The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials

The aims of this study were to determine whether placebo treatment in randomised controlled trials (RCTs) is effective for fibromyalgia and to identify possible determinants of the magnitude of any such placebo effect. A systematic literature search was undertaken for RCTs in people with fibromyalgi...

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Main Authors: Chen, Xi, Zou, Kun, Abdullah, Natasya, Whiteside, Nicola, Sarmanova, Aliya, Doherty, Michael, Zhang, Weiya
Format: Article
Published: Springer 2017
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Online Access:https://eprints.nottingham.ac.uk/41183/
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author Chen, Xi
Zou, Kun
Abdullah, Natasya
Whiteside, Nicola
Sarmanova, Aliya
Doherty, Michael
Zhang, Weiya
author_facet Chen, Xi
Zou, Kun
Abdullah, Natasya
Whiteside, Nicola
Sarmanova, Aliya
Doherty, Michael
Zhang, Weiya
author_sort Chen, Xi
building Nottingham Research Data Repository
collection Online Access
description The aims of this study were to determine whether placebo treatment in randomised controlled trials (RCTs) is effective for fibromyalgia and to identify possible determinants of the magnitude of any such placebo effect. A systematic literature search was undertaken for RCTs in people with fibromyalgia that included a placebo and/or a no-treatment (observation only or waiting list) control group. Placebo effect size (ES) for pain and other outcomes was measured as the improvement of each outcome from baseline divided by the standard deviation of the change from baseline. This effect was compared with changes in the no-treatment control groups. Meta-analysis was undertaken to combine data from different studies. Subgroup analysis was conducted to identify possible determinants of the placebo ES. A total of 3912 studies were identified from the literature search. After scrutiny, 229 trials met the inclusion criteria. Participants who received placebo in the RCTs experienced significantly better improvements in pain, fatigue, sleep quality, physical function, and other main outcomes than those receiving no treatment. The ES of placebo for pain relief was clinically moderate (0.53, 95%CI 0.48 to 0.57). The ES increased with increasing strength of the active treatment, increasing participant age and higher baseline pain severity, but decreased in RCTS with more women and with longer duration of fibromyalgia. In addition, placebo treatment in RCTs is effective in fibromyalgia. A number of factors (expected strength of treatment, age, gender, disease duration) appear to influence the magnitude of the placebo effect in this condition.
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spelling nottingham-411832020-05-04T18:37:37Z https://eprints.nottingham.ac.uk/41183/ The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials Chen, Xi Zou, Kun Abdullah, Natasya Whiteside, Nicola Sarmanova, Aliya Doherty, Michael Zhang, Weiya The aims of this study were to determine whether placebo treatment in randomised controlled trials (RCTs) is effective for fibromyalgia and to identify possible determinants of the magnitude of any such placebo effect. A systematic literature search was undertaken for RCTs in people with fibromyalgia that included a placebo and/or a no-treatment (observation only or waiting list) control group. Placebo effect size (ES) for pain and other outcomes was measured as the improvement of each outcome from baseline divided by the standard deviation of the change from baseline. This effect was compared with changes in the no-treatment control groups. Meta-analysis was undertaken to combine data from different studies. Subgroup analysis was conducted to identify possible determinants of the placebo ES. A total of 3912 studies were identified from the literature search. After scrutiny, 229 trials met the inclusion criteria. Participants who received placebo in the RCTs experienced significantly better improvements in pain, fatigue, sleep quality, physical function, and other main outcomes than those receiving no treatment. The ES of placebo for pain relief was clinically moderate (0.53, 95%CI 0.48 to 0.57). The ES increased with increasing strength of the active treatment, increasing participant age and higher baseline pain severity, but decreased in RCTS with more women and with longer duration of fibromyalgia. In addition, placebo treatment in RCTs is effective in fibromyalgia. A number of factors (expected strength of treatment, age, gender, disease duration) appear to influence the magnitude of the placebo effect in this condition. Springer 2017-03-15 Article PeerReviewed Chen, Xi, Zou, Kun, Abdullah, Natasya, Whiteside, Nicola, Sarmanova, Aliya, Doherty, Michael and Zhang, Weiya (2017) The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials. Clinical Rheumatology . ISSN 1434-9949 Fibromyalgia Meta-analysis Pain management Placebo effect Rheumatic diseases Systematic reviews and methodology https://link.springer.com/article/10.1007%2Fs10067-017-3595-8 doi:10.1007/s10067-017-3595-8 doi:10.1007/s10067-017-3595-8
spellingShingle Fibromyalgia
Meta-analysis
Pain management
Placebo effect
Rheumatic diseases
Systematic reviews and methodology
Chen, Xi
Zou, Kun
Abdullah, Natasya
Whiteside, Nicola
Sarmanova, Aliya
Doherty, Michael
Zhang, Weiya
The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials
title The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials
title_full The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials
title_fullStr The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials
title_full_unstemmed The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials
title_short The placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials
title_sort placebo effect and its determinants in fibromyalgia: meta-analysis of randomized controlled trials
topic Fibromyalgia
Meta-analysis
Pain management
Placebo effect
Rheumatic diseases
Systematic reviews and methodology
url https://eprints.nottingham.ac.uk/41183/
https://eprints.nottingham.ac.uk/41183/
https://eprints.nottingham.ac.uk/41183/