Wednesday, September 21, 2016

"Strong placebo response thwarts painkiller trials "

"An extensive analysis of trial data1 has found that responses to sham treatments have become stronger over time, making it harder to prove a drug’s advantage over placebo.
The change in reponse to placebo treatments for pain, discovered by researchers in Canada, holds true only for US clinical trials. "We were absolutely floored when we found out," says Jeffrey Mogil, who directs the pain-genetics lab at McGill University in Montreal and led the analysis. Simply being in a US trial and receiving sham treatment now seems to relieve pain almost as effectively as many promising new drugs. Mogil thinks that as US trials get longer, larger and more expensive, they may be enhancing participants’ expectations of their effectiveness...
"Our data suggest that the longer a trial is and the bigger a trial is, the bigger the placebo is going to be," he says...
Mogil's data also challenge one of the fundamental principles of placebo-controlled trials — that comparing a drug against placebo tells us how well a drug works."
This is fascinating, and I hope there is a lot more research here. It also possibly says something about the therapeutic impacts of environment and belief/hope. Like, if placebos work, let's think about how we can use them ethically. 

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