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Biomedicines
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Drug Therapies for the Treatment of Fibromyalgia
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Drug Therapies for the Treatment of Fibromyalgia

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (28 February 2017) | Viewed by 68818

Special Issue Editor

Dr. Kim Lawson

E-Mail Website
Guest Editor
Department of Biosciences and Chemistry, Biomolecular Sciences Research Centre, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
Interests: fibromyalgia; pain; potassium channels; drug design/discovery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Treatment of fibromyalgia, a common, complex chronic widespread pain condition, is difficult, usually involving an empiric approach to drug therapy focused towards individual symptoms. Current medications are often limited in their effectiveness due to patients discontinuing use as a consequence of a high incidence of adverse effects. Drugs targeting a diverse range of molecular mechanisms have demonstrated modest improvement of health status in patients with fibromyalgia. Thus, the heterogeneity of fibromyalgia, suggesting existence of patient subgroups, central and peripheral aspects of the pathophysiology and a requirement of treatments targeting multiple molecular dysfunction need to be considered in the identification of new or improved therapies for the condition. Authors are invited to submit original or review articles of preclinical and clinical findings contributing to the understanding of drug therapies for the treatment of fibromyalgia.

Dr. Kim Lawson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Fibromyalgia
  • Pain
  • Fatigue
  • Cognitive dysfunction
  • Central sensitization
  • Drug targets
  • Novel molecular mechanisms
  • Fibromyalgia animal models

Published Papers (5 papers)

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Research

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Article
Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia
by Luke Parkitny and Jarred Younger
Biomedicines 2017, 5(2), 16; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines5020016 - 18 Apr 2017
Cited by 69 | Viewed by 16861
Abstract
Fibromyalgia (FM) is a complex, multi-symptom condition that predominantly affects women. The majority of those affected are unlikely to gain significant symptomatic control from the few treatments that are approved for FM. In this 10-week, single-blind, crossover trial we tested the immune effects [...] Read more.
Fibromyalgia (FM) is a complex, multi-symptom condition that predominantly affects women. The majority of those affected are unlikely to gain significant symptomatic control from the few treatments that are approved for FM. In this 10-week, single-blind, crossover trial we tested the immune effects of eight weeks of oral administration of low-dose naltrexone (LDN). We enrolled eight women with an average age of 46 years, symptom severity of 62 out of 100, and symptom duration of 14 years. We found that LDN was associated with reduced plasma concentrations of interleukin (IL)-1β, IL-1Ra, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p40, IL-12p70, IL-15, IL-17A, IL-27, interferon (IFN)-α, transforming growth factor (TGF)-α, TGF-β, tumor necrosis factor (TNF)-α, and granulocyte-colony stimulating factor (G-CSF). We also found a 15% reduction of FM-associated pain and an 18% reduction in overall symptoms. The findings of this pilot trial suggest that LDN treatment in fibromyalgia is associated with a reduction of several key pro-inflammatory cytokines and symptoms. The potential role of LDN as an atypical anti-inflammatory medication should be explored further. Full article
(This article belongs to the Special Issue Drug Therapies for the Treatment of Fibromyalgia)
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Review

