End Fatigue

Pfizer's Lyrica Seems to Be Better Than Eli Lilly's Cymbalta for the Treatment of Fibromyalgia, Physicians Say

Published in Pharmawire.com
October 8, 2007
by Kimberly Ha in New York

Pfizer's Lyrica seems to be better than Eli Lilly's Cymbalta for the treatment of fibromyalgia (FMS), physicians said. Eli Lilly is currently awaiting FDA approval on the drug for the treatment of fibromyalgia - a chronic syndrome characterized by widespread pain and fatigue. Cymbalta is currently approved for major depressive disorder (MDD), generalized anxiety disorder (GAD), and pain related to diabetic peripheral neuropathy. Physicians said they believed that Pfizer's Lyrica seems to be a better drug than Cymbalta in the treatment of FMS, and added they were unsure whether Lilly's drug would be as efficacious.

“Lyrica is better than Eli Lilly's Cymbalta, as clinically we've used both,” said Dr Jacob Teitelbaum, internist and Director of the Annapolis Research Center for Effective CFS/Fibromyalgia Therapies.

Dr Bruce Solitar, a rheumatologist at NYU Medical Center, also agreed he was unsure if Cymbalta would be as effective as Lyrica. Although Lyrica reported side-effects of dizziness and somnolence in the high-20s, patients have reported that the side-effects lessen over time. Solitar added that Lyrica's side-effect profile may limit patient use.

"With Lyrica, patients who started with a low dose would get the side-effects but not the benefits of the drug. Patients also have reported weight gain of around USD 1.7kg on average with Lyrica. Although the weight gain is not huge, it is a problem," added Solitar.

"Lyrica is better than Cymbalta, and also helps with central sensitization," said Teitelbaum. "Cymbalta helps with serotonin issues, and both drugs work together in combination. None of the drugs are a cure for the illness, and each drug targets a different part of the disease," added Teitelbaum. Dr Elizabeth Lee Vliet, a women's health specialist who has conducted extensive research on fibromyalgia, added there is a market for Lyrica and Cymbalta but these drugs have profound side effects and patients may experience an increased risk of sexual dysfunction. Fibromyalgia has many medical, endocrine, metabolic, and environmental causes that are often overlooked in the field of rheumatology.

Lyrica may also be used in combination with dual reuptake inhibitors, such as Cypress Bioscience's milnaciprin, which is currently in Phase III trials. "Lyrica and milnacipran may also be used in combination, as a lot of patients have disturbed sleep," said Micheal Hufford, company spokesperson at Cypress Bioscience. "However, Cypress Bioscience's milnaciprain may also be a more activating agent compared to Lyrica, as the drug targets a variety of functional syndromes as well. Milnacipran could be in a better position because of positive endpoints across all indications," added Hufford.

"An over-the-counter drug developed by Bioenergy Life Science, called Bioenergy RIBOSE is also effective in treating fibromyalgia," added Teitelbaum. The compound is a bioactive ingredient that energizes functional foods. "Our study showed a 45% increase in energy in patients taking additional ribose," said Teitelbaum.

"Lyrica is at the head of the pack," said Teitelbaum. Another drug going for approval for chronic fatigue syndrome is Ampligen. Ampligen is being developed by listed Philadelphia-based Hemispherx Biopharma, but the company has missed several target deadlines. "Lilly's Cymbalta is a distant third after Lyrica and the ribose-supplement," he added.