• Filippo Migliorini, Nicola Maffulli, Jörg Eschweiler, Marcel Betsch, Markus Tingart, and Giorgia Colarossi.
• Departement of Orthopedic Surgery, University Clinic Aachen, RWTH Aachen University Clinic, Pauwelsstraße 30, 52074 Aachen, Germany.
• Br. Med. Bull. 2021 Sep 10; 139 (1): 73-85.

IntroductionThe management of fibromyalgia involves a combination of pharmacological and non-pharmacological treatments.Source Of DataRecently published literature in PubMed, Google Scholar and Embase databases.Areas Of AgreementSeveral pharmacological and non-pharmacological strategies have been proposed for the management of fibromyalgia. However, the management of fibromyalgia remains controversial. The administration of placebo has proved to be more effective than no treatment in many clinical settings and evidence supports the 'therapeutic' effects of placebo on a wide range of symptoms.Areas Of ControversyThe placebo effect is believed to impact the clinical outcomes, but its actual magnitude is controversial.Growing PointsA meta-analysis comparing pharmacological management versus placebo administration for fibromyalgia was conducted.Areas Timely For Developing ResearchDrug treatment resulted to be more effective than placebo administration for the management of fibromyalgia. Nevertheless, placebo showed a beneficial effect in patients with fibromyalgia. Treatment-related adverse events occurred more frequently in the drug treatment.Level Of EvidenceI, Bayesian network meta-analysis of double-blind randomized clinical trials.© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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