Branco 2010.

Study characteristics
Methods	Design: parallel Duration: 17 weeks Assessment: baseline and post‐intervention Country: Czech Republic, Denmark, Finland, France, Germany, Italy, Norway, Poland, Portugal, Romania, Spain, Sweden, UK
Participants	Pain condition: fibromyalgia Population: adults with fibromyalgia Minimum pain intensity: baseline VAS pain intensity rating between 40 and 90 (0‐100 scale) Inclusion criteria Aged 18‐70 Diagnosed with fibromyalgia as per the ACR criteria Raw score ≥ 3 on physical function component of the FIQ Baseline VAS pain intensity rating between 40 and 90 (0‐100 scale) Exclusion criteria Severe mental health conditions Comorbid physical health conditions Total participants randomised: 884 Age in years (mean): 48.4 Gender: 826 were female Pain duration in years (mean): 9.5
Interventions	Placebo n = 449 Matched dosing and identical appearance Inert Milnacipran 200 mg n = 435 SNRI Forced titration to fixed dose
Outcomes	Pain intensity Quality of life Physical function Mood PGIC AEs SAEs Withdrawal
Missing data methods	ITT with LOCF, and BOCF sensitivity analyses
Funding source	Pharmaceutical ‐ Pierre Fabre Medicament, France
Conflicts of interest	Dr Branco has received grant support as an investigator and consultant for Pierre Fabre Medicament. Drs Zachrisson and Perrot have served as speakers and consultants for Pierre Fabre Medicament. Dr Mainguy is an employee and shareholder of Pierre Fabre Medicament. Medical writing assistance provided by Prescott Medical Communications Group was supported by Pierre Fabre Medicament.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Randomisation methods not specified
Allocation concealment (selection bias)	Unclear risk	Allocation procedure not specified
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Matched dosing but no information regarding appearance of drugs
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Self‐reported outcomes from participants, but unsure of blinding procedures
Incomplete outcome data (attrition bias) All outcomes	High risk	ITT with LOCF and BOCF as sensitivity analysis. More dropouts in antidepressant arm related to side‐effects Attrition Total: 206/882 (23.3%) Placebo: 79/449 (17.6%) Milnacipran 200 mg: 127/435 (29.2%)
Selective reporting (reporting bias)	Unclear risk	Primary outcome matches trial registry, but secondary outcomes not listed
Other bias	Low risk	No other sources of bias were identified.