Global Recruiting Patterns and Placebo Response Rates in Clinical Trials of Psoriatic Arthritis and Plaque Psoriasis.

Objective: Placebo effects are a significant challenge in the conduct of clinical trials. We explored how global recruitment patterns influence the extent of placebo responses in randomized controlled trials of psoriatic arthritis and plaque psoriasis. Methods: We conducted an analysis of 51 trials...

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Publicado en:Arthritis & Rheumatology Vol. 78; no. 1; pp. 141 - 152
Autores principales: Kerschbaumer, Andreas, Steiner, Marlene, Khalili, Suzanne, Shehab, Azad, Jordanov, Alexander, Wildner, Brigitte, Maad, Magdalena, Smolen, Josef S., Aletaha, Daniel
Formato: pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell Jan2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2026
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1002/art.43302
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        atl: Global Recruiting Patterns and Placebo Response Rates in Clinical Trials of Psoriatic Arthritis and Plaque Psoriasis.
      aug:
        au:
          Kerschbaumer, Andreas
          Steiner, Marlene
          Khalili, Suzanne
          Shehab, Azad
          Jordanov, Alexander
          Wildner, Brigitte
          Maad, Magdalena
          Smolen, Josef S.
          Aletaha, Daniel
        affil: Division of Rheumatology, Department of Medicine III, Medical University of Vienna, Vienna, Austria
      sug:
        subj:
          Research Subject Recruitment
          Randomized Controlled Trials
          Arthritis, Psoriatic
          Psoriasis
          Socioeconomic Factors
          Placebos
          Human
          Female
          Male
          Biological Products Therapeutic Use
          Therapeutics
          Confidence Intervals
          Descriptive Statistics
          Antirheumatic Agents Therapeutic Use
          Adult
          Middle Age
          Disease Duration
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: Placebo effects are a significant challenge in the conduct of clinical trials. We explored how global recruitment patterns influence the extent of placebo responses in randomized controlled trials of psoriatic arthritis and plaque psoriasis. Methods: We conducted an analysis of 51 trials (6,843 patients; 52% ± 5.7% female) in psoriatic arthritis and 43 trials (5,671 patients; 32% ± 7.1% female) in plaque psoriasis investigating biologic and targeted synthetic therapeutics. We investigated to what extent global recruitment patterns are related to the extent of response rates in the placebo arms of these clinical trials by investigating underlying socioeconomic factors using the average per capita gross national income (GNI; weighted for recruiting study centers per country) as proxy of these patterns in linear mixed models. Results: We identified a negative association of GNI and placebo response rates on the primary endpoints across psoriatic arthritis trials (American College of Rheumatology 20%: β = ‐5.7% per 10,000 international dollars; 95% confidence interval [CI] −7.8% to −3.5%; P < 0.001) and plaque psoriasis trials (Psoriasis Area and Severity Index 75%: β = ‐1.1%; 95% CI −2.0 to −0.3; P = 0.011). Sensitivity analyses using other outcome measures and alternative economic metrics, such as the United Nations Human Development Index and World Health Organization out‐of‐pocket health expenditures, were confirmatory. Conclusion: The global expansion of trial recruitment to less affluent countries may increase placebo rates in studies of psoriatic arthritis and plaque psoriasis. These higher placebo rates may reflect the higher perceived benefit in these countries, leading to regression to the mean after patients have been successfully enrolled.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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