geoffrey modest medical blogs

  A recent systematic review and meta-analysis evaluated the placebo  response and adverse event rates in treatments for gastroparesis (see placebo response rate in gastroparesis ClinGastroHep2023 in dropbox, or  doi.org/10.1016/j.cgh.2022.09.033 )     Details : -- the medical literature was reviewed through August 2022 to identify RCTs comparing active drug with placebo in patients with gastroparesis -- placebo response rates were assessed for at least one of nausea, vomiting, abdominal pain, bloating, or fullness (typical gastroparesis symptoms), as well as for adverse events. -- 22 articles reported on the placebo response rates, with a total of 1011 patients -- Primary outcome: magnitude of the placebo response as well as adverse events associated with placebo (i.e. the nocebo effect: adverse events associated with the belief that the placebo will cause harm)   Results : -- overall pooled placebo response rate: 29.3% (23.7%-35.2%) ...

again, i was dusting off old medical articles and saved another from the recycle bin, this one revealing that the profound effect of medication adherence (whether a med or placebo) leads to improved outcomes (see  chf CHARM trial adherence lancet 2005  in dropbox, or Lancet2005; 366: 2005). the CHARM trials (all published in the September 3, 2003 issue of Lancet) were a multinational set of trials from 618 sites in 26 countries, enrolling adult patients with symptomatic heart failure (NYHA class II-IV): the CHARM-Alternative trial had patients with low left ventricular ejection fraction (LVEF  ≤ ​40%) who did not tolerate an ACE-inhibitor; the CHARM-A dded trial had patients with LVEF  ≤ 40 and taking an ACE-I; and the CHARM-Preserved included patients with a preserved LVEF (ie >40%) with or without ACE-I. all were randomized to candasartan vs placebo. overall, each of these studies found efficacy for candasartan (though in the  CHAR...