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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
Bioavailability Study Design: Single Versus Multiple Dose Studies01:11

Bioavailability Study Design: Single Versus Multiple Dose Studies

Bioavailability studies are essential for understanding how a drug is absorbed, distributed, metabolized, and excreted in the body. These studies assess the extent and rate at which the active pharmaceutical agent becomes available at the site of action. The design of bioavailability studies can involve single-dose or multiple-dose regimens, each with distinct advantages and limitations.Single-dose studies are the preferred approach due to their simplicity and reduced drug exposure for...
The Placebo Effect01:54

The Placebo Effect

The placebo effect occurs when people's expectations or beliefs influence or determine their experience in a given situation. In other words, simply expecting something to happen can actually make it happen.
Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
Bioavailability Study Design: Healthy Subjects Versus Patients01:15

Bioavailability Study Design: Healthy Subjects Versus Patients

Bioavailability studies are essential for evaluating a drug's therapeutic efficacy and understanding its absorption patterns under various physiological conditions. Conducting such studies on target patient populations provides more relevant data by simulating real-world disease states. However, practical challenges often necessitate the use of young, healthy adult volunteers as study subjects.Patients may exhibit altered drug absorption patterns due to the effects of the disease itself,...
Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.

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Related Experiment Video

Updated: Jun 12, 2026

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
07:02

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

Published on: February 11, 2019

Nocebo effects in multiple sclerosis trials: a meta-analysis.

D Papadopoulos1, D D Mitsikostas

  • 1Department of Neurology, Athens Naval Hospital, Athens, Greece.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|June 12, 2010
PubMed
Summary

Nocebo responses, where patients experience side effects from a placebo, are common in multiple sclerosis (MS) trials. These responses have increased over time and are linked to trial design and medication factors.

Area of Science:

  • Neuroscience
  • Clinical Trials
  • Psychosomatic Medicine

Background:

  • The nocebo effect, characterized by negative symptoms arising from placebo administration, is a significant concern in clinical trials.
  • Understanding the incidence and severity of nocebo responses is crucial for accurate interpretation of treatment efficacy in multiple sclerosis (MS).

Purpose of the Study:

  • To quantify the incidence and severity of nocebo responses in placebo-controlled trials for both symptomatic treatments (STs) and disease-modifying treatments (DMTs) in multiple sclerosis.
  • To explore factors influencing nocebo responses in MS clinical trials.

Main Methods:

  • Systematic literature search of Medline for randomized, placebo-controlled MS trials (1989-2009).
  • Meta-analysis of nocebo response incidence by pooling adverse events in placebo groups.

Related Experiment Videos

Last Updated: Jun 12, 2026

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
07:02

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

Published on: February 11, 2019

  • Meta-analysis of nocebo response severity using dropout rates due to adverse events in placebo groups.
  • Meta-regression analysis to identify associations between nocebo responses and trial characteristics.

    • Main Results:

    • Nocebo response incidence was substantially higher in DMT trials (74.4%) compared to ST trials (25.3%).
    • Nocebo response severity was comparable between DMT (2.1%) and ST trials (2.34%).
    • Higher nocebo incidence in parallel-design ST studies and higher severity in phase II ST studies were observed. DMT nocebo severity correlated with publication year and drug administration frequency.

    Conclusions:

    • Nocebo responses represent a significant challenge in MS clinical trials, with a notable increase in recent years.
    • Factors related to medication and trial design are associated with the occurrence and severity of nocebo effects.
    • These findings have critical implications for the design of future MS trials and clinical practice.