Cannabinoids for fibromyalgia.

Area of Science:

• Pharmacology
• Pain Management
• Rheumatology

Background:

• Fibromyalgia is a chronic condition affecting 2% of the population, characterized by widespread pain, fatigue, and sleep disturbances.
• Current drug therapies aim to alleviate symptoms and improve quality of life (HRQoL).
• Cannabis has a long history of use for pain and somatic symptom relief.

Purpose of the Study:

• To evaluate the efficacy, tolerability, and safety of cannabinoids in treating fibromyalgia symptoms in adults.
• To synthesize evidence from randomized controlled trials on cannabinoid use for fibromyalgia.

Main Methods:

• Searched multiple databases (CENTRAL, MEDLINE, EMBASE) and trial registries up to April 2016.
• Included randomized controlled trials of at least four weeks' duration using any cannabis formulation in adults with fibromyalgia.
• Assessed evidence quality using GRADE, categorizing data into three tiers based on risk of bias and participant numbers.

Main Results:

• Two studies with 72 participants were included, both using synthetic cannabinoid nabilone, with a moderate risk of bias and very low overall evidence quality.
• No high-quality evidence supported nabilone's efficacy for pain relief, fatigue, or depression compared to placebo.
• Nabilone showed potential for improved sleep compared to amitriptyline but had low tolerability, with more adverse events (dizziness, nausea, dry mouth, drowsiness) than controls.

Conclusions:

• There is no convincing, unbiased, high-quality evidence to support the use of nabilone for fibromyalgia treatment.
• The tolerability of nabilone in fibromyalgia patients was found to be low.
• Further research is needed to explore the potential role of cannabinoids in managing fibromyalgia symptoms.