Placebo improves the symptoms of overactive bladder (OAB) and the effects are “non-negligible,” investigators reported in European Urology Focus.
Shahrokh F. Shariat, MD, Medical University of Vienna in Vienna, Austria, and colleagues conducted a systematic review and meta-analysis of 57 randomized placebo-controlled trials (RCTs) of “acceptable” to “high” quality including an estimated 12,901 patients. In significant results from the placebo arms of these trials, placebo resulted in a mean 0.45 fewer daily micturitions, 0.33 fewer daily nocturia episodes, and 25% more volume voided per micturition compared with baseline, using standardized mean differences. As patient age increased, the placebo response in reducing nocturia significantly increased.
In addition, placebo recipients experienced 0.50 fewer daily urgency episodes, 0.46 fewer urgency urinary incontinence episodes, and 0.51 fewer daily incontinence episodes overall compared with baseline.
“Placebo has a statistically significant effect on improving symptoms and signs associated with OAB; this effect is age dependent,” Dr Shariat’s team wrote. “However, there is no consensus on what change of OAB symptoms and signs is clinically meaningful for the affected patient. Taken together, the placebo response seems to be non-negligible in OAB, supporting the need for placebo control in RCTs.”
Mostafaei H, Janisch F, Mori K, et al. Placebo response in patients with oral therapy for overactive bladder: a systematic review and meta-analysis. Published March 2, 2021. Eur Urol Focus. doi:10.1016/j.euf.2021.02.005