Placebo Effect Sizes in Clinical Trials of Knee Osteoarthritis Using Intra‐Articular Injections of Biologic Agents Article Swipe
Johanna M. Borst
,
Severin Ruoss
,
Ian Palmer
,
Trevor Smith
,
Kenneth Kalunian
,
Samuel R. Ward
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/acr.25526
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1002/acr.25526
Objective Patients with knee osteoarthritis rely on symptomatic treatments, in which up to 75% of the pain reduction can be attributed to the placebo effect. This effect may vary based on treatment type (eg, biologics vs nonbiologic injection) and route of administration (eg, intra‐articular vs topical vs oral). The placebo effect is an integral part of treatment effect size calculation; thus, network analyses comparing efficacies of different treatments may be inaccurate. The objective of this study was to test the hypothesis that placebo effects differ between treatment types and route of delivery. Methods A systematic literature search was conducted in August 2019. Randomized trials comparing pain outcomes of oral, topical, or intra‐articular placebo interventions to active treatments were included. The outcome measure of interest was change in pain scores from baseline. Data were stratified by length of follow‐up and treatment subcategory. Results A total of 129 articles were included with 9,218 patients receiving placebo treatments. Reduction in pain from baseline occurred in 93% of the subcategory data points. Biologic intra‐articular placebo injections had the greatest pain reduction at one month (mean ± SD visual analog scale −32.2 ± 24.6; mean ± SD Western Ontario and McMaster Universities Arthritis Index −16.3 ± 3.81). At one month and two months, placebo intra‐articular injections had a greater pain reduction than oral placeboes ( P ≤ 0.01). Conclusion The robust placebo effect is influenced by the active treatment category and changes over time. The variation in placebo response despite analogous placebo methodologies implies using network meta‐analyses to compare treatments from different active treatment categories by evaluating the change from placebo is inaccurate.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1002/acr.25526
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/acr.25526
- OA Status
- bronze
- Cited By
- 1
- References
- 28
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4408615009
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4408615009Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/acr.25526Digital Object Identifier
- Title
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Placebo Effect Sizes in Clinical Trials of Knee Osteoarthritis Using Intra‐Articular Injections of Biologic AgentsWork title
- Type
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reviewOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-03-19Full publication date if available
- Authors
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Johanna M. Borst, Severin Ruoss, Ian Palmer, Trevor Smith, Kenneth Kalunian, Samuel R. WardList of authors in order
- Landing page
-
https://doi.org/10.1002/acr.25526Publisher landing page
- PDF URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/acr.25526Direct link to full text PDF
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YesWhether a free full text is available
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bronzeOpen access status per OpenAlex
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/acr.25526Direct OA link when available
- Concepts
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Osteoarthritis, Medicine, Placebo, Clinical trial, Intra articular, Physical therapy, Physical medicine and rehabilitation, Internal medicine, Alternative medicine, PathologyTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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28Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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