- MeSH
- Biological Therapy * MeSH
- Biosimilar Pharmaceuticals economics therapeutic use MeSH
- Health Services Accessibility economics organization & administration MeSH
- Humans MeSH
- Nocebo Effect MeSH
- Surveys and Questionnaires MeSH
- Arthritis, Rheumatoid * economics drug therapy MeSH
- Patient Education as Topic MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
A placebo is an inert substance normally used in clinical trials for comparison with an active substance. However, a placebo has been shown to have an effect on its own; commonly known as the placebo effect. A placebo is an essential component in the design of conclusive clinical trials but has itself become the focus of intense research. The placebo effect is partly the result of positive expectations of the recipient on the state of health. Conversely, a nocebo effect is when negative expectations from a substance lead to poor treatment outcomes and/or adverse events. Randomized controlled trials in functional urology have demonstrated the importance of the placebo and nocebo effects across different diseases such as overactive bladder, urinary incontinence, lower urinary tract symptoms and interstitial cystitis/painful bladder syndrome, as well as male and female sexual dysfunction. Understanding the true nature of the placebo-nocebo complex and the scope of its effect in functional urology could help urologists to maximize the positive effects of this phenomenon while minimizing its potentially negative effects.
- MeSH
- Humans MeSH
- Nocebo Effect MeSH
- Placebo Effect MeSH
- Lower Urinary Tract Symptoms * MeSH
- Urology * MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- MeSH
- Antirheumatic Agents classification therapeutic use MeSH
- Biological Therapy MeSH
- Biosimilar Pharmaceuticals * economics therapeutic use MeSH
- Humans MeSH
- Nocebo Effect MeSH
- Rheumatic Diseases * epidemiology drug therapy MeSH
- Inflammation epidemiology drug therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Pain * history etiology MeSH
- Pain Measurement MeSH
- Nocebo Effect MeSH
- Analgesics, Opioid MeSH
- Placebo Effect * MeSH
- Animals * MeSH
- Check Tag
- Animals * MeSH
- Publication type
- Review MeSH
- MeSH
- Biosimilar Pharmaceuticals * therapeutic use MeSH
- Humans MeSH
- Neoplasms drug therapy MeSH
- Drug Substitution ethics MeSH
- Drug Costs MeSH
- Nocebo Effect MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
The nocebo effect is defined as the incitement or the worsening of symptoms induced by any negative attitude from non-pharmacological therapeutic intervention, sham, or active therapies. When a patient anticipates a negative effect associated with an intervention, medication or change in medication, they may then experience either an increase in this effect or experience it de novo. Although less is known about the nocebo effect compared with the placebo effect, widespread interest in the nocebo effect observed with statin therapy and a literature review highlighting the nocebo effect across at least ten different disease areas strongly suggests this is a common phenomenon. This effect has also recently been shown to play a role when introducing a medication or changing an established medication, for example, when switching patients from a reference biologic to a biosimilar. Given the important role biosimilars play in providing cost-effective alternatives to reference biologics, increasing physician treatment options and patient access to effective biologic treatment, it is important that we understand this phenomenon and aim to reduce this effect when possible. In this paper, we propose three key strategies to help mitigate the nocebo effect in clinical practice when switching patients from reference biologic to biosimilar: positive framing, increasing patient and healthcare professionals' understanding of biosimilars and utilising a managed switching programme.
- MeSH
- Analgesia MeSH
- beta-Endorphin physiology secretion MeSH
- Humans MeSH
- Nocebo Effect MeSH
- Opioid Peptides physiology secretion MeSH
- Pain Perception MeSH
- Placebo Effect * MeSH
- Receptors, Dopamine MeSH
- Receptors, Opioid agonists physiology MeSH
- Gray Matter anatomy & histology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- History of Medicine MeSH
- Informed Consent * standards legislation & jurisprudence MeSH
- Ethics, Medical MeSH
- Psychology, Medical MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions etiology psychology MeSH
- Nocebo Effect * MeSH
- Parasympathetic Nervous System physiology physiopathology MeSH
- Pathological Conditions, Signs and Symptoms * MeSH
- Shamanism history MeSH
- Sympathetic Nervous System physiology physiopathology MeSH
- Legislation, Medical MeSH
- Check Tag
- Humans MeSH
