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Nabilone for the Treatment of Pain in Fibromyalgia

  • Ryan Quinlan Skrabek
    Correspondence
    Address reprint requests to Dr. Ryan Quinlan Skrabek, Physical Medicine and Rehabilitation, PGY4, Rehabilitation Hospital, RR133-800 Sherbrook Street, Winnipeg, Manitoba, Canada, R3A 1M4.
    Affiliations
    Section of Physical Medicine and Rehabilitation, University of Manitoba, Rehabilitation Hospital, Health Sciences Centre, Winnipeg, Manitoba, Canada.
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  • Lena Galimova
    Affiliations
    Section of Physical Medicine and Rehabilitation, University of Manitoba, Rehabilitation Hospital, Health Sciences Centre, Winnipeg, Manitoba, Canada.
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  • Karen Ethans
    Affiliations
    Section of Physical Medicine and Rehabilitation, University of Manitoba, Rehabilitation Hospital, Health Sciences Centre, Winnipeg, Manitoba, Canada.
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  • Daryl Perry
    Affiliations
    Section of Physical Medicine and Rehabilitation, University of Manitoba, Rehabilitation Hospital, Health Sciences Centre, Winnipeg, Manitoba, Canada.
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Published:November 02, 2007DOI:https://doi.org/10.1016/j.jpain.2007.09.002

      Abstract

      A randomized, double-blind, placebo-controlled trial was conducted to determine the benefit of nabilone in pain management and quality of life improvement in 40 patients with fibromyalgia. After a baseline assessment, subjects were titrated up on nabilone, from 0.5 mg PO at bedtime to 1 mg BID over 4 weeks or received a corresponding placebo. At the 2- and 4-week visits, the primary outcome measure, visual analog scale (VAS) for pain, and the secondary outcome measures, number of tender points, the average tender point pain threshold, and the Fibromyalgia Impact Questionnaire (FIQ), were evaluated. After a 4-week washout period, subjects returned for reassessment of the outcome measures. There were no significant differences in population demographics between groups at baseline. There were significant decreases in the VAS (−2.04, P < .02), FIQ (−12.07, P < .02), and anxiety (−1.67, P < .02) in the nabilone treated group at 4 weeks. There were no significant improvements in the placebo group. The treatment group experienced more side effects per person at 2 and 4 weeks (1.58, P < .02 and 1.54, P < .05), respectively. Nabilone appears to be a beneficial, well-tolerated treatment option for fibromyalgia patients, with significant benefits in pain relief and functional improvement.

      Perspective

      To our knowledge, this is the first randomized, controlled trial to assess the benefit of nabilone, a synthetic cannabinoid, on pain reduction and quality of life improvement in patients with fibromyalgia. As nabilone improved symptoms and was well-tolerated, it may be a useful adjunct for pain management in fibromyalgia.

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