{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:55:56Z","timestamp":1787788556160,"version":"build-2784847793"},"reference-count":47,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between the degree of response to placebo in migraine studies and the observed difference between drug and placebo across studies of preventative treatments for migraine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was performed using MEDLINE and the Cochrane Central Register of Controlled Clinical Trials from January 1988 to June 2019. Randomized, double-blind, parallel-group, placebo-controlled trials on oral or injection preventative treatments for migraine were included. Single- and multi-variable linear regression analyses were performed on the placebo-subtracted response rate (i.e. placebo responders subtracted from active responders), and the proportion of placebo responders. Fisher\u2019s exact tests were performed on the level of placebo response and the success in meeting the study\u2019s primary endpoint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for route of administration and number of randomized subjects, there was a statistically significant association between the proportion of patients who were placebo responders and the placebo-subtracted response rate (b\u2009=\u2009\u22120.27,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). There was a statistically significant difference in trial success rate (60%) between studies with \u226420% placebo responders and studies with\u2009&gt;\u200930% placebo responders (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Considering the detrimental impact that high placebo response can have on clinical trials, it is imperative to find effective solutions to decrease the placebo response and increase assay sensitivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0333102420960020","type":"journal-article","created":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T18:36:10Z","timestamp":1600799770000},"page":"247-255","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["The relation between the placebo response, observed treatment effect, and failure to meet primary endpoint: A systematic review of clinical trials of preventative pharmacological migraine treatments"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7675-6750","authenticated-orcid":false,"given":"Kathryn","family":"Evans","sequence":"first","affiliation":[{"name":"WCG Analgesic Solutions, Wayland, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Romero","sequence":"additional","affiliation":[{"name":"Boston Headache Institute, PainCare, Waltham, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egilius LH","family":"Spierings","sequence":"additional","affiliation":[{"name":"Boston Headache Institute, PainCare, Waltham, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Katz","sequence":"additional","affiliation":[{"name":"WCG Analgesic Solutions, Wayland, MA, USA"},{"name":"Tufts University School of Medicine, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,9,22]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.11.008"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)00066-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001538"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000275528.01263.6c"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2019.06.001"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.10391"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-017-0720-7"},{"key":"e_1_3_2_10_2","unstructured":"Evans K Katz N. 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