Abstract
This randomized clinical trial assessed the effect of patients’ treatment expectations on the efficacy of propranolol vs placebo among patients with temporomandibular disorder–associated myalgia.
Highlights
Amid the United States’ chronic pain crisis, novel analgesics are failing to show efficacy in clinical trials.[1]
The relatively small sample size limited the power to test if the magnitude of effect of propranolol on temporomandibular disorder–associated pain differed by treatment expectation, yet our findings offer credible evidence of interaction
Few clinical or psychological factors were associated with heightened expectation, with sensitivity to experimental pressure pain being the exception
Summary
Amid the United States’ chronic pain crisis, novel analgesics are failing to show efficacy in clinical trials.[1] High failure rates are attributed to an upward trend in placebo response,[2] driven by patients’ heightened expectation of treatment benefit.[3] We hypothesized that heightened expectations differentially amplify placebo analgesia, leading to underestimation of the treatment effect in randomized clinical trials
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