The placebo effect in the pharmacologic treatment of patients with lower urinary tract symptoms
| Autor: | Jules H. Schagen van Leeuwen, Ramiro Castro, Bart L.H. Bemelmans, Michael Busse |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Urologic Diseases Adrenergic Antagonists medicine.medical_specialty Urge urinary incontinence Urology Prostatic Hyperplasia MEDLINE Urinary incontinence Muscarinic Antagonists Placebo law.invention Randomized controlled trial law Lower urinary tract symptoms Internal medicine medicine Humans Enzyme Inhibitors Translational research [CTR 3] Clinical Trials as Topic Urinary Bladder Overactive business.industry Placebo Effect medicine.disease Urinary Bladder Neck Obstruction Urinary Incontinence Overactive bladder Female Observational study medicine.symptom business Functional Neurogenomics [DCN 2] Selective Serotonin Reuptake Inhibitors |
| Zdroj: | European Urology, 50, 3, pp. 440-52 European Urology, 50, 440-52 |
| ISSN: | 0302-2838 |
| DOI: | 10.1016/j.eururo.2006.05.014 |
| Popis: | Objectives We reviewed placebo responses in randomised controlled trials (RCTs) for pharmacologic treatment of lower urinary tract symptoms (LUTS), including urinary incontinence (UI), overactive bladder, and benign prostatic hyperplasia. Review papers on placebo effects in non-urologic disorders were assessed to compare the magnitude of placebo responses in drugs for LUTS with those reported for other diseases. Methods Data were retrieved from registration trials for LUTS drugs on the Web sites of the Food and Drugs Administration and the European Medicines Agency. Reviews were retrieved from Medline using the MeSH term "placebo effect" (English language; published between 1990 and 2005). Results Placebo treatment of LUTS yields reductions in incontinence episodes (IEs) ranging from 32% to 65%, whereas prostate or UI symptom scores are reduced by 9–34%. Genuine drugs decrease IEs by 45–77% and symptom scores by 22–45%. Placebo responses are much lower when objective changes in voided volume or peak flow rate are assessed. Conclusions The placebo effect in LUTS has a strong behavioural component as patients become aware of their voiding habits and potential risk factors. Symptom severity, treatment naivety, study duration, and interaction with health care providers may also influence it. Proper patient selection, study duration, and objective and subjective outcome measures may better separate genuine treatment effects from artefacts. Observational studies with patients representative for real-life situations and covering a sufficient period of time could allow for better understanding of RCT results and their applicability in clinical practice. |
| Databáze: | OpenAIRE |
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