2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T82f,Fibromyalgia is a common condition characterised by widespread chronic pain, associated with comorbid mental health disorders and reduced quality of life. Preclinical data suggest cannabis-based medicinal products (CBMPs) may have potential benefits in fibromyalgia, but there is a paucity of high-quality clinical evidence. This study aims to assess the change in patient-reported outcome measures (PROMs) and incidence of adverse events (AEs) in patients treated with CBMPs for fibromyalgia. This case series analysed data from the UK Medical Cannabis Registry (UKMCR). The primary outcome was change in PROMs [Fibromyalgia Symptom Severity, Fibromyalgia Widespread Pain Index, EQ-5D-5L, Generalised Anxiety Disorder-7, and Single-Item Sleep Quality Scale] from baseline to follow-up at 1, 3, 6, 12, and 18 months. Statistical significance was defined as p < 0.050. Four hundred ninety-seven patients were included. The mean age was 44.66 ± 12.02 years, 341 patients (68.61%) were female, and the majority of patients were unemployed (n = 268, 53.92%). There was an improvement in all PROMs (p < 0.010) from baseline to all follow-up periods. Higher CBD doses (> 25.00 mg/day) and previous cannabis use were associated with increased odds of improvement on fibromyalgia-specific scales (p < 0.050). 227 patients (45.67%) reported 2100 AEs (422.54%). Most AEs were mild-to-moderate (n = 1792, 85.33%). The most common AE was fatigue (n = 153, 30.78%). There was an association between treatment with CBMPs and improvements in pain, anxiety, sleep, and general quality of life. The high incidence of AEs in relation to other patient cohorts from the UKMCR may relate to the central sensitisation mechanism of fibromyalgia. Key Points • This study found that CBMPs were associated with short to medium-term improvements in pain, anxiety, sleep, and general quality-of-life in patients with fibromyalgia. • More randomised controlled trials are warranted to consolidate the literature, but this large analysis provides real-world data to inform their rollout.31:Tf51,Abstract Introduction Fibromyalgia is a common condition characterised by widespread chronic pain, associated with comorbid mental health disorders and reduced quality of life. Preclinical data suggest cannabis-based medicinal products (CBMPs) may have potential benefits in fibromyalgia, but there is a paucity of high-quality clinical evidence. This study aims to assess the change in patient-reported outcome measures (PROMs) and incidence of adverse events (AEs) in patients treated with CBMPs for fibromyalgia. Methods This case series analysed data from the UK Medical Cannabis Registry (UKMCR). The primary outcome was change in PROMs [Fibromyalgia Symptom Severity, Fibromyalgia Widespread Pain Index, EQ-5D-5L, Generalised Anxiety Disorder-7, and Single-Item Sleep Quality Scale] from baseline to follow-up at 1, 3, 6, 12, and 18 months. Statistical significance was defined as p < 0.050. Results Four hundred ninety-seven patients were included. The mean age was 44.66 ± 12.02 years, 341 patients (68.61%) were female, and the majority of patients were unemployed ( n = 268, 53.92%). There was an improvement in all PROMs ( p < 0.010) from baseline to all follow-up periods. Higher CBD doses (> 25.00 mg/day) and previous cannabis use were associated with increased odds of improvement on fibromyalgia-specific scales ( p < 0.050). 227 patients (45.67%) reported 2100 AEs (422.54%). Most AEs were mild-to-moderate ( n = 1792, 85.33%). The most common AE was fatigue ( n = 153, 30.78%). Conclusions There was an association between treatment with CBMPs and improvements in pain, anxiety, sleep, and general quality of life. The high incidence of AEs in relation to other patient cohorts from the UKMCR may relate to the central sensitisation mechanism of fibromyalgia.

Key Points • This study found that CBMPs were associated with short to medium-term improvements in pain, anxiety, sleep, and general quality-of-life in patients with fibromyalgia. • More randomised controlled trials are warranted to consolidate the literature, but this large analysis provides real-world data to inform their rollout.

32:Tdc8,Madhur Varadpande is a medical student at Imperial College London. Madhur Varadpande has no shareholdings in pharmaceutical companies.Simon Erridge is a resident doctor and Research Director at Curaleaf Clinic. Simon Erridge is a research fellow at Imperial College London. Simon Erridge has no shareholdings in pharmaceutical companies.Arushika Aggarwal is a medical student at Imperial College London. Arushika Aggarwal has no shareholdings in pharmaceutical companies.Evonne Clarke is the Patient Care Director at Curaleaf Clinic. Evonne Clarke has no shareholdings in pharmaceutical companies.Katy McLachlan is the Chief Pharmacist at Curaleaf Clinic. Katy McLachlan has no shareholdings in pharmaceutical companies.Ross Coomber is a consultant orthopaedic surgeon at St George’s Hospital, London, and Operations Director at Curaleaf Clinic. Ross Coomber has no shareholdings in pharmaceutical companies.Shelley Barnes is a consultant pain specialist at Curaleaf Clinic. Shelley Barnes has no shareholdings in pharmaceutical companies.Alia Darweish Medniuk is a consultant pain specialist at Curaleaf Clinic. Alia Darweish Medniuk has no shareholdings in pharmaceutical companies.Rahul Guru is a consultant pain specialist at Curaleaf Clinic. Rahul Guru has no shareholdings in pharmaceutical companies.Wendy Holden is a consultant rheumatologist and pain specialist at Curaleaf Clinic. Wendy Holden has no shareholdings in pharmaceutical companies.Mohammed Sajad is a consultant pain specialist at Curaleaf Clinic. Mohammed Sajad has no shareholdings in pharmaceutical companies.Robert Seale is a consultant pain specialist at Curaleaf Clinic. Robert Seale has no shareholdings in pharmaceutical companies.Azfer Usmani is a consultant pain specialist at Curaleaf Clinic. Azfer Usmani has no shareholdings in pharmaceutical companies.Sanjay Varma is a consultant pain specialist at Curaleaf Clinic. Sanjay Varma has no shareholdings in pharmaceutical companies.James Rucker is a consultant psychiatrist at Curaleaf Clinic. James Rucker is an honorary consultant psychiatrist at The South London & Maudsley NHS Foundation Trust, and an NIHR Clinician Scientist Fellow at the Centre for Affective Disorders at King’s College London. James Rucker is funded by a fellowship (CS-2017–17-007) from the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health. James Rucker leads the Psychedelic Trials Group at King’s College London. King’s College London receives grant funding from COMPASS Pathways PLC to undertake phase 1 and phase 2 trials with psilocybin. COMPASS Pathways PLC has paid for James Rucker to attend trial-related meetings and conferences to present the results of research using psilocybin. James Rucker has undertaken paid consultancy work for Beckley PsyTech and Clerkenwell Health. Payments for consultancy work are received and managed by King’s College London, and James Rucker does not benefit personally. James Rucker has no shareholdings in pharmaceutical companies.Michael Platt is a consultant in pain services at Curaleaf Clinic. Michael Platt has no shareholdings in pharmaceutical companies.Mikael Sodergren is a consultant hepatopancreatobiliary surgeon at Imperial College NHS Trust, London, a senior clinical lecturer at Imperial College London, and the chief medical officer of Curaleaf International. Mikael Sodergren has no shareholdings in pharmaceutical companies.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Fibromyalgia: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Fibromyalgia (condition). