Fibromyalgia, a cause of chronic pain, is a common condition that has been diagnosed for about 100 years, but until recently there was no drug available to treat it.
Dr. Erdal Diri, a rheumatologist for Trinity Health of Minot, participated in early trials of a drug to treat fibromyalgia that he said has had a positive impact on patients locally.
"Fibromyalgia is a very common disease," Diri said. "It is estimated that in the U.S., it affects about 5 million to 6 million people primarily younger middle-aged women."
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Katina Tengesdal/MDN - - Dr. Erdal Diri, rheumatologist for Trinity Health of Minot, participated in a trial of a drug to treat fibromyalgia.
"We were not able to prove what was causing the disease," he said. "Now, with functional MRI studies, it's proven that they have abnormal blood flow in the part of the brain affecting pain controlling function."
MRI studies on fibromyalgia patients has shown the condition to be more than just a psychological problem. The MRIs revealed that patients have a chemical imbalance in the brain causing problems with pain control.
With the new knowledge, scientists were able to develop a drug that has since been approved by the FDA, and studies have shown that it is effective. The drug, pregabalin, is sold under the brand name Lyrica. The multi-center study of 750 fibromyalgia patients found that those treated with pregabalin showed improvements in their symptoms.
Fact Box
Just the facts: About fibromyalgia
The first thing people with fibromyalgia say, explained Dr. Erdal Diri, rheumatologist for Trinity Health of Minot, is that they hurt all over.
In addition to the pain, sufferers may have bowel problems such as irritable bowel syndrome with constipation or diarrhea; bladder problems or frequent urinary tract infections; and trouble sleeping. They may also have different chemical allergies or asthma.
Risk factors for developing the condition, Diri said, include a possible hereditary component or a previous social or physical trauma that can cause or trigger symptoms.
Fibromyalgia seemed to be a condition that affected only those in developed countries. Through another study, Diri said, it was discovered to affect individuals in underdeveloped countries as well, especially in women, but because of political and cultural differences, individuals weren't coming forward about their pain.
For ongoing treatment of fibromyalgia, Diri suggested that several fibromyalgia educational groups in the area have been a benefit to patients, as well as regular exercise programs. Treatment for fibromyalgia is done through a multi-disciplinary approach, involving a primary care provider, physical therapy, psychiatrists and rheumatology and pain specialists.
Seeking help for the pain can be an important first step.
"This disease is common, it's there, and people shouldn't be afraid to seek medical attention," he said. "We don't call them crazy. They need to get treatments. They don't need to suffer from it in silence."
"It's really exciting to see finally getting hope for this devastating problem, which affects mainly the young, productive population," Diri said.
Trials
Through the trial, Diri said three important points about the drug were discovered. During treatment, pain was significantly reduced for patients, and patients' functional capacity and quality of life greatly improved. Surrogate findings included that patients' sleeping problems, as well as bladder and bowel disruptions, also improved.
Diri presented the data at an American College of Rheumatology national meeting in Boston in 2007. The results also appeared in the September 2008 issue of The Journal of Pain.
Following the approval of pregabalin, two other drugs were approved to treat fibromyalgia symptoms.
"It's interesting to see how much the drug industry gets interested in developing new drugs after there is an understanding of the pathology of the disease," Diri said.
The new drugs approved to treat fibromyalgia have not yet been studied for long term efficacy.
"In practice, physicians are just trying to help them (fibromyalgia sufferers) get this normal balance, and after that, it's about maintenance," Diri said.
"The new drugs can help people get severe pain under control, and then make the lifestyle changes to help them continue to be in control of symptoms," he said. "With time, it's not unusual to get off medication."