Effect of placebo groups on blood pressure in hypertension: a meta-analysis of beta-blocker trials

Wilhelm, Marcel; Winkler, Alexander W.; Rief, Winfried; Doering, Bettina K.

doi:10.1016/j.jash.2016.10.009

Cited by 26 publications

(31 citation statements)

References 81 publications

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“…Despite these limitations, we believe that this meta‐analysis can be a useful contribution to the understanding of the placebo response across a variety of medical conditions and to the development of better designs for future MG trials. In the present study, we show that placebo responses in MG are quite small when assessed through QMG scores, a quantitative finding that parallels other conditions, such as cancer, obsessive‐compulsive disorder, insomnia, and hypertension . These conditions differ from others such as pain, Parkinson's disease, depression, fibromyalgia, epilepsy, and dermatological conditions, thereby emphasizing the need to map placebo responses across diseases.…”

Section: Discussionsupporting

confidence: 53%

“…In the present study, we show that placebo responses in MG are quite small when assessed through QMG scores, a quantitative finding that parallels other conditions, such as cancer, 57,58 obsessive-compulsive disorder, 59,60 insomnia, 10 and hypertension. 11 These conditions differ from others such as pain, 3,[14][15][16][17][18][19][20][21]54 Parkinson's disease, 5,6,61-66 depression, 1,67 fibromyalgia, 4 epilepsy, 7 and dermatological conditions, 9 thereby emphasizing the need to map placebo responses across diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Since the beginning of randomized placebo‐controlled clinical trials (RCTs) in pharmacology, placebo responses have received great attention. More recently, placebo effects have been investigated in their own right and meta‐analyses on the magnitude of placebo effects have been conducted in several clinical conditions such as pain, fibromyalgia, psychiatric disorders, Parkinson's disease, epilepsy, gastrointestinal disorders, dermatological conditions, insomnia, and hypertension …”

mentioning

confidence: 99%

“…More recently, placebo effects have been investigated in their own right and meta-analyses on the magnitude of placebo effects have been conducted in several clinical conditions such as pain, 3 fibromyalgia, 4 psychiatric disorders, 1 Parkinson's disease, 5,6 epilepsy, 7 gastrointestinal disorders, 8 dermatological conditions, 9 insomnia, 10 and hypertension. 11 Placebo effects have been conceptualized as the effects of inert treatments administered within a psychosocial context; this context leads the patient to believe that a therapy is being performed and that an improvement should be expected. 12 Importantly, placebo effects are typically controlled for confounding factors such as the natural history of the diseases and regression to the mean by including a no treatment control condition, whereas placebo responses simply represent changes in the symptom following placebo treatment.…”

mentioning

confidence: 99%

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The placebo response in myasthenia gravis assessed by quantitative myasthenia gravis score: A meta‐analysis

Frisaldi

Shaibani²,

Vollert

et al. 2019

Muscle and Nerve

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Introduction This meta‐analysis investigates the placebo response in generalized myasthenia gravis (MG) trials by means of Quantitative Myasthenia Gravis (QMG) scores. Methods PubMed, Scopus, Web of Science, Cochrane Controlled Trial Register, and EMBASE were searched. QMG score, dropouts rate, adverse events (AEs), and AEs responsible for dropouts were examined, together with treatment moderators. Results The magnitude of placebo response showed an effect size of 0.24, which was significantly lower than 0.67 of the drug response (P = 0.019). Furthermore, the forest plot revealed that, overall, active treatments showed a significantly higher impact on QMG scores than placebos. Conclusions Placebo and drug responses in MG trials are small and moderate, respectively. The lack of MG trials with a pure placebo arm or a no‐treatment control arm made it impossible to disentangle improvements due to the placebo psychological effect from other effects such as natural history and/or regression to the mean. Muscle Nerve 59:671–678, 2019

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The placebo response in myasthenia gravis assessed by quantitative myasthenia gravis score: A meta‐analysis

Frisaldi

Shaibani²,

Vollert

et al. 2019

Muscle and Nerve

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“…Furthermore, among works that support homoeopathy efficacy, one review studied individualised homoeopathy for fibromyalgia (Baranowsky et al, ) and the other one both individualised and non‐individualised homoeopathy for IBS (Peckham et al, ), health conditions recognised to show significant response to placebo (Supporting Information Table ) (Bradford & Meston, ; Brunoni, Lopes, Kaptchuk, & Fregni, ; Cepeda, Berlin, Gao, Wiegand, & Wada, ; Chen, Doherty, & Zhang, ; Dorn et al, ; Eredics, Madersbacher, & Schauer, ; Forsberg, Martinussen, & Flaten, ; Fulda & Wetter, ; Häuser, Bartram‐Wunn, Bartram, Reinecke, & Tölle, ; Hróbjartsson & Gøtzsche, ; Khan, Faucett, Lichtenberg, Kirsch, & Brown, ; Kuten‐Shorrer, Kelley, Sonis, & Treister, ; Lee, Malhotra, Creanga, Carlsson, & Glue, ; lovieno & Papakostas, ; Macedo, Farré, & Baños, ; Meissner, Distel, & Mitzdorf, ; Moncrieff, Wessely, & Hardy, ; Patel et al, ; Puhl, Reinhart, Rok, & Injeyan, ; Quinn & Colagiuri, ; Walsh, Seidman, Sysko, & Gould, ; Wilhelm, Winkler, Rief, & Doering, ; Yeung, Sharpe, Glozier, Hackett, & Colagiuri, ; Zhang, Robertson, Jones, Dieppe, & Doherty, ). Accordingly, these conditions tend to have good response to placebo in classical trial designs.…”

