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Effect of intramuscular depot betamethasone injection in patients with fibromyalgia and elevated C-reactive protein levels

Nageb Dirawi, George Habib
DOI: 10.1136/jim-2021-002293 Published 3 October 2022
Nageb Dirawi
1 Medicine, Laniado Hospital, Netanya, Israel
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George Habib
2 Rheumatology Clinic, Nazareth Hospital, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
3 Rheumatology Unit, Laniado Hospital, Netanya, Israel
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Abstract

Fibromyalgia is characterized by diffuse musculoskeletal pain and fatigue. There are limited data about systemic steroid treatment of patients with fibromyalgia in the English literature. Patients with fibromyalgia with ongoing diffuse musculoskeletal pain despite standard treatment, extreme fatigue and elevated C-reactive protein (CRP) levels without evidence of synovitis, or other source of inflammation, were asked to participate in our study. After consent, demographic, clinical and laboratory parameters in addition to body mass index were documented. These patients were interviewed and asked to answer the Revised Fibromyalgia Impact Questionnaire (FIQR) just prior, 1 and 4 weeks following 14 mg depot betamethasone intramuscular injection. Twenty-three patients were recruited and 21 completed the study. 19 patients were women with mean age of 42±10.12 and CRP level of 14.1±3.96 mg%, and all had negative rheumatoid factor and antinuclear antibodies. All patients had significant improvement in all of the FIQR parameters, at 1 and 4 weeks, except memory, anxiety and balance. It can be concluded that systemic intramuscular depot betamethasone injection seems to have a favorable effect in patients with fibromyalgia with elevated CRP levels for at least 4 weeks.

Footnotes

  • Contributors GH: conception of the study, design and planning of the study, acquisition of results, interpretation of results, drafting of the work and final approval of the version to be published. GH participated in writing of the final report and is accountable for all aspects of the work. ND: design and planning, acquisition of results, analysis of results, drafting of the work and final approval of the version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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Vol 70 Issue 7 Table of Contents
Journal of Investigative Medicine: 70 (7)
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Effect of intramuscular depot betamethasone injection in patients with fibromyalgia and elevated C-reactive protein levels
Nageb Dirawi, George Habib
Journal of Investigative Medicine Oct 2022, 70 (7) 1553-1556; DOI: 10.1136/jim-2021-002293

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Effect of intramuscular depot betamethasone injection in patients with fibromyalgia and elevated C-reactive protein levels
Nageb Dirawi, George Habib
Journal of Investigative Medicine Oct 2022, 70 (7) 1553-1556; DOI: 10.1136/jim-2021-002293
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Effect of intramuscular depot betamethasone injection in patients with fibromyalgia and elevated C-reactive protein levels
Nageb Dirawi, George Habib
Journal of Investigative Medicine Oct 2022, 70 (7) 1553-1556; DOI: 10.1136/jim-2021-002293
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