The size of the improvements in the various end points was consistently numerically greater in the pain-avoidance group than in the pain-persistence arm, but not statistically significantly so.
Ms. van Koulil said the treatment effect sizes achieved with a tailored approach in this study were much larger than those seen in prior published studies of various one-size-fits-all therapies.
Pain scores (which have a theoretical range of 6-25) went from a mean baseline of 20 in the pain-avoidance treatment arm to 16 at the end of treatment and 17 at 6 months of follow-up. In the pain-persistence arm, pain scores went from a baseline of 19 to 16, then 16 at follow-up. Pain scores were unchanged over time in the control arm.
The impact of fibromyalgia on daily life as assessed by the FIQ (with a theoretical range of 0-100 points) went from a baseline of 66 to 48 at the end of pain-avoidance therapy, with a modest rebound to 50 at 6 months of follow-up. In the pain-persistence treatment arm, scores improved from a baseline of 57 to 47 at treatment's end and 43 at follow-up. Again, scores were flat over time in the control arms.
The encouraging results are welcome because of the dearth of effective treatment options for fibromyalgia. Fibromyalgia has the highest associated financial costs of all chronic pain and rheumatologic conditions, and the disease's negative impact on daily life is often profound, Ms. van Koulil said.
Disclosures: The study was fimded by the Dutch Arthritis Association and the Netherlands Organization for Health Research. Ms. van Koulil reported having no conflicts of interest.
In all, 60% of patients with tailored therapy had a clinically significant reduction in the impact of fibromyalgia on daily life.
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