NEW YORK (Reuters Health) - A review of previous clinical trial results shows that a multifaceted approach can be effective for treating fibromyalgia, German researchers report.

Fibromyalgia is characterized by pain, fatigue and difficulty sleeping. It's a somewhat mysterious condition with no clear-cut cause.

Dr. Winfried Haeuser told Reuters Health that German guidelines recommend "multicomponent treatment" of fibromyalgia -- "at least two components: patient education or psychological therapy and exercise as second-line therapy for patients whose symptoms and restrictions in daily life are not sufficiently reduced by a single therapy, such as medication."

To investigate how well this strategy works, Haeuser, of Klinikum Saarbruecken, and her colleagues examined pooled evidence from nine clinical trials of multicomponent therapy involving more than 1100 patients. The researchers report the results in the medical journal Arthritis and Rheumatism.

The findings, Haeuser explained, "demonstrated that multicomponent treatment was superior to monocomponent treatment in relieving pain, depressed mood and fatigue and improving physical fitness."

However, she and her colleagues found, "There is strong evidence that the positive effects of multicomponent therapy on the key symptoms of fibromyalgia syndrome decline with time."

The longest follow-up was for 15 months. The researchers conclude, "Strategies to maintain the benefits of multicomponent treatment in the long term need to be developed."

SOURCE: Arthritis and Rheumatism, February 15, 2009.

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