV. There was significant better improvement (P&lt;0.05) in group III than in group I and II. The levels of serum β- Endorphin were significantly elevated in the first 3 groups only (P&lt;0.05) with no significant difference between the 3 groups (P&gt;0.05). The results of the study are summarized in table 1. <h3>Conclusion</h3> The combination therapy of pregabalin and duloxetine is more effective than monotherapy in treatment of fibromyalgia <h3>References</h3> [1] Egunsola O, Wylie CE, Chitty KM, Buckley NA. Systematic Review of the Efficacy and Safety of Gabapentin and Pregabalin for Pain in Children and Adolescents. Anesth Analg. 2018 Nov 16. doi: 10.1213/ANE.0000000000003936. [Epub ahead of print] [2] Gilron I, Chaparro LE, Tu D, Holden RR, et al. Combination of pregabalin with duloxetine for fibromyalgia: a randomized controlled trial. Pain. 2016 Jul;157(7):1532-40. <h3>Disclosure of Interests</h3> None declared