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/condition/Fibromyalgia\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Conditions\",\"item\":\"https://www.reachrx.ai/hub/tag/condition\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Fibromyalgia\",\"item\":\"https://www.reachrx.ai/hub/tag/condition/Fibromyalgia\"}]}}"}}]],["$","$L2f",null,{"title":"Fibromyalgia: Research & Clinical Takeaways","description":"Discover peer-reviewed research on Fibromyalgia with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1007/s10880-026-10167-8","pmid":"42668351","title":"“I’m afraid to eat a piece of toast”: The Lived Experience of Balancing Eating and Health Behaviors in Adults with Chronic Pain","journal_title":"Journal of Clinical Psychology in Medical Settings","journal_issn":"1068-9583","published_at":"2026-08-29T00:00:00.000Z","url":"https://doi.org/10.1007/s10880-026-10167-8","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-07T06:30:41.381Z","updated_at":"2026-09-07T06:30:41.381Z","tags":[{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"condition","value":"Chronic Pain","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"condition","value":"Disordered Eating","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"condition","value":"Ehlers-Danlos Syndrome","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"sample_size","value":"n=16","value_numeric":16},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"study_design","value":"Qualitative Study (Reflexive Thematic Analysis)","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"warning","value":"All participants were drawn from a specialty multidisciplinary pain clinic, making findings less applicable to community-dwelling or primary care chronic pain populations.","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"warning","value":"One self-cited reference ('Anonymized for Review') is referenced in the text but not fully identified, suggesting unpublished or masked companion data was used to contextualize findings.","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10167-8","tag_type":"warning","value":"Sample is almost entirely female (15/16) and exclusively White non-Hispanic, which substantially limits applicability to other demographic groups.","value_numeric":null}],"summaries":{"what_studied":"This qualitative study explored the lived experience of eating problems in 16 adults with complex chronic pain (15 women, age 21–69, all White non-Hispanic, cisgender) recruited from a multidisciplinary academic pain clinic; interviews were analyzed using Reflexive Thematic Analysis.","key_result":"Five core themes emerged: (1) fear-driven unpredictability around food triggers; (2) vicious cycles linking pain, medication side effects, mood, and maladaptive eating; (3) disrupted body image and identity; (4) social isolation tied to dietary restrictions; and (5) practical barriers—financial, physical, and logistical—to obtaining and preparing food. Eating difficulties extended well beyond standard eating disorder criteria.","limitations":"- Sample was small (n=16), nearly all female, exclusively White non-Hispanic, and English-speaking—severely limiting generalizability.\n- Treatment-seeking sample from a single specialty pain clinic, not representative of community populations.\n- Qualitative design does not allow causal inference or prevalence estimates.","practice_takeaway":"Screen chronic pain patients for the full range of eating difficulties—including fear-based restriction, comfort eating, and medication-related appetite changes—not just formal eating disorder diagnoses. Replace weight-centric advice with individualized, biopsychosocial approaches that address fear-avoidance, decision fatigue, social isolation, and practical food-access barriers."}},{"doi":"10.1111/bjhp.70103","pmid":"42617657","title":"Gratitude and health behaviours: A temporal affective self‐regulation resource analysis across 24 samples","journal_title":"British Journal of Health Psychology","journal_issn":"1359-107X","published_at":"2026-08-19T00:00:00.000Z","url":"https://doi.org/10.1111/bjhp.70103","source_score":21,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-28T06:25:26.806Z","updated_at":"2026-08-28T06:25:26.806Z","tags":[{"paper_doi":"10.1111/bjhp.70103","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"condition","value":"Cancer","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"condition","value":"Chronic Fatigue Syndrome","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"condition","value":"Chronic Illness","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"condition","value":"Healthy Behaviour Promotion","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"modality","value":"Positive Psychology Intervention","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"sample_size","value":"n=6967","value_numeric":6967},{"paper_doi":"10.1111/bjhp.70103","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"study_design","value":"Meta-Analysis","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"warning","value":"Causal inference is limited: all included data are cross-sectional correlational studies; the mediating roles of affect and FTO were tested via semi-partial correlations, not structural models or RCTs.","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"warning","value":"The level of evidence is rated 2 (meta-analysis), but the non-standard MOD design means confidence is slightly lower than a conventional systematic meta-analysis of independent published literature.","value_numeric":null},{"paper_doi":"10.1111/bjhp.70103","tag_type":"warning","value":"This is a 'Meta-analysis of Own Data' (MOD), not a traditional systematic meta-analysis — all 24 samples came from the authors' labs, which may introduce lab-specific bias despite the authors' mitigations.","value_numeric":null}],"summaries":{"what_studied":"This meta-analysis of own data (MOD) examined whether gratitude (trait or state) is associated with health-promoting behaviours across 24 diverse samples (N = 6,967; community, student, and medical/chronic illness populations) collected 2011–2020, and whether positive affect, negative affect, and future time orientation (FTO) explain that link.","key_result":"Gratitude showed a small-to-moderate positive association with health-promoting behaviours (r = .270; 95% CI [.24, .30]). After controlling for positive affect, negative affect, and FTO separately, the association remained significant but shrank to small effects (sr ≈ .135–.208), indicating these self-regulation resources partially mediate the link. No moderating effects were found for sample type, trait vs. state gratitude, age, or sex.","limitations":"- All 24 samples came from the authors' own labs, raising risk of lab-specific bias (though a failsafe N of 3,020 suggests low publication bias).\n- Samples were predominantly White and from Western cultures, limiting generalizability.\n- Self-regulation resources (positive affect, negative affect, FTO) were tested separately, not simultaneously, so their synergistic roles per the TASRR model were not fully tested.","practice_takeaway":"Gratitude practices (e.g., gratitude journaling) appear consistently linked to healthier behaviours—including eating, exercise, sleep, and stress management—across medical and non-medical populations. Clinicians can consider low-resource gratitude-based interventions as an adjunct strategy for health behaviour change, particularly given their positive affect and future-orientation benefits."}},{"doi":"10.1136/lupus-2026-002188","pmid":"42508962","title":"Risk of falls, recurrent falls and osteoporotic fractures in SLE patients with comorbid fibromyalgia: a propensity score-matched cohort study using the TriNetX Network","journal_title":"Lupus Science & Medicine","journal_issn":"2053-8790","published_at":"2026-07-27T00:00:00.000Z","url":"https://doi.org/10.1136/lupus-2026-002188","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:05.264Z","updated_at":"2026-08-04T18:18:05.264Z","tags":[{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"condition","value":"Falls","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"condition","value":"Osteoporotic Fractures","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"amitriptyline","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"duloxetine","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"gabapentin","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"hydroxychloroquine","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"milnacipran","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"prednisone","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"generic","value":"pregabalin","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Antimalarial","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Gabapentinoid","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Glucocorticoid","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Serotonin-Norepinephrine Reuptake Inhibitor","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"modality","value":"Tricyclic Antidepressant","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"sample_size","value":"n=47550","value_numeric":47550},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"study_design","value":"Propensity Score-Matched Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"warning","value":"Outcomes 3 (thoracolumbar vertebral fractures) and 4 (osteoporotic fractures) partially overlap at the vertebral level and are not statistically independent; they are reported separately by design.","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"warning","value":"The cohort was ~96% female, reflecting SLE demographics; findings may have limited generalizability to male SLE patients.","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied cautiously — findings are observational and the authors explicitly call for prospective confirmation before clinical guideline changes.","value_numeric":null},{"paper_doi":"10.1136/lupus-2026-002188","tag_type":"warning","value":"The landmark sensitivity analysis (8,458 matched pairs) showed modestly stronger associations (falls HR 1.68 vs 1.37), suggesting the primary design may slightly underestimate true risk due to survivorship of the exposed cohort until FM diagnosis.","value_numeric":null}],"summaries":{"what_studied":"This propensity score-matched (PSM) retrospective cohort study used the TriNetX US Collaborative Network to assess whether comorbid fibromyalgia (FM) independently increases the risk of falls, recurrent falls, thoracolumbar vertebral fractures, and osteoporotic fractures in adult SLE patients over a 5-year follow-up period (6-month washout; 2013–2024).","key_result":"After 1:1 PSM (23,775 matched pairs), SLE+FM patients had significantly higher 5-year risks vs. SLE-only: incident falls (aHR 1.38, 95% CI 1.29–1.48), recurrent falls (aHR 1.53, 95% CI 1.32–1.76), thoracolumbar vertebral fractures (aHR 1.18, 95% CI 1.01–1.37), and osteoporotic fractures (aHR 1.14, 95% CI 1.02–1.27); Kaplan-Meier curves diverged early and progressively.","limitations":"- Bone mineral density (DXA T-scores) was unavailable in TriNetX and could not be adjusted for, leaving residual confounding for fracture outcomes.