{"id":17902,"date":"2025-09-03T08:00:00","date_gmt":"2025-09-03T12:00:00","guid":{"rendered":"https:\/\/fibrocanada.ca\/?p=17902"},"modified":"2026-01-16T10:56:57","modified_gmt":"2026-01-16T15:56:57","slug":"fibromyalgiacadencetrial","status":"publish","type":"post","link":"https:\/\/fibrocanada.ca\/fr\/fibromyalgiacadencetrial","title":{"rendered":"D\u00e9veloppement d'une combinaison d'analg\u00e9siques pour une efficacit\u00e9 clinique am\u00e9lior\u00e9e (essai CADENCE) : un essai contr\u00f4l\u00e9 en double aveugle d'une combinaison d'acide alpha-lipo\u00efque et de pr\u00e9gabaline pour la douleur li\u00e9e \u00e0 la fibromyalgie."},"content":{"rendered":"<p><\/p>\n\n\n\n<p>Fibromyalgia pain may respond to different drugs. However only 40 - 60 % of people with fibromyalgia notice the drugs decrease their pain. Those who do see a decrease, experience a reduction of 25-40%. These results are partly due to the beneficial effects of the drug and its side-effects on the person taking the drugs. The individual\u2019s tolerance will determine their ideal dose.<\/p>\n\n\n\n<p>Combining two drugs that work differently may result in better pain control and at lower doses than when either of the drugs are used alone. The authors predict that combining one pain-relieving drug (pregabalin) that has central nervous system side effects (for example, drowsiness, dizziness,) with a drug that does not have the same side effects (alpha-lipoic acid) could result in better pain relief and less side effects.<\/p>\n\n\n\n<p><strong><u>Titre de l'article<\/u><\/strong><\/p>\n\n\n\n<p>D\u00e9veloppement d'une combinaison d'analg\u00e9siques pour une efficacit\u00e9 clinique am\u00e9lior\u00e9e (essai CADENCE) : un essai contr\u00f4l\u00e9 en double aveugle d'une combinaison d'acide alpha-lipo\u00efque et de pr\u00e9gabaline pour la douleur li\u00e9e \u00e0 la fibromyalgie.<\/p>\n\n\n\n<p><strong><u>Date de publication<\/u>&nbsp; <\/strong>2023<\/p>\n\n\n\n<p><strong><u>Journal Citation<\/u><\/strong><\/p>\n\n\n\n<p>Gilron I et al. Combination analgesic development for enhanced clinical efficacy (the CADENCE trial): a double-blind, controlled trial of an alpha-lipoic acid-pregabalin combination for fibromyalgia pain. PAIN 2023;164(6):1783-1792. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36877492\/\" target=\"_blank\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/36877492\/<\/a><\/p>\n\n\n\n<p><strong><u>Contexte<\/u><\/strong><\/p>\n\n\n\n<p>Fibromyalgia pain may respond to different drugs. However only 40 - 60 % of people with fibromyalgia notice the drugs decrease their pain. Those who do see a decrease, experience a reduction of 25-40%. These results are partly due to the beneficial effects of the drug and its side-effects on the person taking the drugs. The individual\u2019s tolerance will determine their ideal dose.&nbsp;<\/p>\n\n\n\n<p>Combining two drugs that work differently may result in better pain control and at lower doses than when either of the drugs are used alone. The authors predict that combining one pain-relieving drug (pregabalin) that has central nervous system side effects (for example, drowsiness, dizziness,) with a drug that does not have the same side effects (alpha-lipoic acid) could result in better pain relief and less side effects.<\/p>\n\n\n\n<p><strong><u>Qui a particip\u00e9 \u00e0 l'\u00e9tude ?<\/u><\/strong><\/p>\n\n\n\n<p>Canadian adults who met the 2016 diagnostic criteria for fibromyalgia and were in moderate pain (scoring 4 or above on a numeric pain scale) on a daily basis were recruited. Participants were able to continue drug and non-drug management strategies that were already routine to them.<\/p>\n\n\n\n<p><strong><u>Comment l'\u00e9tude a-t-elle \u00e9t\u00e9 men\u00e9e ?<\/u><\/strong><\/p>\n\n\n\n<p>There were 41 patients (4 male, 37 female) randomly put into 3 groups during the trial, with 24 patients completing all three treatment options.<\/p>\n\n\n\n<p>Each participant who completed the trial took pregabalin alone, alpha-lipoic acid (ALA) alone or pregabalin with ALA. Each treatment period was 6 weeks long including slow increases to maximum tolerated doses and then a dose taper followed by a no study drug period in between each treatment. Participants then returned to try a different treatment option until they had tried all three options.