Section: Discussionmentioning

confidence: 99%

Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review

Antonelli

Donelli²

2018

Health Soc Care Community

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Homoeopathy is widespread, and users claim to benefit from it. However, clear evidence of its efficacy over placebo is not available to date. As a consequence, a social separation between homoeopathy users and mainstream medicine exists, exposing these patients to many risks. Our primary objective is to assess homoeopathy efficacy by systematically reviewing existing systematic reviews and meta-analyses and to systematically review trials on open-label placebo (OLP) treatments. A secondary objective is to understand if homoeopathy as a whole may be considered as a placebo treatment. PubMed/Medline, Embase, Google Scholar, and Cochrane Library were systematically searched for systematic reviews and meta-analyses on homoeopathy efficacy, and 61 studies were included. Same databases plus Journal of Interdisciplinary Placebo Studies (JIPS) were also systematically searched for randomised controlled trials (RCTs) on OLP treatments, and 10 studies were included. Databases were searched up to 24 February 2018. Two authors independently screened all retrieved articles and selected studies eligible for inclusion. The quality of reviews of included studies was evaluated with a dedicated NIH tool in the first review, whereas the risk of bias of trials of included studies was assessed with the specific Cochrane tool in the second review.Qualitative syntheses show that homoeopathy efficacy can be considered comparable to placebo, and that OLP treatments may be effective in some health conditions. Placebo effects like placebo itself, treatment context, physician-patient relationship, and other nonspecific factors can define the idea of placebo treatments, which may be effective in some conditions. If homoeopathy efficacy is comparable to placebo, and if placebo treatments can be effective in some conditions, then homoeopathy as a whole may be considered as a placebo treatment. Reinterpreting homoeopathy as a placebo treatment would define limits and possibilities of this practice. This perspective shift suggests a strategy to manage patients who seek homoeopathic care and to reconcile them with mainstream medicine in a sustainable way. K E Y W O R D S complementary and alternative medicine, homoeopathy, open-label placebo, patientphysician relationship, placebo effects, placebo treatment

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Respiratory muscle endurance training improves exercise performance but does not affect resting blood pressure and sleep in healthy active elderly

2022

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Purpose Ageing is associated with increased blood pressure (BP), reduced sleep, decreased pulmonary function and exercise capacity. The main purpose of this study was to test whether respiratory muscle endurance training (RMET) improves these parameters. Methods Twenty-four active normotensive and prehypertensive participants (age: 65.8 years) were randomized and balanced to receive either RMET (N = 12) or placebo (PLA, N = 12). RMET consisted of 30 min of volitional normocapnic hyperpnea at 60% of maximal voluntary ventilation while PLA consisted of 1 inhalation day−1 of a lactose powder. Both interventions were performed on 4–5 days week−1 for 4–5 weeks. Before and after the intervention, resting BP, pulmonary function, time to exhaustion in an incremental respiratory muscle test (incRMET), an incremental treadmill test (IT) and in a constant-load treadmill test (CLT) at 80% of peak oxygen consumption, balance, sleep at home, and body composition were assessed. Data was analyzed with 2 × 2 mixed ANOVAs. Results Compared to PLA, there was no change in resting BP (independent of initial resting BP), pulmonary function, IT performance, sleep, body composition or balance (all p > 0.05). Performance significantly increased in the incRMET (+ 6.3 min) and the CLT (+ 3.2 min), resulting in significant interaction effects (p < 0.05). Conclusion In the elderly population, RMET might be used to improve respiratory and whole body endurance performance either as an adjunct to physical exercise training or as a replacement thereof for people not being able to intensively exercise even if no change in BP or sleep may be expected.

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Effect of placebo groups on blood pressure in hypertension: a meta-analysis of beta-blocker trials

Cited by 26 publications

References 81 publications

The placebo response in myasthenia gravis assessed by quantitative myasthenia gravis score: A meta‐analysis

The placebo response in myasthenia gravis assessed by quantitative myasthenia gravis score: A meta‐analysis

Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review

Respiratory muscle endurance training improves exercise performance but does not affect resting blood pressure and sleep in healthy active elderly

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