{"id":412085,"date":"2010-03-10T14:01:11","date_gmt":"2010-03-10T19:01:11","guid":{"rendered":"http:\/\/blogs.jwatch.org\/hiv-id-observations\/?p=772"},"modified":"2010-03-10T14:01:11","modified_gmt":"2010-03-10T19:01:11","slug":"the-extraordinary-power-of%c2%a0placebo","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/412085","title":{"rendered":"The Extraordinary Power of\u00a0Placebo"},"content":{"rendered":"

\"monty_footSmWide\"<\/p>\n

Just published in the journal Neurology <\/em>– not typically on my radar screen — is this remarkable study comparing pregabalin to placebo<\/a> for HIV-related distal sensory peripheral neuropathy.<\/p>\n

Here are the results:<\/p>\n

\n

At endpoint, pregabalin and placebo showed substantial reductions in mean Numeric Pain Rating Scale (NPRS) score from baseline: -2.88 vs -2.63, p = 0.3941.
\n(-snip-)
\nIndividuals with HIV-associated neuropathy achieved NPRS treatment effect size similar to those in studies of diabetic peripheral and postherpetic neuralgia.\u00a0However, the placebo group in the current study had a much higher NPRS change than in the diabetic peripheral neuropathy or postherpetic neuralgia studies<\/p>\n<\/blockquote>\n

In other words, the pregabalin here worked great, but the placebo effect was so gargantuan that the placebo was just as good.<\/p>\n

Writing in Journal Watch: \u00a0AIDS Clinical Care<\/a><\/em>, the always-astute Abbie Zuger has a theory why this happened:<\/p>\n

\n

Notably, this study is not the first in which a treatment for HIV-related peripheral neuropathy has elicited an unusually high placebo response.\u00a0The reasons behind that phenomenon would be extremely interesting to pursue \u2014 might HIV-positive individuals have greater faith in the power of medication than do others?<\/p>\n<\/blockquote>\n

I think she’s on to something important here. \u00a0After all, in how many other diseases can patients so directly link the medications they are taking to their own survival?<\/p>\n

And we clinicians who practice HIV medicine should keep this in mind when prescribing medications to our patients. \u00a0Strong mutual conviction that something will<\/em> work — from both provider and patient — may well be a self-fulfilling prophecy.<\/p>\n

Why not leverage this for all it’s worth?<\/p>\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Just published in the journal Neurology – not typically on my radar screen — is this remarkable study comparing pregabalin to placebo for HIV-related distal sensory peripheral neuropathy. Here are the results: At endpoint, pregabalin and placebo showed substantial reductions in mean Numeric Pain Rating Scale (NPRS) score from baseline: -2.88 vs -2.63, p = […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-412085","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/412085","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=412085"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/412085\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=412085"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=412085"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=412085"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}