Abstract
<title>Abstract</title> <p>BACKGROUND Fibromyalgia (FM) is a nociplastic pain condition. Clinical remission has rarely been studied despite observations of favorable trajectories in some patients. We aimed to identify factors associated with remission. METHODS In this retrospective matched case-control study (n = 72), 36 patients with remission and 36 matched controls (on age, sex, and follow-up duration) with persistent FM were included. Remission was defined as sustained patient-reported improvement for at least one year together with exit from the ACR diagnostic criteria. RESULTS Remission was associated with cessation of sedentary behavior, paracetamol and opioid de-escalation (OR 3.50, 95% CI 1.09–11.22), greater physical activity (OR 8.29, 95% CI 2.82–24.34), therapeutic education programs, physiotherapy and mind-body interventions. Baseline clinical characteristics, disease-onset context, comorbidities, and medication use were comparable between groups. INTERPRETATION These findings support an association between remission, behavioral activation, and selective pharmacological de-escalation. They justify prospective and qualitative evaluation of remission trajectories in fibromyalgia.</p>