A Relevant Midterm (12 Months) Placebo Effect on Lower Urinary Tract Symptoms and Maximum Flow Rate in Male Lower Urinary Tract Symptom and Benign Prostatic Hyperplasia—A Meta-analysis

Eredics, Klaus; Madersbacher, Stephan; Schauer, Ingrid

doi:10.1016/j.urology.2017.05.011

Cited by 25 publications

(22 citation statements)

References 29 publications

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“…Furthermore, among works that support homoeopathy efficacy, one review studied individualised homoeopathy for fibromyalgia (Baranowsky et al, ) and the other one both individualised and non‐individualised homoeopathy for IBS (Peckham et al, ), health conditions recognised to show significant response to placebo (Supporting Information Table ) (Bradford & Meston, ; Brunoni, Lopes, Kaptchuk, & Fregni, ; Cepeda, Berlin, Gao, Wiegand, & Wada, ; Chen, Doherty, & Zhang, ; Dorn et al, ; Eredics, Madersbacher, & Schauer, ; Forsberg, Martinussen, & Flaten, ; Fulda & Wetter, ; Häuser, Bartram‐Wunn, Bartram, Reinecke, & Tölle, ; Hróbjartsson & Gøtzsche, ; Khan, Faucett, Lichtenberg, Kirsch, & Brown, ; Kuten‐Shorrer, Kelley, Sonis, & Treister, ; Lee, Malhotra, Creanga, Carlsson, & Glue, ; lovieno & Papakostas, ; Macedo, Farré, & Baños, ; Meissner, Distel, & Mitzdorf, ; Moncrieff, Wessely, & Hardy, ; Patel et al, ; Puhl, Reinhart, Rok, & Injeyan, ; Quinn & Colagiuri, ; Walsh, Seidman, Sysko, & Gould, ; Wilhelm, Winkler, Rief, & Doering, ; Yeung, Sharpe, Glozier, Hackett, & Colagiuri, ; Zhang, Robertson, Jones, Dieppe, & Doherty, ). Accordingly, these conditions tend to have good response to placebo in classical trial designs.…”

Section: Discussionmentioning

confidence: 99%

“…Several conditions show a greater response to placebos than others, and many studies were performed to assess the magnitude of placebo response in various conditions. Some of these placebo‐responsive conditions, both chronic and “short‐term” ones, are pain (and low back pain), IBS, hypertension, insomnia symptoms, women's sexual dysfunction, major depressive disorder, osteoarthritis, lower urinary tract symptoms, overactive bladder, restless legs syndrome, fibromyalgia, diabetic peripheral neuropathy, nausea, and burning mouth syndrome (Bradford & Meston, ; Brunoni et al, ; Cepeda et al, ; Chen et al, ; Dorn et al, ; Eredics et al, ; Forsberg et al, ; Fulda & Wetter, ; Häuser et al, ; Hróbjartsson & Gøtzsche, ; Khan et al, ; Kuten‐Shorrer et al, ; Lee et al, ; lovieno and Papakostas, ; Macedo et al, ; Meissner et al, ; Moncrieff et al, ; Patel et al, ; Puhl et al, ; Quinn & Colagiuri, ; Walsh et al, ; Wilhelm et al, ; Yeung et al, ; Zhang et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Even if more studies are needed to consider placebo treatments as an evidence‐based practice, current evidence about OLP treatments outline a promising field, and several clues already indicate the possible range of application of such treatments (Bradford & Meston, ; Brunoni et al, ; Carvalho et al, ; Cepeda et al, ; Chen et al, ; Dorn et al, ; Eredics et al, ; Forsberg et al, ; Fulda & Wetter, ; Häuser et al, ; Hoenemeyer et al, ; Hróbjartsson & Gøtzsche, ; Kam‐Hansen et al, ; Kaptchuk et al, ; Kelley et al, ; Khan et al, ; Kuten‐Shorrer et al, ; Lee et al, ; Locher et al, ; lovieno and Papakostas, ; Macedo et al, ; Meeuwis et al, ; Meissner et al, ; Moncrieff et al, ; Patel et al, ; Puhl et al, ; Quinn & Colagiuri, ; Sandler & Bodfish, ; Sandler et al, ; Schaefer et al, ; Walsh et al, ; Wilhelm et al, ; Yeung et al, ; Zhang et al, ). Data show that placebos may have a role in helping patients in different clinical conditions, for example individuals affected by different diseases may benefit from placebo effects for symptom relief (Forsberg et al, ; Locher et al, ; Meeuwis et al, ; Quinn & Colagiuri, ; Yeung et al, ).…”