\n- Cumulative glucocorticoid dose/duration, menopausal status, physical activity, disease activity, frailty, and opioid/benzodiazepine use were unmeasured or only coarsely captured.\n- All outcomes were ICD-10-CM code–based (not clinically adjudicated), so low-trauma fractures cannot be distinguished from high-energy events, and asymptomatic morphometric vertebral fractures were likely undercaptured.","practice_takeaway":"Screen SLE patients routinely for comorbid FM, as it independently raises fall risk by 38% and recurrent fall risk by 53% — risks that are additive to SLE's baseline skeletal fragility. For SLE patients with FM, integrate multidisciplinary fall-prevention strategies (balance/strength assessment, review of gabapentinoids, TCAs, and SNRIs) alongside bone-protective therapy."}},{"doi":"10.1097/rhu.0000000000002369","pmid":"42358124","title":"Prevalence of Attention Deficit Hyperactivity Disorder in Adult Patients With Fibromyalgia","journal_title":"JCR: Journal of Clinical Rheumatology","journal_issn":"1076-1608","published_at":"2026-07-06T00:00:00.000Z","url":"https://doi.org/10.1097/rhu.0000000000002369","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-05T13:38:43.894Z","updated_at":"2026-07-05T13:38:43.894Z","tags":[{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"condition","value":"Attention Deficit Hyperactivity Disorder","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"modality","value":"Neuropsychological Testing","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"sample_size","value":"n=131","value_numeric":131},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"warning","value":"Sex distribution of the study population is described as matched but exact breakdown not reported in the abstract; 'mixed' sex tag is inferred from matching criteria.","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"warning","value":"The paper's listed publication date (2026-07-06) is one day after today's date (2026-07-05); the DOI resolves to JCR: Journal of Clinical Rheumatology — this may be an advance online publication date discrepancy.","value_numeric":null},{"paper_doi":"10.1097/rhu.0000000000002369","tag_type":"warning","value":"The 'safety_signal' impact flag is used here to flag the high prevalence of undiagnosed ADHD in FM, which has clinical management implications rather than a traditional drug safety signal.","value_numeric":null}],"summaries":{"what_studied":"Cross-sectional study evaluating the prevalence of undiagnosed adult ADHD in 60 adults with fibromyalgia (FM, ACR 2016 criteria) vs. 71 age-, sex-, and education-matched controls, using the CPT II and WURS; also assessed FM impact via FIQ-R and HAQ-A.","key_result":"Adult ADHD was found in 61.7% of FM patients vs. 23.9% of controls; 48.6% of those FM patients had been undiagnosed in childhood. Childhood ADHD symptoms strongly predicted adult ADHD (OR 62.3, p=0.003), but ADHD presence did not correlate with higher FIQ-R or HAQ-A scores. Cognitive impairment was also more common in FM (43.3% vs. 16.9%).","limitations":"Small sample size (n=131 total) limits generalizability. Cross-sectional design prevents causal inference. Study conducted in a single center using an Argentine population, which may limit applicability to other settings.","practice_takeaway":"Clinicians managing fibromyalgia patients should screen routinely for ADHD, as nearly two-thirds may be affected and most cases go undetected. Identifying ADHD does not appear to worsen FM impact scores, but the high rate of missed childhood diagnoses suggests a significant untreated burden."}},{"doi":"10.1016/j.bbi.2026.106837","pmid":"42190845","title":"Shared genetic risk between functional somatic syndromes, internalizing disorders, and immune-mediated diseases: a twin-sibling study","journal_title":"Brain, Behavior, and Immunity","journal_issn":"0889-1591","published_at":"2026-05-25T00:00:00.000Z","url":"https://doi.org/10.1016/j.bbi.2026.106837","source_score":8,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-06T13:22:46.205Z","updated_at":"2026-06-06T13:22:46.205Z","tags":[{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"condition","value":"Anxiety Disorders","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"condition","value":"Functional Somatic Syndromes","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"condition","value":"Immune-Mediated Diseases","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"condition","value":"Irritable Bowel Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"condition","value":"Major Depressive Disorder","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"condition","value":"Myalgic Encephalomyelitis / Chronic Fatigue Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"sample_size","value":"n=6097372","value_numeric":6097372},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"study_design","value":"Twin-Sibling Study","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"warning","value":"'Immune-mediated diseases' is a composite category including both autoimmune and autoinflammatory diseases — specific disease-level genetic correlations are not reported separately.","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"warning","value":"Publication date (2026-05-25) is ahead of today's date per some reference frames but is provided as stated in the source.","value_numeric":null},{"paper_doi":"10.1016/j.bbi.2026.106837","tag_type":"warning","value":"The 'level_of_evidence' is rated 3 (large observational/registry study); no experimental intervention was tested, so causal inference is limited.","value_numeric":null}],"summaries":{"what_studied":"This Swedish twin-sibling study (n=6,097,372) used bivariate structural equation modeling to estimate heritability and genetic/environmental correlations between functional somatic syndromes (ME/CFS, fibromyalgia, IBS), internalizing disorders (major depression, anxiety), and immune-mediated diseases, using nationwide register-based ICD diagnoses.","key_result":"Heritability ranged 15–44% for functional somatic syndromes and internalizing disorders; immune-mediated diseases showed 37% heritability. Fibromyalgia had the strongest genetic correlation with immune-mediated diseases (rA = 0.52, 95% CI 0.45–0.63), while IBS, ME/CFS, and major depression showed modest correlations (rA 0.19–0.29), and anxiety disorders showed minimal correlation (rA = 0.04, 95% CI 0.00–0.08).","limitations":"- Diagnoses rely on register-based ICD codes, which may under-capture milder or undiagnosed cases.\n- The twin-sibling design estimates genetic overlap but cannot identify specific shared genes or causal mechanisms.\n- Generalizability may be limited to populations of similar ancestry and healthcare settings as Sweden.","practice_takeaway":"Fibromyalgia shares substantial genetic risk with immune-mediated diseases, supporting a biological—not purely psychosomatic—framing of the condition. Clinicians should consider immune-related workup and cross-disciplinary care when managing fibromyalgia, and to a lesser degree ME/CFS and IBS."