Monday, October 25, 2010


I recently came across an interesting article from Annals of Internal Medicine. Placebo is a very common term we use in our day to day life...when we read articles..when we refer to a study. But I always had some curiosity about what really it has. It has also been named as 'Sugar Pill'. It can contain sugar ..or may be vegetable oil( in fact each study uses its own manufactured placebo!).Well...can it affect results of studies .

a quick example.....If its a vegetable oil,  the monounsaturated and polyunsaturated fatty acids of these 'placebos,' and their antioxidant and anti-inflammatory effects, can reduce lipid levels and heart disease." If this is used in against a lipid lowering drug...then the benefit of the drug might be blunted at the end of the study! Well...if its all sugar....and we comparing it with Metformin..then we know what to expect!!!

In this study, researchers delved into 176 studies published in reputable medical journals, such as the New England Journal of Medicine, the Journal of the American Medical Assn. and the Annals of Internal Medicine, from January 2008 to December 2009 to see if placebo contents were disclosed and if so, what they were. Only a very few number of studies did disclose what the placebo contained. The placebos are manufactured by the company running the research, and they never let the content of the placebo out! 
And to make suspicions worse...FDA does not regulate the placebos used in studies (in fact no one regulates their use...except for the drug companies)

Irrespective of what they placebos have any clinical or the so called psychological benefit. This was addressed in a review published in NEJM in 2000. The placebo did show a little benefit in studies with subjective outcomes, and for treatment of pain!

Lets hope that all studies are done in good faith...good intentions!!!!! and the researchers are willing to publish  this part of evidence as well.