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2015 ; 21
(5
): 285-94
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Genetics and the placebo effect: the placebome
#MMPMID25883069
Hall KT
; Loscalzo J
; Kaptchuk TJ
Trends Mol Med
2015[May]; 21
(5
): 285-94
PMID25883069
show ga
Placebos are indispensable controls in randomized clinical trials (RCTs), and
placebo responses significantly contribute to routine clinical outcomes. Recent
neurophysiological studies reveal neurotransmitter pathways that mediate placebo
effects. Evidence that genetic variations in these pathways can modify placebo
effects raises the possibility of using genetic screening to identify placebo
responders and thereby increase RCT efficacy and improve therapeutic care.
Furthermore, the possibility of interaction between placebo and drug molecular
pathways warrants consideration in RCT design. The study of genomic effects on
placebo response, 'the placebome', is in its infancy. Here, we review evidence
from placebo studies and RCTs to identify putative genes in the placebome,
examine evidence for placebo-drug interactions, and discuss implications for RCTs
and clinical care.