Potential drug therapies for the treatment of fibromyalgia.
BACKGROUND
Fibromyalgia (FM) is a common, complex chronic widespread pain condition is characterized by fatigue, sleep disturbance and cognitive dysfunction. Treatment of FM is difficult, requiring both pharmacological and non-pharmacological approaches, with an empiric approach to drug therapy focused toward individual symptoms, particularly pain. The effectiveness of current medications is limited with many patients discontinuing use.


METHODS
A systemic database search has identified 26 molecular entities as potential emerging drug therapies. Advances in the understanding of the pathophysiology of FM provides clues to targets for new medications. Investigation of bioamine modulation and α2δ ligands and novel targets such as dopamine receptors, NMDA receptors, cannabinoid receptors, melatonin receptors and potassium channels has identified potential drug therapies.


CONCLUSIONS
Modest improvement of health status in patients with FM has been observed with drugs targeting a diverse range of molecular mechanisms. No single drug, however, offered substantial efficacy against all the symptoms characteristic of FM. Identification of new and improved therapies for FM needs to address the heterogeneity of the condition, which suggests existence of patient subgroups, the relationship of central and peripheral aspects of the pathophysiology and a requirement of combination therapy with drugs targeting multiple molecular mechanisms.
a Department of Biosciences and Chemistry, Biomolecular Sciences Research Centre, Faculty of Health and Wellbeing , Sheffield Hallam University , Sheffield , UK.
Kim
K
Lawson
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology; D002186:Cannabinoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology; D016207:Cytokines / Q000097:blood; D055808:Drug Discovery / Q000379:methods*; D005356:Fibromyalgia / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism / Q000523:psychology; D006801:Humans; D018377:Neurotransmitter Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D026902:Potassium Channel Blockers; D017981:Receptors, Neurotransmitter / Q000378:metabolism; D012893:Sleep Wake Disorders / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology
D000700:Analgesics; D000928:Antidepressive Agents; D002186:Cannabinoids; D016207:Cytokines; D018377:Neurotransmitter Agents; D026902:Potassium Channel Blockers; D017981:Receptors, Neurotransmitter; D000324:Adrenocorticotropic Hormone
Fibromyalgia; central sensitization; clinical trials; cognitive dysfunction; fatigue; pain