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Therefore, this study used a model\u2010based meta\u2010analysis method to quantitatively analyse the placebo response and explore its influencing factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included 21\u2009627 subjects from acne\u2010related randomized double\u2010blind placebo\u2010controlled trials. Pharmacodynamic models were developed for four endpoints: total lesion counts absolute change, noninflammatory lesion counts absolute change, inflammatory lesion counts absolute change and treatment success rate defined by the investigator global assessment scale. Covariate modelling and subgroup analyses were performed to explore influencing factors. Placebo response under different conditions was simulated based on the final model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Model simulation results showed that for the typical population, after 12\u2009weeks of placebo intervention, their total lesion counts, noninflammatory lesion counts and inflammatory lesion counts were reduced by 19.05 (95% confidence interval: 16.54\u201321.52), 10.71 (9.18\u201312.17) and 8.58 (7.55\u20139.58) from baseline, respectively; the treatment success rate was 11.83% (9.41%\u201314.35%). Baseline lesion counts, female proportion, Caucasians proportion, sample size, dosage form, type of control drug, skincare programme, number of centres, funding source, study locations and publication year could all influence placebo response. We also used our model to synthesize placebo arms for two single\u2010arm studies, demonstrating the efficacy superiority of the drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study quantitatively described the time\u2010response relationship of placebo in acne clinical trials, revealing the influence of baseline characteristics and trial design characteristics, which could provide evidence for optimizing clinical trial design.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial registration:<\/jats:bold>\n                      PROSPERO (CRD420250649902).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70468","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:48:24Z","timestamp":1771462104000},"page":"2171-2182","source":"Crossref","is-referenced-by-count":0,"title":["Placebo response and its influencing factors in acne vulgaris: A model\u2010based meta\u2010analysis"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8847-8997","authenticated-orcid":false,"given":"Jieren","family":"Luo","sequence":"first","affiliation":[{"name":"Center for Pharmacometrics Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiesen","family":"Yu","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Cai","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoxiang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingze","family":"Liu","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingshan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Dermatology Shanghai University of Traditional Chinese Medicine Affiliated Shuguang Hospital  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2923-3206","authenticated-orcid":false,"given":"Lujin","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Pharmacometrics Shanghai University of Traditional Chinese Medicine  Shanghai China"},{"name":"State Key Laboratory of Integration and Innovation of Classic Formula and Modern Chinese Medicine Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12149"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.17633"},{"issue":"7","key":"e_1_2_10_4_1","first-page":"35","article-title":"Body image disturbance in patients with acne vulgaris","volume":"4","author":"Bowe WP","year":"2011","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.02.040"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.12.017"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.5414\/cp201694"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.21739"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.20080"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.03.051"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.07.052"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004425.pub6"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1462"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejps.2024.106777"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2022.103908"},{"key":"e_1_2_10_16_1","unstructured":"U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER).Guidance for Industry. 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