BACKGROUND AND OBJECTIVE: This systematic review aimed at evaluating the efficacy, acceptability and safety of internet-based psychological therapies (IPTs) in fibromyalgia syndrome (FMS).

DATABASES AND DATA TREATMENT: Cochrane Library, MEDLINE, PsycINFO and SCOPUS were searched from inception to January 2018. Randomized controlled trials (RCTs) comparing IPTs with controls were analysed. Primary outcomes were >/= 50% pain relief, disability, negative mood, acceptability and safety at end of therapy and at six months follow up. Effects were summarized by a random effects model using risk differences (RD) or standardized mean differences (SMD) with 95% confidence intervals (CI). Six RCTs using different types of internet-based cognitive-behavioral therapies [ICBTs] (acceptance-based; exposure-based; traditional) with 493 patients were included. At the end of treatment, ICBTs were superior to controls (waiting list, attention control, treatment as usual) in reducing negative mood (SMD -0.51 [95% CI -0.87 to -0.15]) (moderate quality evidence) and disability (SMD -0.56 [95% CI -1.00 to -0.13]) (moderate quality evidence). There were no statistically significant differences between ICBTs and controls in pain relief of 50% or greater (RD 0.09 [95% CI -0.02 to 0.20] (moderate quality) and acceptability (moderate quality evidence). No data on safety and any outcomes at long-term follow up compared to controls were found. The data available did not allow statistical comparisons between unguided and guided ICBTs and of ICBTs vs. traditional face-to-face therapies.

CONCLUSIONS: ICBTs provided a clinically relevant benefit over control interventions in reducing negative mood and disability at the end of treatment. This article is protected by copyright. All rights reserved.