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371 KiB  
Review
A Brief Review of the Pharmacology of Amitriptyline and Clinical Outcomes in Treating Fibromyalgia
by Kim Lawson
Biomedicines 2017, 5(2), 24; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines5020024 - 17 May 2017
Cited by 37 | Viewed by 12446
Abstract
Fibromyalgia is a complex chronic condition characterized by pain, physical fatigue, sleep disorder and cognitive impairment. Evidence-based guidelines recommend antidepressants as treatments of fibromyalgia where tricyclics are often considered to have the greatest efficacy, with amitriptyline often being a first-line treatment. Amitriptyline evokes [...] Read more.
Fibromyalgia is a complex chronic condition characterized by pain, physical fatigue, sleep disorder and cognitive impairment. Evidence-based guidelines recommend antidepressants as treatments of fibromyalgia where tricyclics are often considered to have the greatest efficacy, with amitriptyline often being a first-line treatment. Amitriptyline evokes a preferential reduction in pain and fatigue of fibromyalgia, and in the Fibromyalgia Impact Questionnaire (FIQ) score, which is a quality of life assessment. The multimodal profile of the mechanisms of action of amitriptyline include monoamine reuptake inhibition, receptor modulation and ion channel modulation. Several of the actions of amitriptyline on multiple nociceptive and sensory processes at central and peripheral locations have the potential to act cumulatively to suppress the characteristic symptoms of fibromyalgia. Greater understanding of the role of these mechanisms of action of amitriptyline could provide further clues to the pathophysiology of fibromyalgia and to a preferable pharmacological profile for future drug development. Full article
(This article belongs to the Special Issue Drug Therapies for the Treatment of Fibromyalgia)
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503 KiB  
Review
New Insights into the Pathophysiology and Treatment of Fibromyalgia
by Tobias Schmidt-Wilcke and Martin Diers
Biomedicines 2017, 5(2), 22; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines5020022 - 13 May 2017
Cited by 38 | Viewed by 11507
Abstract
Fibromyalgia is characterized by chronic widespread pain and several additional symptoms such as fatigue, cognitive dysfunction, depressive episodes, and anxiety. The underlying pathophysiology of fibromyalgia is still poorly understood, and treatment is often unsatisfactory. Current research provides evidence for altered pain processing in [...] Read more.
Fibromyalgia is characterized by chronic widespread pain and several additional symptoms such as fatigue, cognitive dysfunction, depressive episodes, and anxiety. The underlying pathophysiology of fibromyalgia is still poorly understood, and treatment is often unsatisfactory. Current research provides evidence for altered pain processing in chronic pain patients, and specifically in fibromyalgia patients, possibly based on altered functional connectivity and brain chemistry in brain regions within the pain processing system. Besides discussing evidence from studies applying brain imaging (specifically resting state fMRI (Functional magnetic resonance imaging)), the current review aims at providing an overview of pharmacological and non-pharmacological treatment options. We will also summarize the most important results from recently performed brain imaging studies providing new insights into the potential mechanisms of various therapeutic approaches. Full article
(This article belongs to the Special Issue Drug Therapies for the Treatment of Fibromyalgia)
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259 KiB  
Review
Update on Treatment Guideline in Fibromyalgia Syndrome with Focus on Pharmacology
by Sanam Kia and Ernet Choy
Biomedicines 2017, 5(2), 20; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines5020020 - 08 May 2017
Cited by 91 | Viewed by 17045
Abstract
Fibromyalgia syndrome (FMS) is a chronic condition with unknown aetiology. The pathophysiology of the disease is incompletely understood; despite advances in our knowledge with regards to abnormal central and peripheral pain processing, and hypothalamo–pituitary–adrenal dysfunction, there is no clear specific pathophysiological therapeutic target. [...] Read more.
Fibromyalgia syndrome (FMS) is a chronic condition with unknown aetiology. The pathophysiology of the disease is incompletely understood; despite advances in our knowledge with regards to abnormal central and peripheral pain processing, and hypothalamo–pituitary–adrenal dysfunction, there is no clear specific pathophysiological therapeutic target. The management of this complex condition has thus perplexed the medical community for many years, and several national and international guidelines have aimed to address this complexity. The most recent guidelines from European League Against Rheumatism (EULAR) (2016), Canadian Pain Society (2012), and The Association of the Scientific Medical Societies in Germany (AWMF) (2012) highlight the change in attitudes regarding the overall approach to FMS, but offer varying advice with regards to the use of pharmacological agents. Amitriptyline, Pregabalin and Duloxetine are used most commonly in FMS and though modestly effective, are useful adjunctive treatment to non-pharmaceutical measures. Full article
(This article belongs to the Special Issue Drug Therapies for the Treatment of Fibromyalgia)
540 KiB  
Review
Modulation of NMDA Receptor Activity in Fibromyalgia
by Geoffrey Littlejohn and Emma Guymer
Biomedicines 2017, 5(2), 15; https://0-doi-org.brum.beds.ac.uk/10.3390/biomedicines5020015 - 11 Apr 2017
Cited by 34 | Viewed by 10055
Abstract
Activation of the N-methyl-d-aspartate receptor (NMDAR) results in increased sensitivity of spinal cord and brain pathways that process sensory information, particularly those which relate to pain. The NMDAR shows increased activity in fibromyalgia and hence modulation of the NMDAR is [...] Read more.
Activation of the N-methyl-d-aspartate receptor (NMDAR) results in increased sensitivity of spinal cord and brain pathways that process sensory information, particularly those which relate to pain. The NMDAR shows increased activity in fibromyalgia and hence modulation of the NMDAR is a target for therapeutic intervention. A literature review of interventions impacting on the NMDAR shows a number of drugs to be active on the NMDAR mechanism in fibromyalgia patients, with variable clinical effects. Low-dose intravenous ketamine and oral memantine both show clinically useful benefit in fibromyalgia. However, consideration of side-effects, logistics and cost need to be factored into management decisions regarding use of these drugs in this clinical setting. Overall benefits with current NMDAR antagonists appear modest and there is a need for better strategy trials to clarify optimal dose schedules and to delineate potential longer–term adverse events. Further investigation of the role of the NMDAR in fibromyalgia and the effect of other molecules that modulate this receptor appear important to enhance treatment targets in fibromyalgia. Full article
(This article belongs to the Special Issue Drug Therapies for the Treatment of Fibromyalgia)
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