Treatment response patterns and effect size over time in exclusively placebo-controlled trials. Treatment response patterns and effect size over time in exclusively placebo-controlled trials. A: Scatter plot of HbA1c reduction in 22 placebo group treatment arms and 47 antihyperglycemic medication treatment arms plotted with year of approval. A significant meta-regression predicting placebo response (dashed line) based on year of approval was found (P = 0.0013), with an R2 of 0.31. Placebo response increased by 0.035 for each year following 1999. The linear meta-regression to predict antihyperglycemic response (solid line) based on year of approval was also found to be significant (P = 0.0498), with an R2 of 0.076. Drug response increased by 0.017 for each year following 1999. B: Scatter plot of effect sizes for 47 treatment arms plotted with year of approval. A linear meta-regression predicting effect size based on year of approval was found not to be significant (P = 0.725), with an R2 of 0.003. Arif Khan et al. Dia Care 2018;41:994-1000 ©2018 by American Diabetes Association