&nbsp; Neither the patients nor the research personnel knew what treatment the patient was taking.&nbsp;<\/p>\n\n\n\n<p><strong><u>R\u00e9sultats<\/u><\/strong><\/p>\n\n\n\n<p>There also were no significant differences between the 3 groups for the improvement in pain.<\/p>\n\n\n\n<p>The mental health component score was significantly better for pregabalin alone or in combination, compared with ALA alone. Scores were significantly different indicating less sleep disturbance and improved mood for pregabalin alone or in combination, compared to ALA alone.<\/p>\n\n\n\n<p>Each individual took similar doses of pregabalin and ALA whether they were used alone or whether they were used in combination. However individual dosing may have been different from participant to participant.<\/p>\n\n\n\n<p>At least 5% of participants reported side effects when increasing the dose, but these were not common at the highest tolerated doses or when reducing or stopping the medication<\/p>\n\n\n\n<p>Side effects such as drowsiness and cognitive dysfunction were more frequent with pregabalin compared to ALA. Abnormal gait ( a different walking pattern than their normal) was more frequent with pregabalin plus ALA, compared to ALA alone.<\/p>\n\n\n\n<p><strong><u>Limites de l'\u00e9tude<\/u><\/strong><\/p>\n\n\n\n<p>The COVID pandemic created difficulties in recruitment of patients and only 41 of the 54 planned patients started the study. The brief treatment durations used in the trial may have impacted the results.<\/p>\n\n\n\n<p><strong><u>Conclusions<\/u><\/strong><\/p>\n\n\n\n<p>The results do not support any benefits of combining pregabalin with ALA for the treatment of fibromyalgia pain. The results should be interpreted with caution because of the small number of participants.<\/p>\n\n\n\n<p>The ability to reach similar doses of pregabalin and ALA without increased side effects supports future study of potentially more helpful drug combinations that have different side effect profiles.<\/p>\n\n\n\n<p><strong>Article summarized by FAC Research Committee <em>&nbsp;2025<\/em><\/strong><\/p>\n\n\n\n<p><strong>For more information consult the original article<\/strong><\/p>\n\n\n\n<p>Pain.&nbsp;2023 Aug 1;164(8):1783-1792.&nbsp;doi: 10.1097\/j.pain.0000000000002875.&nbsp;Epub 2023 Mar 6. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36877492\/\" target=\"_blank\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/36877492\/<\/a><\/p>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>La douleur li\u00e9e \u00e0 la fibromyalgie peut \u00eatre soulag\u00e9e par diff\u00e9rents m\u00e9dicaments. Cependant, seulement 40 \u00e0 60 % des personnes atteintes de fibromyalgie constatent une diminution de leur douleur gr\u00e2ce aux m\u00e9dicaments. Celles qui constatent une diminution constatent une r\u00e9duction\u2026<\/p>","protected":false},"author":967,"featured_media":17897,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","footnotes":""},"categories":[71,287],"tags":[73,285,84],"class_list":["post-17902","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-research-highlights","category-sociable","tag-fibromyalgia","tag-lay-summary","tag-medications","pmpro-has-access"],"acf":[],"_links":{"self":[{"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/posts\/17902","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/users\/967"}],"replies":[{"embeddable":true,"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/comments?post=17902"}],"version-history":[{"count":0,"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/posts\/17902\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/media\/17897"}],"wp:attachment":[{"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/media?parent=17902"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/categories?post=17902"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/fibrocanada.ca\/fr\/wp-json\/wp\/v2\/tags?post=17902"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}