Le magnésium contre la fibromyalgie

[Nutrimuscle-Conseils]

Short-Term Magnesium Therapy Alleviates Moderate Stress in Patients with Fibromyalgia: A Randomized Double-Blind Clinical Trial
by Nicolas Macian Nutrients 2022, 14(10), 2088;

Patients suffering from fibromyalgia often report stress and pain, with both often refractory to usual drug treatment. Magnesium supplementation seems to improve fibromyalgia symptoms, but the level of evidence is still poor. This study is a randomized, controlled, double-blind trial in fibromyalgia patients that compared once a day oral magnesium 100 mg (Chronomag®, magnesium chloride technology formula) to placebo, for 1 month. The primary endpoint was the level of stress on the DASS-42 scale, and secondary endpoints were pain, sleep, quality of life, fatigue, catastrophism, social vulnerability, and magnesium blood concentrations. After 1 month of treatment, the DASS-42 score decreased in the magnesium and placebo groups but not significantly (21.8 ± 9.6 vs. 21.6 ± 10.8, respectively, p = 0.930). Magnesium supplementation significantly reduced the mild/moderate stress subgroup (DASS-42 stress score: 22.1 ± 2.8 to 12.3 ± 7.0 in magnesium vs. 21.9 ± 11.9 to 22.9 ± 11.9 in placebo, p = 0.003). Pain severity diminished significantly (p = 0.029) with magnesium while the other parameters were not significantly different between both groups.

These findings show, for the first time, that magnesium improves mild/moderate stress and reduces the pain experience in fibromyalgia patients. This suggests that daily magnesium could be a useful treatment to improve the burden of disease of fibromyalgia patients and calls for a larger clinical trial.

[Nutrimuscle-Conseils]

Patterns of pharmacologic and non-pharmacologic treatment, treatment satisfaction and perceived tolerability in patients with fibromyalgia: a patients' survey
Fernando Rico-Villademoros Observational Study Clin Exp Rheumatol . Jan-Feb 2020;38 Suppl 123(1):72-78.

Objectives: To evaluate the patterns of treatment among patients with fibromyalgia (FM) in Spain and to assess patient satisfaction and perceived tolerability of the treatment received.

Methods: An observational, cross-sectional study was conducted in Spain via internet from September 2015 to March 2017. We recorded sociodemographic and clinical information, including treatment satisfaction evaluated using a 10-point numerical rating scale (NRS) and adverse events.

Results: Evaluable subjects (n=915) were predominantly middle-aged, married women who presented with moderate to severe pain, sleep disturbance and affected quality-of-life. The most frequent non-pharmacologic treatments were physical exercise (85%), diet (47%), supplements such as magnesium and vitamins (47%), and psychotherapy (31%). The most frequently prescribed drugs were tramadol (40%), benzodiazepines (30%), duloxetine (22%), pregabalin (19%), amitriptyline (17%) and nonsteroidal anti-inflammatory drugs (NSAIDs; 16%); 7.5% of patients received stronger opioids. After excluding benzodiazepines, NSAIDs, and paracetamol, 46% of patients received ≥2 drugs. Satisfaction with treatment (NRS mean score) was generally poor for pharmacologic treatment (4.1), exercise (4.7), psychotherapy (5.2), diet (5.0), physiotherapy (6.2) and acupuncture (6.3). The increase in the number of drugs prescribed was not associated with an increase in satisfaction, but rather with an increase in adverse events.

Conclusions: Patients with FM in Spain are overtreated with a combination of non-pharmacologic and pharmacologic therapies. Several of these therapies lack adequate support from randomised clinical trials and/or clinical practice guidelines. This overtreatment is not associated with relevant clinical benefits or patient satisfaction and, in the case of pharmacologic treatments, poses tolerability and safety issues.

[Nutrimuscle-Conseils]

Use of Complementary and Integrative Therapies by Fibromyalgia Patients: A 14-Year Follow-up Study
Arya B.Mohabbat Mayo Clinic Proceedings: Innovations, Quality & Outcomes Volume 3, Issue 4, December 2019, Pages 418-428

Objective
To reevaluate the frequency and pattern of complementary and integrative medicine (CIM) use in patients with fibromyalgia (FM).

Patients and Methods
Consecutive patients with FM who were referred to the Mayo Clinic fibromyalgia treatment program from January 5 through July 27, 2017, were invited to complete a survey about their use of CIM therapies in the preceding 6 months. The survey asked about 3 primary CIM domains: treatments and techniques, vitamins and minerals, and herbs and other dietary supplements. For direct comparative purposes, we reused the survey instrument from our prior analogous study of CIM use, performed in 2003.

Results
Of the 310 patients who completed the survey, 304 (98.1%) reported using some form of CIM, similar to the percentage reported in our 2003 study (98%). The most frequently used CIM therapies in the current cohort were spiritual healing (54.0% [163 of 302]), massage therapy (50.0% [152 of 304]), chiropractic treatments (39.3% [118 of 300]), aromatherapy (39.0% [117 of 300]), exercise for a specific medical problem (38.6% [117 of 303]), melatonin (37.9% [77 of 203]), magnesium (36.3% [107 of 295]), green tea (36.1% [73 of 202]), and fish oil (34.5% [68 of 197]). We noted numerous substantial differences from the 2003 data in terms of the pattern of CIM use.

Conclusion
The use of CIM therapies among patients with FM continues to be extremely common for adult patients of all ages. Given the continued high prevalence of CIM use, health care professionals must have awareness and knowledge of these various modalities and their potential incorporation into a multifaceted FM treatment regimen.

