New Patents Aim to Reduce Placebo Effect
   The pharma industry has a big problem on its hands: Placebos are
   What can you do about placebo response? The old saying "It is what it
   One answer: come up with low-placebo-response study designs, and patent
   Placebo effect has always been a problem for drug companies, but it's
     placebo, separated from placebo. In this particular study, Lilly
     observed a greater-than-expected placebo response, which was
   [PlaceboDoctor.png] Fast-forward to August 2012: Lilly throws in the
   demonstrate Serdaxin's efficacy compared to placebo measured by the
   antidepressant, TC-5214, after the drug failed to beat placebo in Phase
   libido in postmenopausal women failed to perform well against placebo
   drugs are ineffective, but because placebos have recently become more
   effective in clinical trials. (For evidence on increasing placebo
   effectiveness, see yesterday's post, where I showed a graph of placebo
   tactics for mitigating high placebo response. The Final Solution?
   two-phase version, you start with a larger-than-usual group of placebo
   subjects relative to non-placebo subjects. In phase one, you run the
   trial as usual, but at the end, placebo non-responders are randomized
   placebo control arm and a study arm). SPCD differs from the usual
   "placebo run-in" design in that it doesn't actually eliminate placebo
   that when the phase-two placebo group's data are added in, they
   effectively dilute the higher phase-one placebo results. The
   assumption, of course, is that placebo non-responders will be
   non-responsive to placebo in phase two after having been identified as
   carry-over of (non)effect from placebo phase one to placebo phase two.
   [PlaceboSPCDProtocol.png]
   some detail, but basically, if you optimize the ratio of placebo to
   the study while keeping placebo response minimized. This translates to
   title "The problem of the placebo response in clinical trials for
   design approach." The title is interesting in that it paints placebo
   Fava and his colleagues point to possible causes of increasing placebo
   at reducing the placebo effect." They go on to present SPCD as a more
   or less revolutionary advance in the quest to quelch placebo effect.
   discussion, in a scientific paper, of a need to attack placebo effect
   Swine Flu. The whole idea that placebo effect is getting in the way of
   performing a clinical trial having a reduced placebo effect is
   (if not actually defeat) the placebo effect. I don't know if anybody
   redesign our scientific protocols in such a way as to defeat placebo
   effect? Are we now to view placebo effect as something that needs to be
       are assuming that placebo response is genuine and not just
       placebo. That should sort them out.
       the placebo response? I've heard this before, and I'm genuinely
       etc. Thus, eliminating the placebo effect would be extremely useful
       normally happen. What is labelled placebo response is in any case
       placebo response stuff as just so much junk science. See
       Kienle, G. S. and H. Kiene (1997). "The powerful placebo effect:
       design, and of attempting to reduce the placebo response in RCTs in
       general. Presumably, reductions in placebo response would happen
       placebo effect size much. If placebo responders were likely to
       simple solution in the placebo run-in period. The problem being, of
       what evidence to we have that SPCD reduces placebo response
       design, then wouldn't a design featuring a placebo run-in -- which
       control groups who are placebo-responders -- they will respond no
       treatment group that includes some unknown placebo responders
       compared to a control group that excludes placebo responders.
       from placebo 20 years ago no longer reliably do so. Did they become
       less active? Probably not. Are placebos working better than they
       patients placebos. But its not really clear whether the placebo
       were routinely handing out placebo. In fact once study found that
       the magnitude of the placebo effect is proportional to the
       treatment, in which the choices are not between drug and placebo
       4)We can try to understand the placebo effect, and engineer it out
       that placebo under at least some test conditions.
       from placebo never arises. If the author has any ideas on how such
       might account for some of the increased placebo effect. I wonder
       with drugs(be it placebo or "real" effective drugs). However, at
       So any study design that tries to lower placebo response is a great
       rather than an underlying cause, and that placebo is efficient at
       medication is efficient for causes where the placebo isn't. An
       ineffective medication that only works through the placebo effect
       whom the placebo didn't work to the medication being tested. Thus
       The above argument assumes that the placebo effect works the same,
       no matter if it's the medication or the actual placebo that causes
       who are able to detect placebos (e.g. through missing side
       effects). For these people, the placebo effect of the real drug may
       weren't present in the previous placebo trial, so they (correctly)
       conclude they're now given "the real thing", making the placebo
       their drugs are ineffective, but because placebos have recently
               o New Patents Aim to Reduce Placebo Effect
               o Placebos Are Becoming More Effective
               o Placebo Surgery