1
|
Gaertner K, Beer AM, Matthes H, Keusgen M, Frass M, Teut M, Steinmann D, Etter G, Geiger M, Weiermayer P. [Argument for an objective review of the available evidence on homeopathy in rheumatic diseases]. Z Rheumatol 2023; 82:711-713. [PMID: 37792029 DOI: 10.1007/s00393-023-01423-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Katharina Gaertner
- Institut für Integrative Medizin, Universität Witten/Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Deutschland.
| | - André-Michael Beer
- Klinik für Naturheilkunde, Katholisches Klinikum Bochum, Klinik Blankenstein, Hattingen, Deutschland
| | | | | | - Michael Frass
- Institut für Homöopathieforschung, Wissenschaftliche Gesellschaft für Homöopathie (WissHom), Köthen, Wien, Österreich
| | - Michael Teut
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Diana Steinmann
- Medizinische Hochschule Hannover, Klinik für Strahlentherapie und Spezielle Onkologie, Bereichsleitung Klaus-Bahlsen-Zentrum für Integrative Onkologie am CCC Hannover, Hannover, Deutschland
| | - Gisela Etter
- UNION Schweizerischer komplementärmedizinischer Ärzteorganisationen, Luzern, Schweiz
| | - Michaela Geiger
- Deutscher Zentralverein homöopathischer Ärzte (DZVhÄ), Berlin, Deutschland
| | - Petra Weiermayer
- Wissenschaftliche Gesellschaft für Homöopathie (WissHom), Köthen, Deutschland
| |
Collapse
|
2
|
Keyßer G. [Rheumatology and homeopathy-A critical discussion]. Z Rheumatol 2023; 82:714-717. [PMID: 37792030 DOI: 10.1007/s00393-023-01427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Gernot Keyßer
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Halle (Saale), Ernst-Grube-Str. 40, 06120, Halle, Deutschland.
| |
Collapse
|
3
|
Gaertner K, Loef M, Frass M, Mittal R, Khurana A, Manchanda R, von Ammon K, Frei-Erb M, Walach H, Baumgartner S. Bibliography of Homeopathic Intervention Studies (HOMIS) in Human Diseases. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:14-21. [PMID: 36190509 DOI: 10.1089/jicm.2022.0523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives: Homeopathy (HOM) is a therapeutic method, which is widely used by patients and medical professionals. The medical conditions as well as the homeopathic medical products investigated vary strongly. There is an extensive amount of research, and this necessitates a bibliography that comprehensively presents the entire body of clinical evidence grouped according to medical conditions. Design: Thirty-seven online sources as well as print libraries were searched for HOM and related terms in eight languages (1980 to March 2021). We included studies that compared a homeopathic medicine or intervention with a control regarding the therapeutic or preventive outcome of a disease (classified according to International Classification of Diseases-10). The data were extracted independently by two reviewers and analyzed descriptively. Results: A total of 636 investigations met the inclusion criteria, of which 541 had a therapeutic and 95 a preventive purpose. Seventy-three percent were randomized controlled trials (n = 463), whereas the rest were non-randomized studies (n = 173). The leading comparator was placebo (n = 400). The type of homeopathic intervention was classified as multi-constituent or complex (n = 272), classical or individualized (n = 176), routine or clinical (n = 161) and isopathic (n = 19), or various (n = 8). The potencies ranged from 1X (dilution of -10,000) to 10 M (100-10.000). The included studies explored the effect of HOM in 223 medical indications. We present the evidence in an online database. Conclusions: This bibliography maps the status quo of clinical research in HOM. The data will serve for future targeted reviews, which may focus on the most studied conditions and/or homeopathic medicines, clinical impact, and the risk of bias of the included studies.
