Cited by 71Pain Management and Placebo EffectPain Mechanisms and TreatmentsPain Management and Treatment

Placebo response changes depending on the neuropathic pain syndrome: results of a systematic review and meta-analysis

Cepeda, M. Soledad, Berlin, Jesse A., Gao, C. Yuying, Wiegand, Frank, Wada, D. Russell·2012·Pain Medicine

Abstract

OBJECTIVE: To compare placebo responses in neuropathic pain syndromes. DESIGN: Systematic literature review and meta-analysis. SETTING AND PATIENTS: Randomized placebo-controlled trials assessing pain intensity or pain relief in any neuropathic pain syndrome published since 1995 with ≥5days follow-up. INTERVENTIONS: Placebo response. OUTCOME MEASURES: Pain intensity and responder rates (proportion reporting ≥50% pain relief). Meta-regression models were built. RESULTS: Ninety-four studies (N=5,317) were included in the pain intensity analysis; 47 studies (N=3,087) were included in the responder analysis. After controlling for potential confounders (e.g., subject characteristics, study design characteristics), the placebo response was found to be large and varied with the pain syndrome. Compared with diabetic neuropathic/polyneuropathic pain (DPN), the placebo response for a decline in pain intensity and responder rate was smaller in trials that assessed central pain and postherpetic neuralgia (PHN) and larger in trials that assessed HIV pain. The model-predicted mean decrease (95% confidence interval [CI]) from baseline in pain intensity (0-10 scale) was as follows: DPN, 1.45 (1.35 to 1.55); PHN, 1.16 (1.03 to 1.29); central pain, 0.44 (-0.41 to 1.30); HIV pain, 1.82 (1.51 to 2.12). The predicted responder rates (95% CI) were as follows: DPN, 20% (14.6 to 25.8); PHN, 11.5% (8.4 to 14.5); central pain, 7.2% (2.1 to 12.3); HIV pain, 42.8% (34.9 to 50.7). The type of treatment in the active arm also influenced the placebo response. CONCLUSIONS: Placebo response is influenced by the pain syndrome evaluated. These differences should be considered when evaluating novel compounds for the treatment of neuropathic pain conditions.

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Crossref · 10.1111/j.1526-4637.2012.01340.x

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  • Side effects may to some degree depend on aetiology; for example, drugs with CNS-related side effects may be less tolerated in patients with CNS lesions.

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Authors
Cepeda, M. S., Berlin, J. A., Gao, C. Y., Wiegand, F., & Wada, D. R.
Corresponding author
Cepeda, M. Soledad
Venue
Pain Medicine
Published
2012-04
Volume
13
Issue
4
Pages
575-595
ISSN
  • 1526-2375 (ISSN-L)
  • 1526-4637
OpenAlex
W1848692709
Cited by
71
References
158
Citations by year
2026: 2 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 9 · 2019: 3 · 2018: 7 · 2017: 2 · 2016: 3 · 2015: 13 · 2014: 8 · 2013: 11 · 2012: 2
FWCI
0.87
Type
journal article
Language
en
Open access
closed
Locations
  • Pain Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
placebo response, neuropathic pain, diabetic neuropathic pain, postherpetic neuralgia, central pain, pain intensity, responder rate, treatment effect estimation
MeSH terms
Diabetic Neuropathies, Humans, Neuralgia, Placebos, Randomized Controlled Trials as Topic, Neuralgia, Postherpetic, Pain Perception

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