Fibromyalgia Patients Stick with Combo Therapies Better Than Stand-alones, Study Reports

Fibromyalgia Patients Stick with Combo Therapies Better Than Stand-alones, Study Reports

Fibromyalgia patients stick with combination therapies better than stand-alone treatments, but the combo approaches are more expensive, according to a study that examined South Carolina health insurance claims.

The results could reflect patients’ belief that combination therapies do a better job, researchers said. They also said patients may stick with combos better because they reduce side effects. But to prove this, more studies are needed, they said.

The study, Healthcare Costs and Medication Adherence Among Patients with Fibromyalgia: Combination Medication vs. Duloxetine, Milnacipran, Venlafaxine, and Pregabalin Initiators,” was published in the journal Pain Practice.

Lyrica (pregabalin), Cymbalta (duloxetine), Savella (milnacipran), and Effexor (venlafaxine) were the four treatments that researchers from the University of Florida and the Medical University of South Carolina evaluated.

Earlier studies suggested that combining Cymbalta, Savella, or Effexor with Lyrica generated better patients outcomes, but there was no real-world data on how patients stick with treatments.

The research team looked at the records of 100 fibromyalgia patients on combination treatments, 655 patients on Lyrica alone, 713 on Cymbalta alone, 131 on Savella alone, and 272 on Effexor alone.

Sixty-percent of the patients had muscle pain. Other fibromyalgia-related problems were nervousness, fatigue, abdominal pain, headache, and insomnia. Each affected less than 22 percent of the group, however. Depression, irritable bowel syndrome, muscle weakness, and cognitive problems were seen in less than 5 percent of the patients.

Nearly half the group had two or more fibromyalgia symptoms. Only 36 percent had one symptom.

Many patients were taking other drugs besides the four included in the analysis. Fifty-eight percent used opioids, 47 percent NSAIDs, or nonsteroidal anti-inflammatory drugs, and 39 percent benzodiazepines. Other commonly used medications included muscle relaxants, antidepressants, tramadol, and sedatives.

Patients did a better job of sticking with combination therapies. The chance of a patient sticking with a combo that included a selective serotonin norepinephrine reuptake inhibitor (SNRI) like Cymbalta, Savella, or Effexor was 39 percent higher than the chance of the patient sticking with Cymbalta alone. Patients were 69 percent more likely to stick with a combo involving Savella than Savella alone, and 115 percent more likely to stay with a combo involving Effexor than Effexor alone.

The cost of combo medication was higher than the cost of any of the four drugs alone, according to records of the insurer, the South Carolina Blue Cross Blue Shield State Health Plan.

Combo users’ penchant for sticking with their treatment could yield indirect economic benefits, however, the researchers said. These include lower rates of absenteeism and better productivity.

To understand if a patient’s penchant for sticking with a treatment can generate a better disease outcome, researchers should do studies that follow patients over time, the team said.

 

5 comments

  1. Em says:

    any of the meds mentioned above caused severe personality changes. I have turned to essential oils and diet for some relief. Diet is essential for this fibro female.

    • Val says:

      Hi Em,
      Would you mind sharing your diet and what essential oils you use? I’m really struggling and want to avoid meds.
      Thanks
      Val

  2. Denise Bault says:

    Excuse me. The research was for fibromyalgia patients of which “60% had muscle pain.” Are you kidding me? I’ve never met a fibromyalgia patient that DIDN’T have muscle pain. Isn’t that one of the criteria for being diagnosed with fibromyalgia??????????? I’m sorry, but I really have to question this study. BTW- I have been on many “combo therapies” – two of which almost killed me because a physician put me on an anti-depressant that did not go with the pain medication I was taking. Cymbalta was by far the worst. A forty pound weight gain and I felt like a zombie. How did I know I felt like a zombie? Because I quit it cold turkey, not recommended by the way, and almost immediately felt like I was alive for the first time in years.

  3. Anita says:

    Many fibromyalgia research studies seem to be poorly done so it’s hard to know what is accurate. There also needs to be longitudinal studies and studies of drug-resistant patients.

  4. Em says:

    Hi Val! Thank you for asking. 1st I will say that we are not all wired the same and what works for 1 may not work for another. Essential oils are an aid that do need to be approached carefully because what goes on the skin enters the body and when mixing them w/ a carrier oil be sure to follow the instructions on the label try it on a small patch of skin just in case of an allergy. There are many companies out there claiming to have pure essential oils-Do your home work. My favorite oil is a combo of lavender/hops. There are many beneficial oils that help w/ a variety of issues and doing research is the key. Start slowly and find what works the best for you. Many have spent a lot only to find they do not use all of them. Even combining some w/ others can be harmful. Remember that your skin typically knows what your body knows and as w/ any meds too much of a good thing can be harmful. Most places that sell oils have testers-if not, find some where else. Start slow.
    My diet is quite simple-no sugar, no flour, no dairy ( I do eat eggs) and have also learned that anything in the Nightshade family causes a severe flare. this is not true for everyone. again, start slow. Try eliminating one food at a time. Listen to your body and not your taste buds. Baby greens are tender and sweet and are yummy in green smoothies. Lots of recipes out there. I prefer coconut milk. I do eat a lot of fish and only wild caught-I prefer salmon and albacore tuna. Again many delicious recipes online. I fry nothing and only use extra virgin unrefined coconut oil internally and externally also some olive oil. Lots of fresh produce and nothing w/ ingredients I cannot pronounce or and the same is true for things I put on my skin.
    This is only a sketch, but may be a starting place.
    Try to keep positive and be gentle w/ yourself-this is true for even those w/o fibro and other illnesses. We are what we eat.
    Thank you for asking. Blessings as you continue on your journey.

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