Section: Discussionmentioning

confidence: 99%

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Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review

Antonelli

Donelli²

2018

Health Soc Care Community

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Homoeopathy is widespread, and users claim to benefit from it. However, clear evidence of its efficacy over placebo is not available to date. As a consequence, a social separation between homoeopathy users and mainstream medicine exists, exposing these patients to many risks. Our primary objective is to assess homoeopathy efficacy by systematically reviewing existing systematic reviews and meta-analyses and to systematically review trials on open-label placebo (OLP) treatments. A secondary objective is to understand if homoeopathy as a whole may be considered as a placebo treatment. PubMed/Medline, Embase, Google Scholar, and Cochrane Library were systematically searched for systematic reviews and meta-analyses on homoeopathy efficacy, and 61 studies were included. Same databases plus Journal of Interdisciplinary Placebo Studies (JIPS) were also systematically searched for randomised controlled trials (RCTs) on OLP treatments, and 10 studies were included. Databases were searched up to 24 February 2018. Two authors independently screened all retrieved articles and selected studies eligible for inclusion. The quality of reviews of included studies was evaluated with a dedicated NIH tool in the first review, whereas the risk of bias of trials of included studies was assessed with the specific Cochrane tool in the second review.Qualitative syntheses show that homoeopathy efficacy can be considered comparable to placebo, and that OLP treatments may be effective in some health conditions. Placebo effects like placebo itself, treatment context, physician-patient relationship, and other nonspecific factors can define the idea of placebo treatments, which may be effective in some conditions. If homoeopathy efficacy is comparable to placebo, and if placebo treatments can be effective in some conditions, then homoeopathy as a whole may be considered as a placebo treatment. Reinterpreting homoeopathy as a placebo treatment would define limits and possibilities of this practice. This perspective shift suggests a strategy to manage patients who seek homoeopathic care and to reconcile them with mainstream medicine in a sustainable way. K E Y W O R D S complementary and alternative medicine, homoeopathy, open-label placebo, patientphysician relationship, placebo effects, placebo treatment

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review

Antonelli

Donelli²

2018

Health Soc Care Community

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“…LUTS are particularly susceptible to placebo [31]. In fact, randomised controlled trials conducted with synthetic drugs and plant extracts have coherently demonstrated considerable placebo effects which lead to clinically relevant improvements in LUTS after 12 months [32]. Patients always experience placebo and active treatment effects as a sum, and one should be aware that placebo effects account for 40-60% of the overall improvement.…”

Section: The Effects Of Specific Plant Extracts Are Equal To Those Ofmentioning

confidence: 99%

“…Even with prescription drugs, the therapeutic outcome barely goes beyond the placebo effect. Actually, α 1 -blockers have failed to achieve a clinically meaningful 3-point difference over placebo [31][32][33].…”

Section: The Effects Of Specific Plant Extracts Are Equal To Those Ofmentioning

confidence: 99%

Phytotherapy Adds to the Therapeutic Armamentarium for the Treatment of Mild-To-Moderate Lower Urinary Tract Symptoms in Men