}},{"doi":"10.1007/s10067-026-08184-x","pmid":"42183918","title":"Fibromyalgia in men: beyond invisibility—a biopsychosocial and clinical perspective in rheumatology","journal_title":"Clinical Rheumatology","journal_issn":"0770-3198","published_at":"2026-05-25T00:00:00.000Z","url":"https://doi.org/10.1007/s10067-026-08184-x","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-05T13:26:35.554Z","updated_at":"2026-06-05T13:26:35.554Z","tags":[{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"condition","value":"Chronic Pain","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"modality","value":"Biopsychosocial Rehabilitation","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"modality","value":"Exercise Therapy","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"study_design","value":"Narrative Review / Perspective","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"warning","value":"No primary data were collected; all conclusions are derived from a targeted literature review with acknowledged selection bias.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"warning","value":"Study design label 'Narrative Review / Perspective' is used because the paper is explicitly framed as a perspective/opinion piece with a non-systematic literature search—not a standard study design category.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08184-x","tag_type":"warning","value":"This is a single-author, non-systematic perspective article; the framework is hypothesis-generating and not based on a formal systematic review or meta-analysis.","value_numeric":null}],"summaries":{"what_studied":"This perspective critically examines fibromyalgia in men as an underrecognized clinical entity, proposing an integrative conceptual framework that covers epidemiological, sociocultural, biological, and clinical dimensions of the condition in male patients.","key_result":"The authors argue that underdiagnosis of fibromyalgia in men results from three interacting factors: sociocultural barriers to care-seeking (driven by masculinity norms), clinician diagnostic bias, and heterogeneous symptom expression. Emerging evidence points to small fiber pathology, reduced handgrip strength, gait impairments (slower speed, reduced stride/cadence), and psychological comorbidities in male patients—but current evidence is limited by small samples and methodological heterogeneity.","limitations":"- Non-systematic, narrative review with targeted literature selection; susceptible to selection bias.\n- Most underlying studies have small samples, cross-sectional designs, and lack sex-balanced comparison groups.\n- Male-focused primary research is scarce; much inference relies on mixed-sex or female-dominant cohorts.","practice_takeaway":"Rheumatologists should actively screen men with persistent diffuse musculoskeletal pain, fatigue, and non-restorative sleep for fibromyalgia—even without inflammatory or structural findings—and consider simple functional measures (handgrip strength, gait assessment) alongside explicit symptom validation to reduce diagnostic delay.\n\nA biopsychosocial, gender-sensitive approach that integrates pain education, exercise-based rehabilitation, and shared decision-making may improve engagement and adherence in male patients."}},{"doi":"10.1007/s10880-026-10154-z","pmid":"42171865","title":"Psychological Pain Care in Medical Settings: A Special Issue Highlighting Recent Advances in Intervention and Delivery","journal_title":"Journal of Clinical Psychology in Medical Settings","journal_issn":"1068-9583","published_at":"2026-05-22T00:00:00.000Z","url":"https://doi.org/10.1007/s10880-026-10154-z","source_score":5,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-30T13:22:39.296Z","updated_at":"2026-05-30T13:22:39.296Z","tags":[{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"category","value":"Psychology, Clinical","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"condition","value":"Cancer Pain","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"condition","value":"Chronic Daily Headache","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"condition","value":"Chronic Pain","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"condition","value":"Complex Regional Pain Syndrome","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"condition","value":"Osteogenesis Imperfecta","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"condition","value":"Sickle Cell Disease","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"modality","value":"Biofeedback","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"modality","value":"Cognitive Behavioral Therapy","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"modality","value":"Emotional Awareness and Expression Therapy","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"modality","value":"Mindfulness-Based Intervention","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"modality","value":"Mobile Health Application","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"modality","value":"Telehealth / Videoconferencing","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"modality","value":"Virtual Reality","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"study_design","value":"Editorial / Narrative Overview","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"warning","value":"No sample size is applicable to this editorial itself; individual study sample sizes vary and are not aggregated here.","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"warning","value":"Study designs within the referenced articles range from qualitative studies and feasibility pilots to RCTs, so the overall evidence base is heterogeneous.","value_numeric":null},{"paper_doi":"10.1007/s10880-026-10154-z","tag_type":"warning","value":"This is a special issue editorial, not a primary research article — it summarizes 17 separate studies without original data or statistical analysis.","value_numeric":null}],"summaries":{"what_studied":"This special issue editorial synthesizes 17 articles examining recent advances in psychological pain interventions (CBT, mindfulness, EAET, biofeedback, virtual reality) and their delivery across diverse medical settings, digital platforms, and community contexts.","key_result":"Key themes across included studies: multimodal CBT + biofeedback outperformed either alone for chronic daily headache; mobile app engagement correlated with greater pain outcomes; VR showed feasibility for acute procedural pain in burn centers; digital screeners and telehealth expanded access but referral-to-treatment conversion remained low in primary care.","limitations":"This is an editorial overview, not a primary study — no pooled data, effect sizes, or statistical synthesis are provided. Individual study findings vary widely in design rigor (feasibility pilots to RCTs), limiting generalizable conclusions.","practice_takeaway":"Embedding behavioral health consultants in primary care and using digital/mobile tools can extend psychological pain care to underserved patients — but screening programs must include clear referral-to-treatment workflows to avoid low conversion rates. Empathic communication training for all clinicians is highlighted as a modifiable driver of pain care quality."}},{"doi":"10.1002/acr.80090","pmid":"42148468","title":"Phenotypes of Chronic Overlapping Pain Multimorbidity in Rheumatology: A Population‐Based Claims Study","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2026-05-18T00:00:00.000Z","url":"https://doi.org/10.1002/acr.80090","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:34:51.057Z","updated_at":"2026-05-26T13:34:51.057Z","tags":[{"paper_doi":"10.1002/acr.80090","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Ankylosing Spondylitis","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Autoimmune Rheumatic Disease","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Chronic Low Back Pain","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Chronic Overlapping Pain Conditions","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Sjögren's Disease","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"condition","value":"Systemic Sclerosis","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"sample_size","value":"n=149742","value_numeric":149742},{"paper_doi":"10.1002/acr.80090","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"warning","value":"Results may not generalize to older adults or underserved populations, as the database covers only commercially insured individuals.","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"warning","value":"The 'impact_flag' of practice_changing is applied cautiously — the study is observational and does not test an intervention, but its screening and treatment recommendations represent a meaningful clinical shift for rheumatology practice.","value_numeric":null},{"paper_doi":"10.1002/acr.80090","tag_type":"warning","value":"The study period ends in 2021; coding patterns and COPC recognition may have evolved since then.","value_numeric":null}],"summaries":{"what_studied":"This population-based claims study analyzed 149,742 adults with autoimmune rheumatic diseases (ARDs) from the 2008–2021 Merative MarketScan database to characterize the prevalence and co-occurrence patterns of chronic overlapping pain conditions (COPCs) such as fibromyalgia, chronic low back pain, migraine, IBS, chronic fatigue syndrome, TMD, and pelvic pain.","key_result":"57.5% of ARD patients had ≥1 COPC and 22.7% had multiple COPCs. Chronic low back pain (41.4%) and fibromyalgia (21.1%) were most common. COPC pairs co-occurred more than expected by chance (e.g., fibromyalgia + chronic low back pain O/E ratio 1.35; migraine + chronic low back pain 1.42), with the strongest dyad being urologic chronic pelvic pain + vulvodynia (OR 10.46). Women and adults aged 31–50 had the highest COPC burden.","limitations":"Diagnoses relied on ICD-9/10-CM billing codes, which may undercount or misclassify COPCs. The commercially insured database excludes uninsured, Medicare, and Medicaid populations, limiting generalizability. Observational design prevents causal inference about shared mechanisms.","practice_takeaway":"Clinicians managing ARD patients should routinely screen for COPCs—especially chronic low back pain and fibromyalgia—given that over half of patients carry at least one. Prioritize non-opioid multimodal pain strategies, particularly for patients with common COPC dyads."