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Migraine

Differential effects of placebos in migraine clinical trials

Nature Reviews Neurology volume 10, pages 10–11 (2014)Cite this article

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According to a new systematic review, placebo treatment in clinical trials of migraine prophylaxis results in responder rates ranging from 0–56%, probably owing to variable combinations of spontaneous improvement and genuine placebo effects. Clinicians who treat patients with migraine should be aware of the potential nonspecific effects of any treatment modality.

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Figure 1: Slow clinical improvement in the placebo arms of three topiramate trials.

References

  1. Meissner, K. et al. Differential effectiveness of placebo treatments: a systematic review of migraine prophylaxis. JAMA Intern. Med. http://dx.doi.org/10.1001/jamainternmed.2013.10391.

  2. Krogsbøll, L. T., Hróbjartsson, A. & Gøtzsche, P. C. Spontaneous improvement in randomised clinical trials: meta-analysis of three-armed trials comparing no treatment, placebo and active intervention. BMC Med. Res. Methodol. 9, 1 (2009).

    Article  PubMed  PubMed Central  Google Scholar 

  3. Linde, M., Mulleners, W. M., Chronicle, E. P. & McCrory, D. C. Topiramate for the prophylaxis of episodic migraine in adults. Cochrane Database of Systematic Reviews, Issue 6. Art. No.: CD010610 http://dx.doi.org/10.1002/14651858.CD010610.

  4. Macedo, A., Baños, J.-E. & Farré, M. Placebo response in the prophylaxis of migraine: a meta-analysis. Eur. J. Pain 12, 68–75 (2008).

    Article  PubMed  Google Scholar 

  5. Patel, S. M. et al. The placebo effect in irritable bowel syndrome trials: a meta-analysis. Neurogastroenterol. Motil. 17, 332–340 (2005).

    Article  CAS  PubMed  Google Scholar 

  6. Linde, K. et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA 293, 2118–2125 (2005).

    Article  CAS  PubMed  Google Scholar 

  7. de Craen, A. J., Tijssen, J. G., de Gans, J. & Kleijnen, J. Placebo effect in the acute treatment of migraine: subcutaneous placebos are better than oral placebos. J. Neurol. 247, 183–188 (2000).

    Article  CAS  PubMed  Google Scholar 

  8. Diener, H.-C. et al. Topiramate in migraine prophylaxis—results from a placebo-controlled trial with propranolol as an active control. J. Neurol. 251, 943–950 (2004).

    Article  CAS  PubMed  Google Scholar 

  9. Tfelt-Hansen, P. et al. Guidelines for controlled trials of drugs in migraine: third edition. A guide for investigators. Cephalalgia 32, 6–38 (2012).

    Article  PubMed  Google Scholar 

  10. Pradalier, A. et al. The PROMISE study: PROphylaxis of MIgraine with SEglor (dihydroergotamine mesilate) in French primary care. CNS Drugs 18, 1149–1163 (2004).

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, Glostrup Hospital, Nordre Ringvej 57, Glostrup, 2600, Denmark

    Peer C. Tfelt-Hansen & Anders Hougaard

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  1. Peer C. Tfelt-Hansen
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  2. Anders Hougaard
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Correspondence to Peer C. Tfelt-Hansen.

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The authors declare no competing financial interests.

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Tfelt-Hansen, P., Hougaard, A. Differential effects of placebos in migraine clinical trials. Nat Rev Neurol 10, 10–11 (2014). https://doi.org/10.1038/nrneurol.2013.255

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