Albuterol Inhaler And Placebo Are Subjectively Equal In The Treatment Of Asthma

by Dr Sam Girgis on July 16, 2011

The successful treatment of asthma can be measured in several ways such as the subjective improvement felt by the patient and the physiologic response to medication.  Researchers lead by Dr. Michael Wechsler, from Harvard Medical School, studied the effects of a bronchodilator, two placebo interventions, and no intervention on asthma patients.  The results were very remarkable and showed that on a subjective basis, placebo was equally as beneficial in asthma patients as albuterol treatment.  The results of their study were published online in the current issue of the New England Journal Of Medicine.  The researchers used a double blind crossover study to randomly assign 46 patients with asthma to receive treatment with placebo inhaler, sham acupuncture, albuterol inhaler, or no medical treatment.  The researchers rotated these treatments in random order during the visits for a total of 12 treatment visits for each patient.  In addition, the researchers tested the response to treatment by using spirometry to measure forced expiratory volume in 1 second (FEV1).  The subjective response to the treatments was also recorded for each study participant.  Of the 46 study participants, 39 completed the entire study.  The researchers found that albuterol inhaler resulted in a 20% increase in the FEV1, while the other three interventions resulted in a 7% increase in the FEV1.  Despite these statistically significant differences in recorded physiological response to treatment, the subjective response to treatment as reported by the participants was equally beneficial among albuterol inhaler and placebo.  In other words, the actual treatment was equally as good as the placebo in causing a feeling of improvement.  The researchers wrote, “Placebo effects can be clinically meaningful and can rival the effects of active medication in patients with asthma”.  It is important to note that although the participants reported feeling better with the placebo treatment, they did not have an actual improvement in their lung function as measured by FEV1.  This study adds to the already existence body of evidence that shows that the placebo effect can have a strong influence on the subjective feelings of patients to treatment.


Michael E. Wechsler et al. “Active Albuterol or Placebo, Sham Acupuncture, or No Intervention in AsthmaN Engl J Med published July 14, 2011.

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