The Italian Society for Rheumatology clinical practice guidelines for the diagnosis and management of fibromyalgia. Best practices based on current scientific evidence

  • A. Ariani | aariani@ao.pr.it Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Dipartimento di Medicina, Unità di Medicina Interna e Reumatologia, Azienda Ospedaliero-Universitaria di Parma, Italy. https://orcid.org/0000-0003-1428-6102
  • L. Bazzichi Unità di Reumatologia, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
  • P. Sarzi-Puttini Unità di Reumatologia, ASST Fatebenefratelli-Sacco, Università di Milano, Italy.
  • F. Salaffi Clinica Reumatologica, Ospedale ‘Carlo Urbani’, Università Politecnica delle Marche, Jesi (AN), Italy.
  • M. Manara Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Reumatologia Clinica, Centro Specialistico Ortopedico-Traumatologico Gaetano Pini CTO, ASST Gaetano Pini, Milano, Italy.
  • I. Prevete Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Unità di Reumatologia, Azienda Ospedaliera San Camillo-Forlanini, Roma, Italy.
  • A. Bortoluzzi Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Dipartimento di Scienze Mediche, Sezione di Reumatologia, Università di Ferrara, Azienda Ospedaliero-Universitaria Sant’Anna, Cona (FE), Italy.
  • G. Carrara Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy. https://orcid.org/0000-0001-9752-2275
  • C.A. Scirè Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Dipartimento di Scienze Mediche, Sezione di Reumatologia, Università di Ferrara, Azienda Ospedaliero-Universitaria Sant’Anna, Cona (FE), Italy. https://orcid.org/0000-0001-7451-0271
  • N. Ughi Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Division of Rheumatology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy.
  • S. Parisi Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Unità di Reumatologia, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Italy. https://orcid.org/0000-0003-4496-8315

Abstract

Fibromyalgia or fibromyalgia syndrome (FMS) is defined as a central sensitization syndrome characterized by the dysfunction of neurocircuits detecting, transmitting and processing nociceptive stimuli; the prevalent manifestation is musculoskeletal pain. In addition to pain, there are multiple accompanying symptoms, in common with other algo-dysfunctional syndromes, which are reflected in a broad spectrum of somatic, neurocognitive and neuro-vegetative manifestations. An evidence-based approach is essential in FMS management, in order to improve patient health and to reduce its social burden. Since in the last ten years new international guidelines for clinical practice (Clinical Practice Guidelines or CPGs) concerning FMS diagnosis and pharmacological/ non-pharmacological management have been published, the Italian Society of Rheumatology (SIR) has decided to adapt them to the Italian national setting. The framework of the Guidelines International Network Adaptation Working Group was adopted to identify, appraise (AGREE II), synthesize, and customize the most recent CPGs on FMS to the needs of the Italian healthcare context. A working group of rheumatologists from SIR epidemiology unit and FMS experts identified relevant clinical questions to guide the systematic review of the literature. The target audience of these CPGs included physicians and healthcare professionals who manage FMS. The adapted recommendations were finally assessed by an external multidisciplinary panel. From the systematic search in databases (Pubmed/Medline, Embase) and grey literature, 6 CPGs were selected and appraised by two independent raters. The combination of the scientific evidence underlying the original CPGs with expert opinion lead to the development of 17 recommendations. The quality of evidence for each recommendation was reported and their potential impact on clinical practice was assessed. These SIR recommendations are expected to be a valuable aid in the diagnosis and treatment of FMS, as they will contribute to disseminate the best practice on the basis of the current scientific evidence.

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Published
2021-08-03
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Issue
Section
Guidelines
Keywords:
Clinical Practice Guideline, recommendations, fibromyalgia, diagnosis, treatment.
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How to Cite
Ariani, A., Bazzichi, L., Sarzi-Puttini, P., Salaffi, F., Manara, M., Prevete, I., Bortoluzzi, A., Carrara, G., Scirè, C., Ughi, N., & Parisi, S. (2021). The Italian Society for Rheumatology clinical practice guidelines for the diagnosis and management of fibromyalgia. Best practices based on current scientific evidence. Reumatismo, 73(2), 89-105. https://doi.org/10.4081/reumatismo.2021.1362

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