The placebo response in medicine: minimize, maximize or personalize?
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The placebo response in medicine: minimize, maximize or personalize? / Enck, Paul; Bingel, Ulrike; Schedlowski, Manfred; Rief, Winfried.
In: NAT REV DRUG DISCOV, Vol. 12, No. 3, 01.03.2013, p. 191-204.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The placebo response in medicine: minimize, maximize or personalize?
AU - Enck, Paul
AU - Bingel, Ulrike
AU - Schedlowski, Manfred
AU - Rief, Winfried
PY - 2013/3/1
Y1 - 2013/3/1
N2 - Our understanding of the mechanisms mediating or moderating the placebo response to medicines has grown substantially over the past decade and offers the opportunity to capitalize on its benefits in future drug development as well as in clinical practice. In this article, we discuss three strategies that could be used to modulate the placebo response, depending on which stage of the drug development process they are applied. In clinical trials the placebo effect should be minimized to optimize drug-placebo differences, thus ensuring that the efficacy of the investigational drug can be truly evaluated. Once the drug is approved and in clinical use, placebo effects should be maximized by harnessing patients' expectations and learning mechanisms to improve treatment outcomes. Finally, personalizing placebo responses - which involves considering an individual's genetic predisposition, personality, past medical history and treatment experience - could also maximize therapeutic outcomes.
AB - Our understanding of the mechanisms mediating or moderating the placebo response to medicines has grown substantially over the past decade and offers the opportunity to capitalize on its benefits in future drug development as well as in clinical practice. In this article, we discuss three strategies that could be used to modulate the placebo response, depending on which stage of the drug development process they are applied. In clinical trials the placebo effect should be minimized to optimize drug-placebo differences, thus ensuring that the efficacy of the investigational drug can be truly evaluated. Once the drug is approved and in clinical use, placebo effects should be maximized by harnessing patients' expectations and learning mechanisms to improve treatment outcomes. Finally, personalizing placebo responses - which involves considering an individual's genetic predisposition, personality, past medical history and treatment experience - could also maximize therapeutic outcomes.
KW - Clinical Trials as Topic
KW - Drug Design
KW - Drug Discovery
KW - Humans
KW - Individualized Medicine
KW - Physician-Patient Relations
KW - Placebo Effect
KW - Treatment Outcome
U2 - 10.1038/nrd3923
DO - 10.1038/nrd3923
M3 - SCORING: Journal article
C2 - 23449306
VL - 12
SP - 191
EP - 204
JO - NAT REV DRUG DISCOV
JF - NAT REV DRUG DISCOV
SN - 1474-1776
IS - 3
ER -