}},{"doi":"10.1002/art.70202","pmid":"42045797","title":"Determinants of Difficult‐to‐Manage and Treatment‐Refractory Axial Spondyloarthritis: A Cross‐Sectional Analysis Within a Longitudinal Cohort","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-05-10T00:00:00.000Z","url":"https://doi.org/10.1002/art.70202","source_score":18,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-10T14:23:52.929Z","updated_at":"2026-06-10T14:23:52.929Z","tags":[{"paper_doi":"10.1002/art.70202","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"sample_size","value":"n=536","value_numeric":536},{"paper_doi":"10.1002/art.70202","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"warning","value":"No drug-specific modality or brand tags were applied, as the study does not focus on a specific therapeutic intervention.","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"warning","value":"The cross-sectional design means the 'longitudinal cohort' framing reflects the source registry, not a longitudinal analysis of outcomes over time — causal relationships cannot be inferred.","value_numeric":null},{"paper_doi":"10.1002/art.70202","tag_type":"warning","value":"The TR subgroup (n=12) is very small; estimates for that group should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"Cross-sectional analysis of 536 axSpA patients in a longitudinal cohort to estimate the prevalence of ASAS-defined difficult-to-manage (D2M) and treatment-refractory (TR) disease, and to identify associated factors using multivariable logistic regression.","key_result":"9.1% (49/536) met D2M criteria and 2.2% (12/536) were classified as TR. Higher spinal pain scores (OR 1.48, 95% CI 1.29–1.70) and fibromyalgia (OR 3.09, 95% CI 1.33–7.15) were independently associated with D2M. TR patients had greater inflammatory disease burden and were more often male and HLA-B27-positive, with fewer noninflammatory pain contributors.","limitations":"Single-cohort cross-sectional design limits generalizability and causal inference. The relatively small number of TR patients (n=12) reduces statistical power for that subgroup. Study population is from a single academic spondylitis program, which may introduce referral bias.","practice_takeaway":"Screen axSpA patients with persistent high spinal pain and fibromyalgia for D2M status, as these are the strongest independent drivers — not just active inflammation. TR and D2M patients need distinct management strategies: address noninflammatory pain contributors (e.g., fibromyalgia) in D2M, and optimize anti-inflammatory therapy in TR."}},{"doi":"10.1016/s2665-9913(26)00041-x","pmid":"41999719","title":"Associated lifestyle factors and comorbidities of difficult-to-treat rheumatoid arthritis: a systematic review and meta-analysis","journal_title":"The Lancet Rheumatology","journal_issn":"2665-9913","published_at":"2026-04-15T00:00:00.000Z","url":"https://doi.org/10.1016/s2665-9913(26)00041-x","source_score":20,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-15T13:23:08.700Z","updated_at":"2026-05-15T13:23:08.700Z","tags":[{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"condition","value":"Difficult-to-Treat Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"sample_size","value":"n=22968","value_numeric":22968},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"warning","value":"All included studies are observational; pooled ORs reflect association, not causation.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"warning","value":"Subgroup analyses for socioeconomic status, osteoarthritis, and alcohol consumption are based on very few studies and should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00041-x","tag_type":"warning","value":"The PROSPERO registration number (CRD420251148710) appears atypical in format — clinicians should verify registration if consulting the full protocol.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis examined lifestyle factors (smoking, obesity, alcohol) and comorbidities (fibromyalgia, depression, anxiety, osteoarthritis) associated with difficult-to-treat rheumatoid arthritis (D2T RA), as defined by EULAR, across 21 observational studies (22,968 RA patients; 2,783 with D2T RA) published between Jan 2021 and Sept 2025.","key_result":"Smoking history (OR 1.16, 95% CI 1.01–1.34), obesity (OR 1.38, 95% CI 1.11–1.72), fibromyalgia (OR 2.20, 95% CI 1.64–2.96), and depression (OR 1.74, 95% CI 1.39–2.18) were each significantly associated with D2T RA; current smoking alone, anxiety, and BMI as a continuous variable were not.","limitations":"- Evidence on socioeconomic status, osteoarthritis, and alcohol was sparse (few contributing studies).\n- All included studies were observational, limiting causal inference.\n- People with lived experience of RA were not involved in the review design.","practice_takeaway":"Screen RA patients for smoking history, obesity, fibromyalgia, and depression, as each independently raises the odds of a difficult-to-treat course. Integrated management targeting these modifiable factors alongside inflammation should be part of routine RA treatment planning."}},{"doi":"10.1007/s10067-025-07846-6","pmid":"41343025","title":"UK Medical Cannabis Registry: a case series analysing clinical outcomes of medicinal cannabis therapy for fibromyalgia","journal_title":"Clinical Rheumatology","journal_issn":"0770-3198","published_at":"2025-12-04T00:00:00.000Z","url":"https://doi.org/10.1007/s10067-025-07846-6","source_score":37,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-08","doi":"10.1007/s10067-025-07846-6","days":"30","issn":"0770-3198","rank":"1","field":"Clinical Medicine","score":"37","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1007/s10067-025-07846-6","title":"UK Medical Cannabis Registry: a case series analysing clinical outcomes of medicinal cannabis therapy for fibromyalgia.","journal":"Clinical rheumatology","methods":"","results":"Four hundred ninety-seven patients were included. The mean age was 44.66 ± 12.02 years, 341 patients (68.61%) were female, and the majority of patients were unemployed (n = 268, 53.92%). There was an improvement in all PROMs (p < 0.010) from baseline to all follow-up periods. Higher CBD doses (> 25.00 mg/day) and previous cannabis use were associated with increased odds of improvement on fibromyalgia-specific scales (p < 0.050). 227 patients (45.67%) reported 2100 AEs (422.54%). Most AEs were mild-to-moderate (n = 1792, 85.33%). The most common AE was fatigue (n = 153, 30.78%).","abstract":"$30","keywords":["Cannabidiol","Cannabinoid","Cannabis","Fibromyalgia","Tetrahydrocannabinol"],"pubmed_id":"41343025","conclusions":"","publication_date":"2025-12-04T00:00:00"},"crossref":{"DOI":"10.1007/s10067-025-07846-6","URL":"https://doi.org/10.1007/s10067-025-07846-6","ISSN":["0770-3198","1434-9949"],"link":[{"URL":"https://link.springer.com/content/pdf/10.1007/s10067-025-07846-6.