Fibromyalgia patients have heightened risk of death from all causes

Fibromyalgia, a condition that causes persistent widespread pain and fatigue, may be linked to a heightened risk of death as a result of vulnerability to accidents, infections, and especially suicide, according to new research.

The pooled data analysis, published in RMD Open, showed that fibromyalgia was associated with a 27% heightened risk of death from all causes over time.

The researchers reviewed the findings of eight relevant studies, published between 1999 and 2020, out of an initial haul of 33. They pooled the results from six of them, involving a total of 188,751 adults, all of whom had other coexisting conditions.

Specifically, the analysis showed that the risk of death from cancer was 12% lower than it was for the general population of the same age, and only marginally higher (5%) for accidents. But it was 44% higher for infections, including pneumonia and septicaemia, and more than three times as high for suicide.

These findings prompted the researchers to call for regular monitoring of patients’ physical and mental health to minimise these risks.

Fibromyalgia patients should be taken seriously

The diagnostic criteria for fibromyalgia have evolved since 1990 in tandem with increasing understanding of the array of clinical symptoms associated with the condition.

The researchers said: “Due to significant heterogeneity across the studies, which were also small in number, no clear conclusions can be drawn from the available data. However, it is possible that for the subgroup of patients diagnosed by the 1990 criteria there is no increased risk for mortality, and for those diagnosed by later versions the risk is increased.

“The finding of increased mortality associated with accidents can stem from fatigue, unrefreshing sleep, and the concentration difficulties that accompany fibromyalgia, and are a component of its diagnostic criteria since 2010.”

Whether this heightened risk is due to the fibromyalgia itself or the concomitant conditions isn’t clear, note the researchers, as their research wasn’t designed to evaluate this. But this is an important issue, they emphasise, which further research needs to address.

They concluded: “Fibromyalgia is often called an ‘imaginary condition,’ with ongoing debates on the legitimacy and clinical usefulness of this diagnosis. Our review provides further proof that fibromyalgia patients should be taken seriously, with particular focus on screening for suicidal ideation, prevention of accidents, and prevention and treatment of infections.”