SynthesisBMJ supportive & palliative care2020
Placebo response in trials of drug treatments for cancer-related fatigue: a systematic review, meta-analysis and meta-regression.
Synthesis in BMJ supportive & palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Guideline
- Placebo administration for dry eye disease: a level I evidence based systematic review and meta-analysis.International journal of clinical pharmacy · 2022Pooled it
- Cancer-related fatigue in patients treated with mistletoe extracts: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Pooled it
- Predictive biomarkers of placebo response in patients with cancer: an exploratory analysis of the ABCD randomized clinical trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Trial
- Methylphenidate versus placebo for fatigue in patients with advanced cancer: the MePFAC randomised controlled trial.Health technology assessment (Winchester, England) · 2025Trial
- Methylphenidate Versus Placebo for Treating Fatigue in Patients With Advanced Cancer: Randomized, Double-Blind, Multicenter, Placebo-Controlled Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Trial
- Evaluating Ma-ol-asal Syrup for Chemotherapy-induced Fatigue in Gastrointestinal Cancer Patients: A Randomized Double-blinded Placebo-controlled Clinical Trial :.Galen medical journal · 2025Article
- Putting Methylphenidate for Cancer-Related Fatigue to Rest?Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
- Working with patients' treatment expectations - what we can learn from homeopathy.Frontiers in psychology · 2024Review
- Predictors of placebo response in three large clinical trials of the V1a receptor antagonist balovaptan in autism spectrum disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Article
- Management of Fatigue in Patients with Advanced Cancer.Current treatment options in oncology · 2023Review
- Review
- Fatigue in Cancer Patients in Palliative Care-A Review on Pharmacological Interventions.Cancers · 2021Review
- [Cancer-related fatigue and immune checkpoint inhibitors].Der Onkologe : Organ der Deutschen Krebsgesellschaft e.V · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundCancer-related fatigue (CRF) is one of the most distressing symptoms experienced by patients. There is no gold standard treatment, although multiple drugs have been tested with little evidence of efficacy. Randomised controlled trials (RCTs) of these drugs have commented on the existence or size of the placebo response (PR). The objective of this systematic review was to establish the magnitude of the PR in RCTs of drugs to relieve CRF and to identify contributing factors.
methodRCTs were included in which the objective was to treat CRF. A meta-analysis was conducted using the standardised mean change (SMC) between baseline and final measurement in the placebo group. To explore factors that may be associated with the PR (eg, population or drug), a meta-regression was undertaken. Risk of bias was assessed using the revised Cochrane tool.
resultsFrom 3916 citations, 30 relevant RCTs were identified. All had limitations that increased their risk of bias. The pooled SMC in reduction in fatigue status in placebo groups was -0.23 (95% confidence intervals -0.42 to -0.04). None of the variables analysed in the meta-regression were statistically significant related to PR.
conclusionThere is some evidence, based on trials with small samples, that the PR in trials testing drugs for CRF is non-trivial in size and statistically significant. We recommend that researchers planning drug studies in CRF should consider implementing alternative trial designs to better account for PR and decrease impact on the study results.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.