[Nutrimuscle-Diététique]

Traduction de l'étude

Utilisation de thérapies complémentaires et intégratives par les patients atteints de fibromyalgie : une étude de suivi de 14 ans
Actes de la clinique Arya B.Mohabbat Mayo : Innovations, qualité et résultats Volume 3, numéro 4, décembre 2019, pages 418-428

Objectif
Réévaluer la fréquence et le schéma d'utilisation de la médecine complémentaire et intégrative (CIM) chez les patients atteints de fibromyalgie (FM).

Patients et méthodes
Les patients consécutifs atteints de FM qui ont été référés au programme de traitement de la fibromyalgie de la Mayo Clinic du 5 janvier au 27 juillet 2017 ont été invités à répondre à une enquête sur leur utilisation des thérapies CIM au cours des 6 mois précédents. L'enquête a posé des questions sur 3 domaines principaux de CIM : les traitements et les techniques, les vitamines et les minéraux, et les herbes et autres compléments alimentaires. À des fins de comparaison directe, nous avons réutilisé l'instrument d'enquête de notre précédente étude analogue sur l'utilisation de la CIM, réalisée en 2003.

Résultats
Sur les 310 patients qui ont répondu à l'enquête, 304 (98,1 %) ont déclaré utiliser une forme de CIM, similaire au pourcentage rapporté dans notre étude de 2003 (98 %). Les thérapies CIM les plus fréquemment utilisées dans la cohorte actuelle étaient la guérison spirituelle (54,0 % [163 sur 302]), la massothérapie (50,0 % [152 sur 304]), les traitements chiropratiques (39,3 % [118 sur 300]), l'aromathérapie (39,0 % [117 sur 300]), exercice pour un problème médical spécifique (38,6 % [117 sur 303]), mélatonine (37,9 % [77 sur 203]), magnésium (36,3 % [107 sur 295]), thé vert (36,1 % [73 sur 202]) et huile de poisson (34,5 % [68 sur 197]). Nous avons noté de nombreuses différences substantielles par rapport aux données de 2003 en termes de modèle d'utilisation des CIM.

Conclusion
L'utilisation des thérapies CIM chez les patients atteints de fibromyalgie continue d'être extrêmement courante chez les patients adultes de tous âges. Compte tenu de la prévalence élevée et continue de l'utilisation de la CIM, les professionnels de la santé doivent être conscients et connaître ces diverses modalités et leur incorporation potentielle dans un régime de traitement FM à multiples facettes.

[Nutrimuscle-Conseils]

Magnesium sulphate activates the L-arginine/NO/cGMP pathway to induce peripheral antinociception in mice
Magn res Volume 35, numéro 1, January-February-March 2022 Loyara Rocha Miranda Teixeira

In the present study, we investigated whether magnesium sulphate activates the L-arginine/NO/cGMP pathway and elicits peripheral antinociception. The male Swiss mice paw pressure test was performed with hyperalgesia induced by intraplantar injection of prostaglandin E2. All drugs were administered locally into the right hind paw of animals. Magnesium sulphate (20, 40, 80 and 160 μg/paw) induced an antinociceptive effect.

The dose of 80 μg/paw elicited a local antinociceptive effect that was antagonized by the non-selective NOS inhibitor, L-NOArg, and by the selective neuronal NOS inhibitor, L-NPA. The inhibitors, L-NIO and L-NIL, selectively inhibited endothelial and inducible NOS, respectively, but were ineffective regarding peripheral magnesium sulphate injection. The soluble guanylyl cyclase inhibitor, ODQ, blocked the action of magnesium sulphate, and the cGMP-phosphodiesterase inhibitor, zaprinast, enhanced the antinociceptive effects of intermediate dose of magnesium sulphate.

Our results suggest that magnesium sulphate stimulates the NO/cGMP pathway via neuronal NO synthase to induce peripheral antinociceptive effects.

[Nutrimuscle-Diététique]

Traduction de l'étude

Le sulfate de magnésium active la voie L-arginine/NO/cGMP pour induire une antinociception périphérique chez la souris
Magn res Volume 35, numéro 1, janvier-février-mars 2022 Loyara Rocha Miranda Teixeira

Dans la présente étude, nous avons cherché à savoir si le sulfate de magnésium active la voie L-arginine/NO/cGMP et provoque une antinociception périphérique. Le test de pression des pattes de souris Swiss mâles a été réalisé avec une hyperalgésie induite par injection intraplantaire de prostaglandine E2. Tous les médicaments ont été administrés localement dans la patte arrière droite des animaux. Le sulfate de magnésium (20, 40, 80 et 160 μg/patte) induit un effet antinociceptif.

La dose de 80 μg/patte a induit un effet antinociceptif local qui a été antagonisé par l'inhibiteur non sélectif de NOS, L-NOArg, et par l'inhibiteur sélectif de NOS neuronal, L-NPA. Les inhibiteurs, L-NIO et L-NIL, inhibaient sélectivement la NOS endothéliale et inductible, respectivement, mais étaient inefficaces en ce qui concerne l'injection périphérique de sulfate de magnésium. L'inhibiteur soluble de la guanylyl cyclase, ODQ, a bloqué l'action du sulfate de magnésium, et l'inhibiteur de cGMP-phosphodiestérase, le zaprinast, a renforcé les effets antinociceptifs d'une dose intermédiaire de sulfate de magnésium.

Nos résultats suggèrent que le sulfate de magnésium stimule la voie NO/cGMP via la NO synthase neuronale pour induire des effets antinociceptifs périphériques.