Global recruitment patterns and placebo responses in clinical trials of rheumatoid arthritis
Primary result · Association of GNI with ACR20 placebo response rateResult — go to the resultβ −3.7 % placebo response per 10 000 international dollars 95% CI −5.61 to −1.80Authors' conclusion
Our findings indicate that recruiting patients from lower-income countries is associated with higher placebo response rates, whereas active treatment responses remain stable.
Study context
- Population
- Randomised controlled trials investigating targeted therapeutics in rheumatoid arthritis (RA)
- Participants
- 14,272 participants124 trials
- Comparison
- Per-capita gross national income (GNI) of recruiting countries and placebo response rates
- Primary endpoint
- ACR20 placebo response rate
Methodological detailslinear mixed models, validated with patient-level data from one global RCT
- Linear mixed models
- Validated with patient-level data from one global RCT
Primary result
As reported in the abstract
Association of GNI with ACR20 placebo response rate
β
−3.7 % placebo response per 10 000 international dollars
95% CI −5.61 to −1.80
P < 0.001
Further findings
Alternative socioeconomic metrics (Human Development Index, out-of-pocket health expenditures) and individual patient-level geographic data
- Results confirmed using alternative metrics as well as geographic data on individual patient level
Association compared with active treatment responses
- Meaningful difference of this association when compared to active treatment responses
Original publication
Global recruitment patterns and placebo responses in clinical trials of rheumatoid arthritis. Ann Rheum Dis. Published 5 August 2025. doi:10.
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