Fornara¹,

Madersbacher²,

Vahlensieck³

et al. 2019

Urol Int

Self Cite

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Background: Practice guidelines hardly recommend herbal extracts for male lower urinary tract symptoms (LUTS). However, many patients are unsatisfied with first-line synthetic drugs and often prefer herbal medicines because of good tolerability. To improve the decision-making process, which should consider the patients' expectations, it is crucial to reflect on the role of phytotherapy in the treatment of LUTS. We (panel experts) reflected on current guideline recommendations and real practice across various European countries and debated the potential role of plant extracts with a focus on pumpkin seed soft extract investigated over 12 months in two randomised placebo-controlled trials. Summary: Most guidelines give no clear recommendations on phytotherapy due to the heterogeneity of clinically investigated extracts. Nevertheless, plant extracts are prescribed to patients with mild-to-moderate LUTS. Also, self-medicating patients often handle their complaints with herbal products. Many patients aim to avoid synthetic drugs for fear of sexual functional side effects and a negative impact on their quality of life. For the elderly, vasoactive comedications might be-come an issue. When taking plant extracts, patients experience an acceptable symptomatic relief similar to that achieved with synthetics but without side effects. Key Messages: In shared decision-making for purely symptomatic treatment, a low risk of side effects takes priority. We propose to consider patient preferences in the treatment of mild-to-moderate LUTS in men with a low risk of disease progression. We found a consensus that pumpkin seed soft extract adds to the therapeutic armamentarium for patients who cannot or do not want to apply synthetic drugs.

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Inhibition of human prostate smooth muscle contraction by the inhibitors of protein kinase C, GF109203X, and Go6983

Huang

Liu

et al. 2021

The Prostate

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Introduction: Prostate smooth muscle contraction is promoted by receptor-induced activation of intracellular signaling pathways. The presumed involvement in etiology and medical treatment of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) imparts a high clinical relevance to prostate smooth muscle contraction, which is contrasted by incomplete understanding at the molecular level. Involvement of protein kinase C (PKC) has been commonly assumed, but available studies were limited to nonhuman prostate smooth muscle or cell cultures.Here, we examined the effects of the PKC inhibitors Go6983 and GF109203x on contractions of human prostate tissues.Methods: Prostate tissues were obtained from radical prostatectomy. Contractions were induced by electric field stimulation (EFS), α 1 -adrenergic agonists (noradrenaline, phenylephrine, methoxamine), thromboxane A 2 analog U46619, endothelin-1, or calcium chloride in an organ bath.Results: GF109203X (500 nM) and Go6983 (300 nM) reduced EFS-, noradrenaline-, phenylephrine-, methoxamine-, and U46619-induced contractions of human prostate tissues, with maximum inhibitions approaching up to 55%. Using concentrations of 3 µM, GF109203X and Go6983 inhibited EFS-and noradrenaline-induced contractions, with similar effect sizes as 500 and 300 nM, respectively. Endothelin-1induced contractions were not inhibited by GF109203X, and to neglectable extent by Go6983. After depolarization in calcium-free solution, calcium chloride-induced concentration-dependent contractions, which were inhibited by GF109203X and Go6983.Conclusions: GF109203X and Go6983 inhibit neurogenic, α 1 -adrenergic, and thromboxane A 2 -induced smooth muscle contractions in the human prostate, suggesting a role of PKC for human prostate smooth muscle contraction. The inhibition may by be imparted by inhibition of calcium sensitivity.

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A Relevant Midterm (12 Months) Placebo Effect on Lower Urinary Tract Symptoms and Maximum Flow Rate in Male Lower Urinary Tract Symptom and Benign Prostatic Hyperplasia—A Meta-analysis

Cited by 25 publications

References 29 publications

Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review

Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review

Phytotherapy Adds to the Therapeutic Armamentarium for the Treatment of Mild-To-Moderate Lower Urinary Tract Symptoms in Men

Inhibition of human prostate smooth muscle contraction by the inhibitors of protein kinase C, GF109203X, and Go6983

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