{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T01:59:58Z","timestamp":1794535198657,"version":"4.9.1"},"reference-count":53,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Symptoms of fibromyalgia (FM) fluctuate and vary in severity. The current study aimed to evaluate the efficacy of palmitoylethanolamide (PEA) and acetyl-L-carnitine (ALC) in FM patients over a 24-month period and to investigate the mediating function of pain catastrophizing subdomains in unfavorable relationships with disease severity levels in patients with FM. Patients were evaluated at baseline, after 12 months, and after 24 months, using different patient-reported measures (FIQR, FASmod, PSD, and PCS) to distinguish different levels of FM disease severity. A reduction of 30% or more from baseline was considered clinically important (\u201cmarkedly improved\u201d). A multivariate analysis was performed to identify the variables predictive of an FIQR reduction. Twenty-two patients (28.6%) were classified as \u201cmarkedly improved\u201d, 16 patients (20.8%) as \u201cslightly\/moderately improved\u201d, and 39 patients (50.6%) as \u201cnot improved.\u201d The FIQR, FASmod, and PSD scores were significantly reduced at 24 months. The pain magnification domain score of the PCS was the only variable predictive of worse FIQR scores (Wald coefficient: \u22122.94; p = 0.047). These results suggest a potential long-term therapeutic role for the PEA + ALC combination, with pain magnification being the primary predictor of poor efficacy.<\/jats:p>","DOI":"10.3390\/jpm14070689","type":"journal-article","created":{"date-parts":[[2024,6,27]],"date-time":"2024-06-27T04:19:26Z","timestamp":1719461966000},"page":"689","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Trajectory of Change in the Severity of Symptoms in Patients with Fibromyalgia over 24 Months: Exploratory Analyses of a Combination Pharmacological Intervention"],"prefix":"10.3390","volume":"14","author":[{"given":"Fausto","family":"Salaffi","sequence":"first","affiliation":[{"name":"Rheumatology Unit, \u201cCarlo Urbani\u201d Hospital, Universit\u00e0 Politecnica delle Marche, Jesi, 60035 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giovanna","family":"Lommano","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, \u201cCarlo Urbani\u201d Hospital, Universit\u00e0 Politecnica delle Marche, Jesi, 60035 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, \u201cCarlo Urbani\u201d Hospital, Universit\u00e0 Politecnica delle Marche, Jesi, 60035 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Farah","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, \u201cCarlo Urbani\u201d Hospital, Universit\u00e0 Politecnica delle Marche, Jesi, 60035 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6874-4941","authenticated-orcid":false,"given":"Francesca","family":"Bandinelli","sequence":"additional","affiliation":[{"name":"Rheumatology Department, San Giovanni di Dio Hospital, USL Tuscany Center, 50143 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piercarlo","family":"Sarzi-Puttini","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, IRCCS Galeazzi-Sant\u2019Ambrogio Hospital, ASST, School of Medicine, University of Milan, 20157 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0906-4647","authenticated-orcid":false,"given":"Marco","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, \u201cCarlo Urbani\u201d Hospital, Universit\u00e0 Politecnica delle Marche, Jesi, 60035 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"279","DOI":"10.2147\/JPR.S100829","article-title":"Identifying the symptom and functional domains in patients with fibromyalgia: Results of a cross-sectional Internet-based survey in Italy","volume":"9","author":"Salaffi","year":"2016","journal-title":"J. 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