OR WAIT null SECS
Despite the lack of association with all-cause mortality, this research emphasizes the value of focusing on patients’ psychological well-being due to increased suicide risk among fibromyalgia patients.
There is no conclusive link between fibromyalgia/widespread chronic pain and risk of all-cause mortality among patients, according to recent findings, though patients with fibromyalgia may be at a heightened risk of suicide.1
These findings resulted from a new meta-analysis conducted to look into the risks of all-cause, specific mortality for individuals that have fibromyalgia. Recent research prior to this analysis led to mixed results on the topic, with some studies showing high mortality risk among patients and others showing no increases in mortality rates.2,3
The new meta-analysis on this topic was led by Lin Huang from the College of Basic Medical Science at Zhejiang Chinese Medical University in Hangzhou, China. Huang and colleagues noted that the subject has become somewhat controversial among researchers.
“What has been reported indicates that the relationship between fibromyalgia and mortality remains uncertain and needs further investigation,” Huang and colleagues wrote. “This meta-analysis was undertaken to ascertain the potential link between fibromyalgia, encompassing chronic widespread pain, and heightened mortality risk.”
The investigators utilized a comprehensive search which they conducted across the Cochrane Library, PubMed, and Embase databases from their inception up to March 2023, making sure not to use any specified restrictions. The team’s search implemented subject terms (Emtree in Embase and MeSH in PubMed) as well as keywords that related to mortality rates, widespread pain which was shown to be chronic, fibromyalgia, and related variations.
Cohort studies which the investigators deemed to be eligible for their search had to meet the following criteria:
The research team looked into the full texts of the appropriate studies to find those deemed suitable for inclusion in their analysis. The team used a quality assessment of their chosen cohort studies which involved the Newcastle–Ottawa Scale.
The method involved a star-based system which had a range from 0 - 9. Their rating criteria included elements such as selection of study participants, statistical analysis, exposure measurements, comparability of studies, adequacy of their outcome evaluations, and follow-up quality.
The investigators noted that higher star ratings suggested research which was of greater quality than others. They noted that research with 0 - 3 stars was viewed as low in quality, 4 - 6 as medium level of quality, and 7 - 9 as high-quality. They also constructed PRISMA tables to enhance the study’s overall transparency.
In the process of reviewing 7 cohort studies—involving a total of 152,933 subjects and spanning from 2001 - 2020—the team’s research did find substantial information which would point to a link between patients’ fibromyalgia or widespread pain and their risk of all-cause mortality (with an odds ratio [OR] of 1.11 and a 95% CI 0.81–1.53; I2 = 82.6%, P = .505).
Despite these findings, the investigators’ subgroup analysis did lead to several unique pieces of information. Specifically, the data showed a substantially greater risk of suicidality among those with the condition when compared to those without (OR 5.39, 95% CI 2.16–13.43; I2 = 69.9%, P < .05).
The research team highlighted the value of new research looking into this potential association between those with fibromyalgia or widespread pain and elevated risk of suicide. They note that their own limited participant pool proved to be a constraint, highlighting the need for further comprehensive research into the interrelationship between the variables.
“Future studies in developing countries should include case–control and cross-sectional studies to augment empirical diversity, validity, and clinical relevance,” they wrote. “The abstracts of international rheumatic conferences from the past few years were not considered in the literature screening process, which might have led to potential inaccuracies.”