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Caregiver placebo effect in analgesic clinical trials for cats with naturally occurring degenerative joint disease-associated pain.
Vet Rec 2017; 180(19):473VR

Abstract

A literature review identified six placebo-controlled studies of analgesics in client-owned cats with degenerative joint disease-associated pain. Five studies with 96 cats had available data. Caregiver responses on a clinical metrology instrument, Client-Specific Outcome Measure (CSOM), were compared to measured activity. Cats were categorised as 'successes' or 'failures' based on change in CSOM score and activity counts from baseline. Effect sizes based on CSOM score were calculated; factors that were associated with success/failure were analysed using logistic regression. Effect sizes ranged from 0.97 to 1.93. The caregiver placebo effect was high, with 54-74 per cent of placebo-treated cats classified as CSOM successes compared with 10-63 per cent of cats classified as successes based on objectively measured activity. 36 per cent of CSOM successes were also activity successes, while 19 per cent of CSOM failures were activity successes. No significant effects of cat age, weight, baseline activity, radiographic score, orthopaedic pain score or study type on CSOM success in the placebo groups were found. The caregiver placebo effect across these clinical trials was remarkably high, making demonstration of efficacy for an analgesic above a placebo difficult. Further work is needed to determine whether a potential placebo-by-proxy effect could benefit cats in clinical settings.

Authors+Show Affiliations

Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA.Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina 27695, USA.Comparative Pain Research Program, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

28270539

Citation

Gruen, M E., et al. "Caregiver Placebo Effect in Analgesic Clinical Trials for Cats With Naturally Occurring Degenerative Joint Disease-associated Pain." The Veterinary Record, vol. 180, no. 19, 2017, p. 473.
Gruen ME, Dorman DC, Lascelles BDX. Caregiver placebo effect in analgesic clinical trials for cats with naturally occurring degenerative joint disease-associated pain. Vet Rec. 2017;180(19):473.
Gruen, M. E., Dorman, D. C., & Lascelles, B. D. X. (2017). Caregiver placebo effect in analgesic clinical trials for cats with naturally occurring degenerative joint disease-associated pain. The Veterinary Record, 180(19), p. 473. doi:10.1136/vr.104168.
Gruen ME, Dorman DC, Lascelles BDX. Caregiver Placebo Effect in Analgesic Clinical Trials for Cats With Naturally Occurring Degenerative Joint Disease-associated Pain. Vet Rec. 2017 May 13;180(19):473. PubMed PMID: 28270539.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Caregiver placebo effect in analgesic clinical trials for cats with naturally occurring degenerative joint disease-associated pain. AU - Gruen,M E, AU - Dorman,D C, AU - Lascelles,B D X, Y1 - 2017/03/07/ PY - 2017/02/12/accepted PY - 2017/3/9/pubmed PY - 2017/5/17/medline PY - 2017/3/9/entrez KW - Arthritis KW - Dispositional optimism KW - Feline KW - Osteoarthritis KW - Placebo-by-proxy SP - 473 EP - 473 JF - The Veterinary record JO - Vet. Rec. VL - 180 IS - 19 N2 - A literature review identified six placebo-controlled studies of analgesics in client-owned cats with degenerative joint disease-associated pain. Five studies with 96 cats had available data. Caregiver responses on a clinical metrology instrument, Client-Specific Outcome Measure (CSOM), were compared to measured activity. Cats were categorised as 'successes' or 'failures' based on change in CSOM score and activity counts from baseline. Effect sizes based on CSOM score were calculated; factors that were associated with success/failure were analysed using logistic regression. Effect sizes ranged from 0.97 to 1.93. The caregiver placebo effect was high, with 54-74 per cent of placebo-treated cats classified as CSOM successes compared with 10-63 per cent of cats classified as successes based on objectively measured activity. 36 per cent of CSOM successes were also activity successes, while 19 per cent of CSOM failures were activity successes. No significant effects of cat age, weight, baseline activity, radiographic score, orthopaedic pain score or study type on CSOM success in the placebo groups were found. The caregiver placebo effect across these clinical trials was remarkably high, making demonstration of efficacy for an analgesic above a placebo difficult. Further work is needed to determine whether a potential placebo-by-proxy effect could benefit cats in clinical settings. SN - 2042-7670 UR - https://www.unboundmedicine.com/medline/citation/28270539/Caregiver_placebo_effect_in_analgesic_clinical_trials_for_cats_with_naturally_occurring_degenerative_joint_disease_associated_pain_ L2 - http://veterinaryrecord.bmj.com/cgi/pmidlookup?view=long&pmid=28270539 DB - PRIME DP - Unbound Medicine ER -