Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Pregabalin for HIV related distal sensory peripheral neuropathy

Paul Sax, MD
Meds
November 24, 2010
Share
Tweet
Share

Published earlier this year in the journal Neurology – not typically on my radar screen — is this remarkable study comparing pregabalin to placebo for HIV-related distal sensory peripheral neuropathy.

Here are the results:

At endpoint, pregabalin and placebo showed substantial reductions in mean Numeric Pain Rating Scale (NPRS) score from baseline: -2.88 vs -2.63, p = 0.3941 …

… Individuals with HIV-associated neuropathy achieved NPRS treatment effect size similar to those in studies of diabetic peripheral and postherpetic neuralgia. However, the placebo group in the current study had a much higher NPRS change than in the diabetic peripheral neuropathy or postherpetic neuralgia studies

In other words, the pregabalin here worked great, but the placebo effect was so gargantuan that the placebo was just as good.

Writing in Journal Watch: AIDS Clinical Care, the always-astute Abbie Zuger has a theory why this happened:

Notably, this study is not the first in which a treatment for HIV-related peripheral neuropathy has elicited an unusually high placebo response. The reasons behind that phenomenon would be extremely interesting to pursue — might HIV-positive individuals have greater faith in the power of medication than do others?

I think she’s on to something important here.  After all, in how many other diseases can patients so directly link the medications they are taking to their own survival?

And we clinicians who practice HIV medicine should keep this in mind when prescribing medications to our patients.  Strong mutual conviction that something will work— from both provider and patient — may well be a self-fulfilling prophecy.

Why not leverage this for all it’s worth?

Paul Sax is the Clinical Director of Infectious Diseases at Brigham and Women’s Hospital. His blog HIV and ID Observations, is part of Journal Watch, where he is Editor of Journal Watch AIDS Clinical Care.

Submit a guest post and be heard .

Prev

Bedbug rashes, and how to prevent and get rid of bedbugs

November 24, 2010 Kevin 1
…
Next

Talk with your family about their end of life wishes

November 25, 2010 Kevin 1
…

Tagged as: Medications

Post navigation

< Previous Post
Bedbug rashes, and how to prevent and get rid of bedbugs
Next Post >
Talk with your family about their end of life wishes

ADVERTISEMENT

More by Paul Sax, MD

  • An infectious disease doctor answers your COVID-19 and coronavirus questions

    Paul Sax, MD
  • When should physicians read the House of God?

    Paul Sax, MD
  • Should we write that patients are “pleasant” in medical notes?

    Paul Sax, MD

More in Meds

  • How medicine repurposing enables value-based pain management and insomnia therapy

    Olumuyiwa Bamgbade, MD
  • Forced voicemail and diagnosis codes are endangering patient access to medications

    Arthur Lazarus, MD, MBA
  • From stigma to science: Rethinking the U.S. drug scheduling system

    Artin Asadipooya
  • How drugmakers manipulate your health from diagnosis to prescription

    Martha Rosenberg
  • The food-drug interaction risks your doctor may be missing

    Frank Jumbe
  • Why retail pharmacies are the future of diverse clinical trials

    Shelli Pavone
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why doctors must stop ignoring unintentional weight loss in patients with obesity

      Samantha Malley, FNP-C | Conditions
    • Why more doctors are choosing direct care over traditional health care

      Grace Torres-Hodges, DPM, MBA | Physician
    • Why hospitals are quietly capping top doctors’ pay

      Dennis Hursh, Esq | Conditions
    • Why point-of-care ultrasound belongs in emergency department triage

      Resa E. Lewiss, MD and Courtney M. Smalley, MD | Conditions
    • Why point-of-care ultrasound belongs in every emergency department triage [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why PSA levels alone shouldn’t define your prostate cancer risk

      Martina Ambardjieva, MD, PhD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why doctors must stop ignoring unintentional weight loss in patients with obesity

      Samantha Malley, FNP-C | Conditions
    • Why more doctors are choosing direct care over traditional health care

      Grace Torres-Hodges, DPM, MBA | Physician
    • Why hospitals are quietly capping top doctors’ pay

      Dennis Hursh, Esq | Conditions
    • Why point-of-care ultrasound belongs in emergency department triage

      Resa E. Lewiss, MD and Courtney M. Smalley, MD | Conditions
    • Why point-of-care ultrasound belongs in every emergency department triage [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why PSA levels alone shouldn’t define your prostate cancer risk

      Martina Ambardjieva, MD, PhD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...