A randomized, blinded, placebo-controlled trial comparing antibody responses to homeopathic and conventional vaccines in university students

Presentation and Analysis of the Online Evidence Gap Map, "Clinical Effectiveness of Homeopathy"

INTRODUCTION AND OBJECTIVE

 This study presents and analyzes the content of an online Evidence Gap Map (EGM), "Clinical Effectiveness of Homeopathy, 1st Edition", which graphically represents evidence from systematic reviews (SRs) of human clinical trials in homeopathy that were published from 1991 to 2021. The EGM was built according to the guidelines of the International Initiative for Impact Evaluation (3ie), adapted for complex interventions, to represent visually relevant evidence and research gaps.

PRESENTATION OF EVIDENCE GAP MAP CONTENT

 The interventions, classified as rows, are characterized in the EGM not only by the homeopathic therapeutic strategy but also by individual medicines and potencies. The outcomes are listed in columns. The associations between both are represented by "bubbles" that refer to the corresponding SRs and whose colors indicate their quality level.

SYNTHESIS OF EVIDENCE GAP MAP CONTENT

 From 239 citations identified, 51 SRs underwent complete characterization for the final construction of the EGM. A further in-depth quality analysis of each SR was performed to list the studied intervention/outcome associations described in each mentioned trial. At this step, those trials considered to have a high risk of bias by the authors of each SR were excluded from the EGM inputs.

ANALYSIS OF EVIDENCE GAP MAP CONTENT

 The methodological quality of each of the EGM's SRs was evaluated using the AMSTAR-2 criteria for level of confidence in an SR's results. Intervention-outcome associations were categorized into one of five effects of a homeopathic intervention: positive, potentially positive, ineffective, inconclusive, or negative.

FINDINGS

 The EGM presents research evidence across a wide range of medical conditions, with substantial heterogeneity of homeopathic interventions and clinical outcomes. Forty-two of the 51 SRs yielded inconclusive findings. AMSTAR-2 analysis identified seven high-quality SRs, in which reliable primary studies presenting positive or potentially positive results for different categories of homeopathy are cited and related to specific clinical conditions: fibromyalgia, otitis media, diarrhea, respiratory infections, menopausal syndrome, irritable bowel syndrome, and attention deficit hyperactivity disorder in children.

CONCLUSION

 The EGM "Clinical Effectiveness of Homeopathy, 1st Edition" presents visually relevant research evidence that is scattered across a large number of medical conditions, showing substantial heterogeneity of homeopathic interventions, clinical outcomes, and research quality. To enhance the precision and relevance of future research, we recommend that the individualized homeopathic approach under investigation be standardized to the greatest extent feasible, and to use measures of well-being and quality of life as primary outcomes.

Safety and Evaluation of the Immune Response of Coronavirus Nosode (BiosimCovex) in Healthy Volunteers: A Preliminary Study Extending the Homeopathic Pathogenetic Trial

Objectives: Regulatory clinical Phase I studies are aimed at establishing the human safety of an active pharmaceutical agent to be later marketed as a drug. Since homeopathic medicines are prepared by a potentizing method using alcohol, past a certain dilution, their toxicity/infectivity is assumed to be unlikely. We aimed to develop a bridge study between homeopathic pathogenetic trials and clinical trials. The primary purpose was to evaluate the safety of a nosode, developed from clinical samples of a COVID-19 patient. The secondary objectives were to explore whether a nosode developed for a specific clinical purpose, such as use during an epidemic, may elicit laboratory signals worthy of further exploration. Methods: An open-label study was designed to evaluate the safety and immune response of the Coronavirus nosode BiosimCovex, given orally on three consecutive days to ten healthy volunteers. Clinical examinations, laboratory safety and immune parameters were established. Interferon-gamma, Interleukin-6, and CD 4 were measured. (CTRI registration number: CTRI/2020/05/025496). Results: No serious/fatal adverse events were reported. Laboratory tests to measure safety were unchanged. Three subjects showed elevated Interleukin-6 (IL-6) on day 17 in comparison to the baseline, and ten subjects showed elevated IL-6 on day 34. A significant difference between IL-6 observations, calculated by repeated measures ANOVA, was found to be highly significant. On day 60, the IL-6 values of nine subjects were found to return to normal. Corresponding CD4 cell elevation was observed on day 60, when compared to day 34. Conclusions: HPT may potentially extend into physiological changes with regards to immune response and should encourage future studies.

Consumption of Herbal Supplements or Homeopathic Remedies to Prevent COVID-19 and Intention of Vaccination for COVID-19 in Latin America and the Caribbean

Users of complementary and alternative medicine (CAM) have a lower intention to receive vaccines. Furthermore, Latin America and the Caribbean (LAC) region are among the most affected areas by the COVID-19 pandemics and present a high proportion of CAM users. Therefore, this study evaluates the association between the consumption of herbal supplements or homeopathic remedies to prevent COVID-19 and the intention to vaccinate against COVID-19 in the LAC region. We conducted a secondary data analysis of a Massachusetts Institute of Technology (MIT) survey with Facebook to assess COVID-19 beliefs, behaviours, and norms. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated using generalized linear models of the Poisson family with the log link function. The prevalence of the use of products to prevent COVID-19 was the following: consumption of herbal supplements (7.2%), use of homeopathic remedies (4.8%), and consumption of garlic, ginger, and lemon (11.8%). An association was found between using herbal supplements (19.0% vs. 12.8%; aPR = 1.44; 95% CI: 1.30–1.58), the use of homeopathic remedies (20.3% vs. 12.3%; aPR = 1.58; 95% CI: 1.25–1.98), and the consumption of garlic, ginger, and lemon (18.9% vs. 11.9%; aPR = 1.55; 95% CI: 1.50–1.61) and non-intention to vaccinate against COVID-19. In the LAC population, there is an association between using herbal supplements, using homeopathic remedies and consuming garlic, ginger, and lemon to prevent infection by COVID-19 and non-intention to vaccinate against this disease. Therefore, it is necessary to design targeted strategies for groups that consume these products as preventive measures against COVID-19 to increase vaccination coverage and expand the information regarding transmission and prevention strategies for SARS-CoV-2.