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Clinical Drug Investigation

06-09-2024 | Pruritus | Systematic Review

The Effect of Placebo on Pruritus in Patients with Chronic Urticaria: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials

Authors: Peiwen Xue, Haiyan Qin, Di Qin, Yunzhou Shi, Huijing Li, Tian Luo, Caiyun Shi, Yeliu Wang, Zihao Zhao, Wei Cao, Zihao Zou, Qian Yang, Rongjiang Jin, Juan Li, Xianjun Xiao

Published in: Clinical Drug Investigation

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Abstract

Background

The anti-pruritic effect of placebo in patients with chronic urticaria has gained increasing attention in clinical research. However, the extent of placebo effect and its influencing factors in the treatment of chronic urticaria are not well understood.

Objective

The objective of this systematic review and meta-analysis was to investigate the effect of placebo on pruritus in patients with chronic urticaria and to explore relevant influencing factors.

Methods

PubMed, Embase, Web of Science, Cochrane Library, and PsycINFO were searched from inception to 10 July, 2024. Primary outcome included pruritus scores. The secondary outcomes focused on global symptoms and quality of life. Subgroup analyses and meta-regression analyses were conducted based on drug types, sample size, participants’ age, and other variables. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and a trial sequential analysis were employed to establish the reliability of evidence.

Results

A total of 65 eligible publications (including 67 randomized controlled trials) involving 10,704 patients with chronic urticaria were included. The pruritus scores decreased following placebo treatment (moderate evidence). In addition, favorable results were observed in global symptoms (moderate evidence) and quality of life (low evidence) after placebo treatment. Subgroup analyses indicated that the type of active medication in intervention groups was an influencing factor of placebo effect of pruritus. Meta-regression analyses demonstrated that the anti-pruritic effect of placebo was inversely correlated with sample size and positively correlated with participants’ age. A trial sequential analysis provided further support for the anti-pruritic effect of placebo.

Conclusions

A substantial improvement of pruritus after placebo treatment was observed in patients with chronic urticaria. The anti-pruritic effect of placebo varied with sample size, participants’ age, and type of active medication used. Future research should further investigate the effect size of placebo and clarify the potential mechanism.

PROSPERO Registration

The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42023482608.
Appendix
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Metadata
Title
The Effect of Placebo on Pruritus in Patients with Chronic Urticaria: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials
Authors
Peiwen Xue
Haiyan Qin
Di Qin
Yunzhou Shi
Huijing Li
Tian Luo
Caiyun Shi
Yeliu Wang
Zihao Zhao
Wei Cao
Zihao Zou
Qian Yang
Rongjiang Jin
Juan Li
Xianjun Xiao
Publication date
06-09-2024
Publisher
Springer International Publishing
Published in
Clinical Drug Investigation
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI
https://doi.org/10.1007/s40261-024-01389-5