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/article/10.1007/s10067-025-07846-6/fulltext.html","content-type":"text/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https://link.springer.com/content/pdf/10.1007/s10067-025-07846-6.pdf","content-type":"application/pdf","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["UK Medical Cannabis Registry: a case series analysing clinical outcomes of medicinal cannabis therapy for fibromyalgia"],"author":[{"given":"Madhur","family":"Varadpande","sequence":"first","affiliation":[]},{"given":"Simon","family":"Erridge","sequence":"additional","affiliation":[]},{"given":"Arushika","family":"Aggarwal","sequence":"additional","affiliation":[]},{"given":"Evonne","family":"Clarke","sequence":"additional","affiliation":[]},{"given":"Katy","family":"McLachlan","sequence":"additional","affiliation":[]},{"given":"Ross","family":"Coomber","sequence":"additional","affiliation":[]},{"given":"Shelley","family":"Barnes","sequence":"additional","affiliation":[]},{"given":"Alia","family":"Darweish Medniuk","sequence":"additional","affiliation":[]},{"given":"Rahul","family":"Guru","sequence":"additional","affiliation":[]},{"given":"Wendy","family":"Holden","sequence":"additional","affiliation":[]},{"given":"Mohammed","family":"Sajad","sequence":"additional","affiliation":[]},{"given":"Robert","family":"Searle","sequence":"additional","affiliation":[]},{"given":"Azfer","family":"Usmani","sequence":"additional","affiliation":[]},{"given":"Sanjay","family":"Varma","sequence":"additional","affiliation":[]},{"given":"James J.","family":"Rucker","sequence":"additional","affiliation":[]},{"given":"Michael","family":"Platt","sequence":"additional","affiliation":[]},{"given":"Mikael H.","family":"Sodergren","sequence":"additional","affiliation":[]}],"issued":{"date-parts":[[2025,12,4]]},"member":"297","prefix":"10.1007","source":"Crossref","volume":null,"created":{"date-time":"2025-12-09T10:39:07Z","timestamp":1765276747000,"date-parts":[[2025,12,9]]},"indexed":{"date-time":"2025-12-09T10:41:42Z","timestamp":1765276902824,"date-parts":[[2025,12,9]]},"license":[{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000,"date-parts":[[2025,12,4]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://creativecommons.org/licenses/by/4.0","start":{"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000,"date-parts":[[2025,12,4]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://link.springer.com/10.1007/s10067-025-07846-6"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"ArticleHistory","label":"Article History"},"label":"Received","order":1,"value":"15 May 2025"},{"name":"revised","group":{"name":"ArticleHistory","label":"Article History"},"label":"Revised","order":2,"value":"18 November 2025"},{"name":"accepted","group":{"name":"ArticleHistory","label":"Article History"},"label":"Accepted","order":3,"value":"20 November 2025"},{"name":"first_online","group":{"name":"ArticleHistory","label":"Article History"},"label":"First Online","order":4,"value":"4 December 2025"},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"},"order":1},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"},"order":2,"value":"Provided by South West–Central Bristol Research Ethics Committee (Reference: 22/SW/0145)."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent"},"order":3,"value":"All study participants gave formal, informed, and written consent, preceding their consecutive enrollment into the database."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations of interest statement"},"order":4,"value":"$32"}],"deposited":{"date-time":"2025-12-09T10:39:15Z","timestamp":1765276755000,"date-parts":[[2025,12,9]]},"issn-type":[{"type":"print","value":"0770-3198"},{"type":"electronic","value":"1434-9949"}],"published":{"date-parts":[[2025,12,4]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.1016/j.semarthrit.2016.08.012","key":"7846_CR1","year":"2016","issue":"3","author":"F Wolfe","volume":"46","first-page":"319","unstructured":"Wolfe F, Clauw DJ, Fitzcharles M, Goldenberg DL, Häuser W, Katz RL et al (2016) 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum 46(3):319–329. https://doi.org/10.1016/j.semarthrit.2016.08.012","article-title":null,"journal-title":"Semin Arthritis Rheum","doi-asserted-by":"publisher"},{"DOI":"10.1002/art.38905","key":"7846_CR2","year":"2015","issue":"2","author":"GT Jones","volume":"67","first-page":"568","unstructured":"Jones GT, Atzeni F, Beasley M, Flüß E, Sarzi-Puttini P, Macfarlane GJ (2015) The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheumatol 67(2):568–575. https://doi.org/10.1002/art.38905","article-title":null,"journal-title":"Arthritis Rheumatol","doi-asserted-by":"publisher"},{"DOI":"10.1007/s40265-021-01602-1","key":"7846_CR3","year":"2021","issue":"18","author":"M Fitzcharles","volume":"81","first-page":"2103","unstructured":"Fitzcharles M, Petzke F, Tölle TR, Häuser W (2021) Cannabis-based medicines and medical cannabis in the treatment of nociplastic pain. Drugs 81(18):2103–2116. https://doi.org/10.1007/s40265-021-01602-1","article-title":null,"journal-title":"Drugs","doi-asserted-by":"publisher"},{"DOI":"10.1186/1477-7525-9-71","key":"7846_CR4","year":"2011","issue":"1","author":"C Schaefer","volume":"9","first-page":"71","unstructured":"Schaefer C, Chandran A, Hufstader M, Baik R, McNett M, Goldenberg D et al (2011) The comparative burden of mild, moderate and severe fibromyalgia: results from a cross-sectional survey in the United States. Health Qual Life Outcomes 9(1):71. https://doi.org/10.1186/1477-7525-9-71","article-title":null,"journal-title":"Health Qual Life Outcomes","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jpain.2010.01.002","key":"7846_CR5","year":"2010","issue":"6","author":"W Häuser","volume":"11","first-page":"505","unstructured":"Häuser W, Petzke F, Sommer C (2010) Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome. J Pain 11(6):505–521. https://doi.org/10.1016/j.jpain.2010.01.002","article-title":null,"journal-title":"J Pain","doi-asserted-by":"publisher"},{"DOI":"10.1186/ar4441","key":"7846_CR6","year":"2014","issue":"1","author":"W Häuser","volume":"16","first-page":null,"unstructured":"Häuser W, Walitt B, Fitzcharles M, Sommer C (2014) Review of pharmacological therapies in fibromyalgia syndrome. Arthritis Res Ther 16(1):201. https://doi.org/10.1186/ar4441","article-title":null,"journal-title":"Arthritis Res Ther","doi-asserted-by":"publisher"},{"DOI":"10.1111/papr.12743","key":"7846_CR7","year":"2019","issue":"3","author":"R Desai","volume":"19","first-page":"295","unstructured":"Desai R, Jo A, Marlow NM (2019) Risk for medication nonadherence among Medicaid enrollees with fibromyalgia: development of a validated risk prediction tool. Pain Pract 19(3):295–302. https://doi.org/10.1111/papr.12743","article-title":null,"journal-title":"Pain Pract","doi-asserted-by":"publisher"},{"DOI":"10.1038/sj.bjp.0706406","key":"7846_CR8","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Pertwee RG (2006) Cannabinoid pharmacology: the first 66 years. Br J Pharmacol. 147(S1). https://doi.org/10.1038/sj.bjp.0706406","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1038/28393","key":"7846_CR9","year":"1998","issue":"6690","author":"A Calignano","volume":"394","first-page":"277","unstructured":"Calignano A, La Rana G, Giuffrida A, Piomelli D (1998) Control of pain initiation by endogenous cannabinoids. Nature 394(6690):277–281. https://doi.org/10.1038/28393","article-title":null,"journal-title":"Nature","doi-asserted-by":"publisher"},{"DOI":"10.1371/journal.pone.0089432","key":"7846_CR10","year":"2014","issue":"2","author":"A Silvani","volume":"9","first-page":null,"unstructured":"Silvani A, Berteotti C, Bastianini S, Lo Martire V, Mazza R, Pagotto U et al (2014) Multiple sleep alterations in mice lacking cannabinoid type 1 receptors. PLoS One 9(2):e89432. https://doi.org/10.1371/journal.pone.0089432","article-title":null,"journal-title":"PLoS One","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.mayocp.2023.12.018","key":"7846_CR11","year":"2024","issue":"4","author":"A Singla","volume":"99","first-page":"542","unstructured":"Singla A, Anstine CV, Huang L, Rosedahl JK, Mohabbat AB, Philpot LM (2024) A cross-sectional survey study of cannabis use for fibromyalgia symptom management. Mayo Clin Proc 99(4):542–550. https://doi.org/10.1016/j.mayocp.2023.12.018","article-title":null,"journal-title":"Mayo Clin Proc","doi-asserted-by":"publisher"},{"DOI":"10.1136/bmj.n1034","key":"7846_CR12","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Wang L, Hong PJ, May C, Rehman Y, Oparin Y, Hong CJ, et al (2021) Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ n1034. https://doi.org/10.1136/bmj.n1034","article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.1136/bmj.n2040","key":"7846_CR13","year":"2021","issue":null,"author":"JW Busse","volume":null,"first-page":null,"unstructured":"Busse JW, Vankrunkelsven P, Zeng L, Heen AF, Merglen A, Campbell F et al (2021) Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline. BMJ. https://doi.org/10.1136/bmj.n2040","article-title":null,"journal-title":"BMJ","doi-asserted-by":"publisher"},{"DOI":"10.1155/2013/918216","key":"7846_CR14","year":"2013","issue":"3","author":"M Fitzcharles","volume":"18","first-page":"119","unstructured":"Fitzcharles M, Ste-Marie PA, Goldenberg DL, Pereira JX, Abbey S, Choinière M et al (2013) 2012 Canadian guidelines for the diagnosis and management of fibromyalgia syndrome: executive summary. Pain Res Manag 18(3):119–126. https://doi.org/10.1155/2013/918216","article-title":null,"journal-title":"Pain Res Manag","doi-asserted-by":"publisher"},{"DOI":"10.3390/biomedicines11061621","key":"7846_CR15","year":"2023","issue":"6","author":"NH