{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:17:45Z","timestamp":1791357465647,"version":"4.3.1"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T00:00:00Z","timestamp":1599177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare the efficacy and tolerability of combined pregabalin (PGB) and milnacipran (MLN) in female patients with fibromyalgia (FM) versus PGB as a monotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The present randomized open study included 58 female patients diagnosed with FM (registered on 4\/2\/19: NCT03905486). Patients were randomly divided into 2 groups (2:2); group 1 included 29 patients who received PGB monotherapy (150\u00a0mg twice daily) and group 2 included 29 patients who received combined PGB (150\u00a0mg twice daily) and MLN (50\u00a0mg twice daily) for 3\u00a0months. At the initial visit, patients were subjected to demographic data collection and assessed by the visual analog scale (VAS) for pain and the FM impact questionnaire (FIQ). Outcome measures after 3\u00a0months: FIQ, VAS and Leeds Sleep Evaluation Questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median disease duration was 2\u00a0years in group 1 (6\u00a0months to 5\u00a0years) and 2\u00a0years in group 2 (6\u00a0months to 12\u00a0years). The dropout rate was 20.7% in group 1 (n\u00a0=\u00a06) and 10.3% in group 2 (n\u00a0=\u00a03). At the follow\u2010up evaluation, a statistically significant improvement was observed in VAS and FIQ scores in both groups (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Although the percentage of patients demonstrating significant improvement in pain, disease impact and sleep pattern were higher in group 2, this did not reach statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although PGB as a monotherapy and in combination with MLN have both shown adequate efficacy in the treatment of patients with FM, the combined therapy did not demonstrate superiority over the monotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.13953","type":"journal-article","created":{"date-parts":[[2020,9,4]],"date-time":"2020-09-04T17:06:23Z","timestamp":1599239183000},"page":"1474-1480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy of pregabalin as a monotherapy versus combined pregabalin and milnacipran in the management of fibromyalgia"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5692-3483","authenticated-orcid":false,"given":"Yousra Hisham","family":"Abdel Fattah","sequence":"first","affiliation":[{"name":"Department of Physical Medicine, Rheumatology and Rehabilitation Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9604-4937","authenticated-orcid":false,"given":"Rehab","family":"Elnemr","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine, Rheumatology and Rehabilitation Faculty of Medicine Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-015-8509-4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209724"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbr.2016.10.004"},{"key":"e_1_2_8_5_1","unstructured":"KaltsasG FibromyalgiaTK.Endotext[Internet]: MDText. com Inc.;2020. www.endotext.org"},{"key":"e_1_2_8_6_1","unstructured":"FDA US.Living with fibromyalgia drugs approved to manage painAvailable athttp:\/\/www.fda.gov\/ForConsumers\/ConsumerUpdates\/ucm107802.htm#approved.2013[updated January 31 2014; Accessed: July 30 216]."},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2020.00083"},{"key":"e_1_2_8_8_1","volume-title":"Serotonin","author":"Onu\u021bu AH","year":"2018"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2016-0009"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X13483894"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1092852900003667"},{"key":"e_1_2_8_12_1","unstructured":"Pfizer Inc. 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