Review of fibromyalgia treatment guidelines: part 2 – pharmacological treatment
Fibromyalgia is a complex condition characterized by widespread chronic pain, fatigue, and sleep disturbances, which significantly affect quality of life. Its pathophysiology involves central sensitization (CS) and changes in neurotransmitters. Management is challenging and requires a multidisciplinary approach that integrates pharmacological and nonpharmacological treatments. This consensus, which is based on the BASCE system, presents updated guidelines for drug and nondrug treatments. The methodology focused on the evaluation of meta-analyses and systematic reviews of the literature and on voting by experts from the Brazilian Society of Rheumatology, ensuring recommendations with at least 70% agreement. Divided into two articles, this article addresses pharmacological strategies, incorporating recent advances to optimize clinical management and promote uniformity in professional practice.
Authors
- Denison Santos Silva
- Andrea Pimentel Fonseca Golmia
- Gabriela Galassi (ORCID: https://orcid.org/0000-0002-6417-0995)
- Fernando Augusto Chiuchetta
- Roberto Ezequiel Heymann
- Marcelo Cruz Rezende (ORCID: https://orcid.org/0000-0002-0238-0153)
- Aline Ranzolin
- Marco Antônio Gonçalves Pontes Filho
- Anna Beatriz Assad Maia
- Marco Aurélio Goldenfum
- José Roberto Provenza (ORCID: https://orcid.org/0000-0002-4533-8182)
- José Eduardo Martinez (ORCID: https://orcid.org/0000-0002-3864-6822)
- Juliana Maria de Freitas Trindade Costa (ORCID: https://orcid.org/0000-0003-0165-0702)
- Rafael Navarrete Fernandez
- Marcos Paulo Veloso CORREIA
- Nilton Salles Rosa Neto (ORCID: https://orcid.org/0000-0001-8457-5132)
- Eduardo Vieira dos Santos Paiva
- Marcos Renato de Assis
- Marcos Aurelio de Freitas Machado
- Alessandra de Sousa Braz
- Izabela Guimarães
- Ana Paula Monteiro Gomides Reis
- Melissa Mariti Fraga
Institutions
- Universidade Federal do Rio de Janeiro (BR)
- Brazilian Medical Association (BR)
- Hospital Israelita Albert Einstein (BR)
- Universidade Tiradentes (BR)
- Deoxi Biotecnologia (Brazil) (BR)
- Hospital Universitário Evangélico de Curitiba (BR)
- Hospital Universitário Lauro Wanderley (BR)
- Centro de Estudos e Sistemas Avançados do Recife (BR)
- Hospital Universitário de Brasília (BR)
- University Center of Brasília (BR)
- Hospital das Clínicas da Universidade Federal de Pernambuco (BR)
- Fundação Faculdade de Medicina (BR)
- International Association for the Study of Pain (US)
- Universidade de Santo Amaro (BR)
- Pontifícia Universidade Católica de Goiás (BR)
- Pontifícia Universidade Católica do Rio Grande do Sul (BR)
- Universidade Federal do Paraná (BR)
- Pontifícia Universidade Católica de Campinas (BR)
- Universidade Federal de São Paulo (BR)
- Pontifícia Universidade Católica de São Paulo (BR)
Publication Details
- Journal
- Advances in Rheumatology
- Published
- 2026-01-22
- DOI
- https://doi.org/10.1186/s42358-025-00483-2
- Primary Topic
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Type
- article
- Field-Weighted Citation Impact
- 0.00