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The placebo response in myasthenia gravis assessed by quantitative myasthenia gravis score: A meta‐analysis
Author(s) -
Frisaldi Elisa,
Shaibani Aziz,
Vollert Jan,
Ferrero Bruno,
Carrino Roberta,
Ibraheem Hayan Dhamer,
Vase Lene,
Benedetti Fabrizio
Publication year - 2019
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26469
Subject(s) - placebo , myasthenia gravis , meta analysis , medicine , adverse effect , placebo response , clinical trial , randomized controlled trial , anesthesia , alternative medicine , pathology
This meta‐analysis investigates the placebo response in generalized myasthenia gravis (MG) trials by means of Quantitative Myasthenia Gravis (QMG) scores. Methods PubMed, Scopus, Web of Science, Cochrane Controlled Trial Register, and EMBASE were searched. QMG score, dropouts rate, adverse events (AEs), and AEs responsible for dropouts were examined, together with treatment moderators. Results The magnitude of placebo response showed an effect size of 0.24, which was significantly lower than 0.67 of the drug response ( P = 0.019). Furthermore, the forest plot revealed that, overall, active treatments showed a significantly higher impact on QMG scores than placebos. Conclusions Placebo and drug responses in MG trials are small and moderate, respectively. The lack of MG trials with a pure placebo arm or a no‐treatment control arm made it impossible to disentangle improvements due to the placebo psychological effect from other effects such as natural history and/or regression to the mean. Muscle Nerve 59:671–678, 2019