Strand","volume":"11","first-page":"1621","unstructured":"Strand NH, Maloney J, Kraus M, Wie C, Turkiewicz M, Gomez DA et al (2023) Cannabis for the treatment of fibromyalgia: a systematic review. Biomedicines 11(6):1621. https://doi.org/10.3390/biomedicines11061621","article-title":null,"journal-title":"Biomedicines","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.rcsop.2024.100524","key":"7846_CR16","year":"2024","issue":null,"author":"V Lopera","volume":"16","first-page":null,"unstructured":"Lopera V, Restrepo JC, Amariles P (2024) Effectiveness and safety of cannabis-based products for medical use in patients with fibromyalgia syndrome: a systematic review. Explor Res Clin Soc Pharm 16:100524. https://doi.org/10.1016/j.rcsop.2024.100524","article-title":null,"journal-title":"Explor Res Clin Soc Pharm","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jpain.2007.09.002","key":"7846_CR17","year":"2008","issue":"2","author":"RQ Skrabek","volume":"9","first-page":"164","unstructured":"Skrabek RQ, Galimova L, Ethans K, Perry D (2008) Nabilone for the treatment of pain in fibromyalgia. J Pain 9(2):164–173. https://doi.org/10.1016/j.jpain.2007.09.002","article-title":null,"journal-title":"J Pain","doi-asserted-by":"publisher"},{"DOI":"10.1093/pm/pnaa303","key":"7846_CR18","year":"2020","issue":"10","author":"C Chaves","volume":"21","first-page":"2212","unstructured":"Chaves C, Bittencourt PCT, Pelegrini A (2020) Ingestion of a THC-rich cannabis oil in people with fibromyalgia: a randomized, double-blind, placebo-controlled clinical trial. Pain Med 21(10):2212–2218. https://doi.org/10.1093/pm/pnaa303","article-title":null,"journal-title":"Pain Med","doi-asserted-by":"publisher"},{"DOI":"10.1213/ANE.0b013e3181c76f70","key":"7846_CR19","year":"2010","issue":"2","author":"MA Ware","volume":"110","first-page":"604","unstructured":"Ware MA, Fitzcharles M, Joseph L, Shir Y (2010) The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesth Analg 110(2):604–610. https://doi.org/10.1213/ANE.0b013e3181c76f70","article-title":null,"journal-title":"Anesth Analg","doi-asserted-by":"publisher"},{"DOI":"10.1097/j.pain.0000000000001464","key":"7846_CR20","year":"2019","issue":"4","author":"T van de Donk","volume":"160","first-page":"860","unstructured":"van de Donk T, Niesters M, Kowal MA, Olofsen E, Dahan A, van Velzen M (2019) An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. Pain 160(4):860–869. https://doi.org/10.1097/j.pain.0000000000001464","article-title":null,"journal-title":"Pain","doi-asserted-by":"publisher"},{"DOI":"10.1080/14737175.2023.2181696","key":"7846_CR21","year":"2023","issue":"3","author":"L Bapir","volume":"23","first-page":"281","unstructured":"Bapir L, Erridge S, Nicholas M, Pillai M, Dalavaye N, Holvey C et al (2023) Comparing the effects of medical cannabis for chronic pain patients with and without co-morbid anxiety: a cohort study. Expert Rev Neurother 23(3):281–295. https://doi.org/10.1080/14737175.2023.2181696","article-title":null,"journal-title":"Expert Rev Neurother","doi-asserted-by":"publisher"},{"DOI":"10.1002/brb3.3072","key":"7846_CR22","year":"2023","issue":null,"author":"C Wang","volume":null,"first-page":null,"unstructured":"Wang C, Erridge S, Holvey C, Coomber R, Usmani A, Sajad M et al (2023) Assessment of clinical outcomes in patients with fibromyalgia: analysis from the UK Medical Cannabis Registry. Brain Behav. https://doi.org/10.1002/brb3.3072","article-title":null,"journal-title":"Brain Behav","doi-asserted-by":"publisher"},{"DOI":"10.1080/15360288.2024.2414073","key":"7846_CR23","year":"2025","issue":"1","author":"S Sridharan","volume":"39","first-page":"24","unstructured":"Sridharan S, Erridge S, Holvey C, Coomber R, Holden W, Rucker JJ et al (2025) Comparison of cannabis-based medicinal product formulations for fibromyalgia: a cohort study. Journal of Pain & Palliative Care Pharmacotherapy 39(1):24–37. https://doi.org/10.1080/15360288.2024.2414073","article-title":null,"journal-title":"Journal of Pain & Palliative Care Pharmacotherapy","doi-asserted-by":"publisher"},{"DOI":"10.1016/S0140-6736(07)61602-X","key":"7846_CR24","year":"2007","issue":"9596","author":"E von Elm","volume":"370","first-page":"1453","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596):1453–1457. https://doi.org/10.1016/S0140-6736(07)61602-X","article-title":null,"journal-title":"Lancet","doi-asserted-by":"publisher"},{"DOI":null,"key":"7846_CR25","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Medicines & Healthcare products Regulatory Agency. The supply, manufacture, importation and distribution of unlicensed cannabis-based products for medicinal use in humans ‘specials’. https://assets.publishing.service.gov.uk/media/5e58eefb86650c53a363f77c/Cannabis_Guidance__unlicensed_CBPMs__updated_2020.pdf. Accessed 10 Apr 2024","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1159/000521288","key":"7846_CR26","year":"2022","issue":"1","author":"ME Charlson","volume":"91","first-page":"8","unstructured":"Charlson ME, Carrozzino D, Guidi J, Patierno C (2022) Charlson comorbidity index: a critical review of clinimetric properties. Psychother Psychosom 91(1):8–35","article-title":null,"journal-title":"Psychother Psychosom","doi-asserted-by":"publisher"},{"DOI":"10.1046/j.1360-0443.2001.9611165311.x","key":"7846_CR27","year":"2001","issue":"11","author":"CM Bernaards","volume":"96","first-page":"1653","unstructured":"Bernaards CM, Twisk JWR, Snel J, Van Mechelen W, Kemper HCG (2001) Is calculating pack‐years retrospectively a valid method to estimate life‐time tobacco smoking? A comparison between prospectively calculated pack‐years and retrospectively calculated pack‐years. Addiction 96(11):1653–1661. https://doi.org/10.1046/j.1360-0443.2001.9611165311.x","article-title":null,"journal-title":"Addiction","doi-asserted-by":"publisher"},{"DOI":"10.1002/npr2.12183","key":"7846_CR28","year":"2021","issue":"3","author":"S Erridge","volume":"41","first-page":"362","unstructured":"Erridge S, Salazar O, Kawka M, Holvey C, Coomber R, Usmani A et al (2021) An initial analysis of the UK Medical Cannabis Registry: outcomes analysis of first 129 patients. Neuropsychopharmacol Rep 41(3):362–370. https://doi.org/10.1002/npr2.12183","article-title":null,"journal-title":"Neuropsychopharmacol Rep","doi-asserted-by":"publisher"},{"DOI":null,"key":"7846_CR29","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Common terminology criteria for adverse events (CTCAE). https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/CTCAE_4.03_2010-06-14_QuickReference_8.5x11.pdf","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.3899/jrheum.100594","key":"7846_CR30","year":"2011","issue":"6","author":"F Wolfe","volume":"38","first-page":"1113","unstructured":"Wolfe F, Clauw DJ, Fitzcharles M, Goldenberg DL, Häuser W, Katz RS et al (2011) Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR preliminary diagnostic criteria for fibromyalgia. J Rheumatol 38(6):1113–1122. https://doi.org/10.3899/jrheum.100594","article-title":null,"journal-title":"J Rheumatol","doi-asserted-by":"publisher"},{"DOI":"10.3389/fpsyt.2023.999242","key":"7846_CR31","year":"2023","issue":null,"author":"C Merino-Soto","volume":null,"first-page":null,"unstructured":"Merino-Soto C, Angulo-Ramos M, Rovira-Millán LV, Rosario-Hernández E (2023) Psychometric properties of the generalized anxiety disorder-7 (GAD-7) in a sample of workers. Front Psychiatry. https://doi.org/10.3389/fpsyt.2023.999242","article-title":null,"journal-title":"Front Psychiatry","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jpain.2007.09.005","key":"7846_CR32","year":"2008","issue":"2","author":"RH Dworkin","volume":"9","first-page":"105","unstructured":"Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT et al (2008) Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 9(2):105–121. https://doi.org/10.1016/j.jpain.2007.09.005","article-title":null,"journal-title":"J Pain","doi-asserted-by":"publisher"},{"DOI":"10.5664/jcsm.7478","key":"7846_CR33","year":"2018","issue":"11","author":"E Snyder","volume":"14","first-page":"1849","unstructured":"Snyder E, Cai B, DeMuro C, Morrison MF, Ball W (2018) A new single-item sleep quality scale: results of psychometric evaluation in patients with chronic primary insomnia and depression. J Clin Sleep Med 14(11):1849–1857. https://doi.org/10.5664/jcsm.7478","article-title":null,"journal-title":"J Clin Sleep Med","doi-asserted-by":"publisher"},{"DOI":"10.1080/14737175.2025.2490539","key":"7846_CR34","year":"2025","issue":null,"author":"A Datta","volume":null,"first-page":null,"unstructured":"Datta A, Erridge S, Warner-Levy J, Clarke E, McLachlan K, Coomber R et al (2025) UK medical cannabis registry: an updated clinical outcomes analysis of patients with post-traumatic stress disorder. Expert Rev