Identifying placebo responders and predictors of response in osteoarthritis: a protocol for individual patient data meta-analysis

  • Yu Fu, Monica S. M. Persson, Archan Bhattacharya, Siew-Li Goh, Joanne Stocks, Marienke van Middelkoop, Sita M. A. Bierma-Zeinstra, David Walsh, Michael Doherty, Weiya Zhang
  • Systematic Reviews, October 2016, Springer Science + Business Media
  • DOI: 10.1186/s13643-016-0362-x

Identifying characteristics of people who respond to placebo treatments for osteoarthritis

What is it about?

In many studies of osteoarthritis (OA) treatment, there is an improvement in pain relief when a dummy ‘placebo’ treatment is compared to no treatment at all, but there is very little extra improvement when the real treatment is compared to placebo. This response to placebo varies greatly from patient to patient. This study aims to identify which patients best respond to placebo in treating OA related pain and to identify potential factors that can affect the placebo response.

Why is it important?

Currently, there is no cure for osteoarthritis (OA). The treatments that are available, aim to reduce pain levels, but are often unsuccessful and also have undesirable side effects. In clinical trials that test pain relief medication, we use a dummy treatment called a placebo, which often looks like the real tablet or gel but doesn’t contain any drug. Half the people in the study will get the drug treatment and half will get the placebo but everything else, including how often they are seen by the researchers, what information they are given or what measurements are taken, is exactly the same. In trials of OA treatments, around 75% of the pain relief benefit can be put down to a placebo response rather than the specific effect of the medication. This response varies greatly from patient to patient. By analysing individual patient data from trials of osteoarthritis treatments, we will compare the characteristics of those people who responded to the placebo treatment compared to those who did not. We hope to be able to identify a subgroup of people with osteoarthritis who are most likely to respond to placebo and to be able to identify factors that will predict a response.

Perspectives

Dr Joanne Stocks
University of Nottingham

Identifying factors that will predict a response to placebo treatments will be useful for future studies as it will allow us to separate participants into groups based on their likely response. It will also be useful for pharmaceutical companies who can improve the design of their studies in order to separate the ‘specific’ effect of their drug or treatment from the ‘non-specific’ placebo effect.

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http://dx.doi.org/10.1186/s13643-016-0362-x

The following have contributed to this page: Dr Joanne Stocks