Neurother. https://doi.org/10.1080/14737175.2025.2490539","article-title":null,"journal-title":"Expert Rev Neurother","doi-asserted-by":"publisher"},{"DOI":"10.5041/RMMJ.10129","key":"7846_CR35","year":"2013","issue":"4","author":"PG Fine","volume":"4","first-page":null,"unstructured":"Fine PG, Rosenfeld MJ (2013) The endocannabinoid system, cannabinoids, and pain. Rambam Maimonides Med J 4(4):10.5041/RMMJ.10129","article-title":null,"journal-title":"Rambam Maimonides Med J","doi-asserted-by":"publisher"},{"DOI":"10.1111/ajad.13456","key":"7846_CR36","year":"2023","issue":"6","author":"Y Zhang-James","volume":"32","first-page":"532","unstructured":"Zhang-James Y, Wyon E, Grapsas D, Johnson B (2023) Daily cannabis use may cause cannabis-induced hyperalgesia. Am J Addict 32(6):532–538. https://doi.org/10.1111/ajad.13456","article-title":null,"journal-title":"Am J Addict","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.pmn.2020.07.003","key":"7846_CR37","year":"2020","issue":"6","author":"AR Pfalzgraf","volume":"21","first-page":"516","unstructured":"Pfalzgraf AR, Lobo CP, Giannetti V, Jones KD (2020) Use of complementary and alternative medicine in fibromyalgia: results of an online survey. Pain Manag Nurs 21(6):516–522. https://doi.org/10.1016/j.pmn.2020.07.003","article-title":null,"journal-title":"Pain Manag Nurs","doi-asserted-by":"publisher"},{"DOI":"10.1038/s41386-022-01322-4","key":"7846_CR38","year":"2022","issue":"7","author":"S Nielsen","volume":"47","first-page":"1315","unstructured":"Nielsen S, Picco L, Murnion B, Winters B, Matheson J, Graham M et al (2022) Opioid-sparing effect of cannabinoids for analgesia: an updated systematic review and meta-analysis of preclinical and clinical studies. Neuropsychopharmacology 47(7):1315–1330. https://doi.org/10.1038/s41386-022-01322-4","article-title":null,"journal-title":"Neuropsychopharmacology","doi-asserted-by":"publisher"},{"DOI":"10.3390/jcm8060807","key":"7846_CR39","year":"2019","issue":"6","author":"I Sagy","volume":"8","first-page":null,"unstructured":"Sagy I, Bar-Lev Schleider L, Abu-Shakra M, Novack V (2019) Safety and efficacy of medical cannabis in fibromyalgia. J Clin Med 8(6):807. https://doi.org/10.3390/jcm8060807","article-title":null,"journal-title":"J Clin Med","doi-asserted-by":"publisher"},{"DOI":"10.1097/AJP.0b013e318208c8e4","key":"7846_CR40","year":"2011","issue":"5","author":"EM O’Brien","volume":"27","first-page":"425","unstructured":"O’Brien EM, Waxenberg LB, Atchison JW, Gremillion HA, Staud RM, McCrae CS et al (2011) Intraindividual variability in daily sleep and pain ratings among chronic pain patients. Clin J Pain 27(5):425–433. https://doi.org/10.1097/AJP.0b013e318208c8e4","article-title":null,"journal-title":"Clin J Pain","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jbmt.2009.08.003","key":"7846_CR41","year":"2010","issue":"1","author":"GL Liptan","volume":"14","first-page":"3","unstructured":"Liptan GL (2010) Fascia: a missing link in our understanding of the pathology of fibromyalgia. J Bodyw Mov Ther 14(1):3–12. https://doi.org/10.1016/j.jbmt.2009.08.003","article-title":null,"journal-title":"J Bodyw Mov Ther","doi-asserted-by":"publisher"},{"DOI":null,"key":"7846_CR42","year":"2001","issue":"8","author":"R Pöyhiä","volume":"28","first-page":"1888","unstructured":"Pöyhiä R, Da Costa D, Fitzcharles MA (2001) Previous pain experience in women with fibromyalgia and inflammatory arthritis and nonpainful controls. J Rheumatol 28(8):1888–1891","article-title":null,"journal-title":"J Rheumatol","doi-asserted-by":null},{"DOI":"10.1111/j.1468-1331.2011.03528.x","key":"7846_CR43","year":"2012","issue":"5","author":"DD Mitsikostas","volume":"19","first-page":"672","unstructured":"Mitsikostas DD, Chalarakis NG, Mantonakis LI, Delicha E‐, Sfikakis PP (2012) Nocebo in fibromyalgia: meta‐analysis of placebo‐controlled clinical trials and implications for practice. Eur J Neurol 19(5):672–680. https://doi.org/10.1111/j.1468-1331.2011.03528.x","article-title":null,"journal-title":"Eur J Neurol","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.eclinm.2019.10.001","key":"7846_CR44","year":"2019","issue":null,"author":"S Watson","volume":"17","first-page":null,"unstructured":"Watson S, Caster O, Rochon PA, den Ruijter H (2019) Reported adverse drug reactions in women and men: aggregated evidence from globally collected individual case reports during half a century. EClinMed 17:100188. https://doi.org/10.1016/j.eclinm.2019.10.001","article-title":null,"journal-title":"EClinMed","doi-asserted-by":"publisher"},{"DOI":"10.1001/jamanetworkopen.2022.43848","key":"7846_CR45","year":"2022","issue":"11","author":"F Gedin","volume":"5","first-page":null,"unstructured":"Gedin F, Blomé S, Pontén M, Lalouni M, Fust J, Raquette A et al (2022) Placebo response and media attention in randomized clinical trials assessing cannabis-based therapies for pain. JAMA Netw Open 5(11):e2243848. https://doi.org/10.1001/jamanetworkopen.2022.43848","article-title":null,"journal-title":"JAMA Netw Open","doi-asserted-by":"publisher"}],"short-title":[],"update-policy":"https://doi.org/10.1007/springer_crossmark_policy","alternative-id":["7846"],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"original-title":[],"container-title":["Clinical Rheumatology"],"reference-count":45,"published-online":{"date-time":null,"timestamp":null,"date-parts":[[2025,12,4]]},"references-count":45,"short-container-title":["Clin Rheumatol"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1007/s10067-025-07846-6","is_oa":true,"title":"UK Medical Cannabis Registry: a case series analysing clinical outcomes of medicinal cannabis therapy for fibromyalgia","updated":"2025-12-11T01:31:13+00:00","published_date":"2025-12-04","best_oa_location":{"url":"https://link.springer.com/content/pdf/10.1007/s10067-025-07846-6.pdf","pmh_id":null,"url_for_pdf":"https://link.springer.com/content/pdf/10.1007/s10067-025-07846-6.pdf","url_for_landing_page":"https://doi.org/10.1007/s10067-025-07846-6"}}},"created_at":"2026-01-08T08:12:02.165Z","updated_at":"2026-01-09T17:12:27.221Z","tags":[{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"condition","value":"Fibromyalgia","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"generic","value":"cannabidiol","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"generic","value":"delta-9-tetrahydrocannabinol","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"modality","value":"Cannabinoid","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"sample_size","value":"n=497","value_numeric":497},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"study_design","value":"Case Series","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"warning","value":"AE reporting mixes patient‑level and event‑level percentages; multiple events per patient occurred.","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"warning","value":"Design is an uncontrolled case series; causality cannot be inferred.","value_numeric":null},{"paper_doi":"10.1007/s10067-025-07846-6","tag_type":"warning","value":"Formulations, doses, and routes varied over time (oils and inhaled flower), limiting comparability.","value_numeric":null}],"summaries":{"what_studied":"A prospective registry case series evaluated changes in patient‑reported outcomes and adverse events in adults with fibromyalgia treated with cannabis‑based medicinal products, with follow‑up at 1, 3, 6, 12, and 18 months.","key_result":"All PROMs improved from baseline across 1–18 months (e.g., Fibromyalgia Symptom Severity −1.16 at 1 month and −0.72 at 18 months; EQ‑5D‑5L index +0.15 at 1 month; all p<0.001). Adverse events were reported by 227/497 (45.67%) patients (2100 events; 85.33% mild–moderate), fatigue was most common (153, 30.78%); higher CBD dose (>25 mg/day) increased odds of improvement (SS OR 1.64 [1.04–2.61]; WPI OR 1.90 [1.19–3.03]) and current cannabis use did too (SS OR 2.32 [1.22–4.43]).","limitations":"Uncontrolled registry case series with subjective PROMs and baseline‑carried‑forward imputation; causality and placebo effects cannot be excluded. Selection bias is likely (68.61% prior cannabis use; private clinic cohort), limiting generalisability. AEs were not confirmed as treatment‑related and MCIDs for SS/WPI were not established.","practice_takeaway":"In this registry, CBMPs were associated with modest improvements in pain, anxiety, sleep, and quality of life up to 18 months, while nearly half reported AEs that were mostly mild–moderate. If considering CBMPs, monitor for fatigue and other AEs, and note that higher CBD doses (>25 mg/day) and prior cannabis use correlated with greater reported benefit in this cohort."}}],"initialOffset":11,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Fibromyalgia"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Fibromyalgia"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Fibromyalgia"}}}]]

Papers