Collapse
Affiliation(s)
- Katharina Gaertner
- Institute of Integrative Medicine, University of Witten/Herdecke, Herdecke, Germany
| | - Martin Loef
- Change Health Science Institute, Berlin, Germany
| | - Michael Frass
- Institute for Homeopathic Research, Vienna, Austria.,Scientific Society for Homeopathy, Koethen, Germany
| | - Renu Mittal
- Central Council for Research in Homeopathy (CCRH), Ministry of AYUSH, New Delhi, India
| | - Anil Khurana
- Central Council for Research in Homeopathy (CCRH), Ministry of AYUSH, New Delhi, India
| | - Rajkumar Manchanda
- Central Council for Research in Homeopathy (CCRH), Ministry of AYUSH, New Delhi, India
| | - Klaus von Ammon
- Scientific Society for Homeopathy, Koethen, Germany.,Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland
| | - Martin Frei-Erb
- Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland
| | | | - Stephan Baumgartner
- Institute of Integrative Medicine, University of Witten/Herdecke, Herdecke, Germany.,Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
4
|
Antonelli M, Donelli D. Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:824-847. [PMID: 30456773 DOI: 10.1111/hsc.12681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/10/2018] [Accepted: 10/12/2018] [Indexed: 06/09/2023]
Abstract
Homoeopathy is widespread, and users claim to benefit from it. However, clear evidence of its efficacy over placebo is not available to date. As a consequence, a social separation between homoeopathy users and mainstream medicine exists, exposing these patients to many risks. Our primary objective is to assess homoeopathy efficacy by systematically reviewing existing systematic reviews and meta-analyses and to systematically review trials on open-label placebo (OLP) treatments. A secondary objective is to understand if homoeopathy as a whole may be considered as a placebo treatment. PubMed/Medline, Embase, Google Scholar, and Cochrane Library were systematically searched for systematic reviews and meta-analyses on homoeopathy efficacy, and 61 studies were included. Same databases plus Journal of Interdisciplinary Placebo Studies (JIPS) were also systematically searched for randomised controlled trials (RCTs) on OLP treatments, and 10 studies were included. Databases were searched up to 24 February 2018. Two authors independently screened all retrieved articles and selected studies eligible for inclusion. The quality of reviews of included studies was evaluated with a dedicated NIH tool in the first review, whereas the risk of bias of trials of included studies was assessed with the specific Cochrane tool in the second review. Qualitative syntheses show that homoeopathy efficacy can be considered comparable to placebo, and that OLP treatments may be effective in some health conditions. Placebo effects like placebo itself, treatment context, physician-patient relationship, and other nonspecific factors can define the idea of placebo treatments, which may be effective in some conditions. If homoeopathy efficacy is comparable to placebo, and if placebo treatments can be effective in some conditions, then homoeopathy as a whole may be considered as a placebo treatment. Reinterpreting homoeopathy as a placebo treatment would define limits and possibilities of this practice. This perspective shift suggests a strategy to manage patients who seek homoeopathic care and to reconcile them with mainstream medicine in a sustainable way.
Collapse
Affiliation(s)
- Michele Antonelli
- Department of Medicine and Surgery, Institute of Public Health, University of Parma, Parma, Italy
- Terme di Monticelli, Parma, Italy
| | | |
Collapse
|
5
|
Mathie RT. Controlled clinical studies of homeopathy. HOMEOPATHY 2015; 104:328-32. [DOI: 10.1016/j.homp.2015.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/12/2015] [Accepted: 05/20/2015] [Indexed: 12/26/2022]
|
6
|
Koley M, Saha S, Ghosh S. A Double-Blind Randomized Placebo-Controlled Feasibility Study Evaluating Individualized Homeopathy in Managing Pain of Knee Osteoarthritis. J Evid Based Complementary Altern Med 2015; 20:186-91. [PMID: 25636410 DOI: 10.1177/2156587214568668] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 12/21/2014] [Indexed: 11/17/2022] Open
Abstract
Few homeopathic complexes seemed to produce significant effects in osteoarthritis; still, individualized homeopathy remained untested. We evaluated the feasibility of conducting an efficacy trial of individualized homeopathy in osteoarthritis. A prospective, parallel-arm, double-blind, randomized, placebo-controlled pilot study was conducted from January to October 2014 involving 60 patients (homeopathy, n = 30; placebo, n = 30) who were suffering from acute painful episodes of knee osteoarthritis and visiting the outpatient clinic of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, West Bengal, India. Statistically significant reduction was achieved in 3 visual analog scales (measuring pain, stiffness, and loss of function) and Osteoarthritis Research Society International scores in both groups over 2 weeks ( P < .05); however, group differences were not significant ( P > .05). Overall, homeopathy did not appear to be superior to placebo; still, further rigorous evaluation in this design involving a larger sample size seems feasible in future. Trial registration: Clinical Trials Registry, India (CTRI/2014/05/004589).
Collapse
Affiliation(s)
- Munmun Koley
- Clinical Research Unit (Homeopathy), Siliguri, under Central Council for Research in Homeopathy, Government of India, Gokhel Road, Arabindapally, Siliguri, Darjeeling, West Bengal, India
| | - Subhranil Saha
- Clinical Research Unit (Homeopathy), Siliguri, under Central Council for Research in Homeopathy, Government of India, Gokhel Road, Arabindapally, Siliguri, Darjeeling, West Bengal, India
| | - Shubhamoy Ghosh
- Department of Pathology and Microbiology, Mahesh Bhattacharyya Homeopathic Medical College and Hospital, Government of West Bengal, Howrah, West Bengal, India
| |
Collapse
|
7
|
|
8
|
Preethi K, Ellanghiyil S, Kuttan G, Kuttan R. Induction of apoptosis of tumor cells by some potentiated homeopathic drugs: implications on mechanism of action. Integr Cancer Ther 2011; 11:172-82. [PMID: 21771822 DOI: 10.1177/1534735411400310] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Homoeopathic medicines treat diseases, including cancer, using ultradiluted preparations. Earlier studies indicated that homoeopathic medicines are cytotoxic to tumor cells and reduced animal tumors. However, the mechanism of homoeopathic medicines at the cellular level is not known. METHODS The following drugs were used in the study: Ruta 200C, Carcinosinum 200C, Hydrastis 200C, Thuja 200C, and Thuja 1M. These drugs were tested for their ability to induce apoptosis as seen by morphology, DNA laddering, expression of genes related to apoptosis, and TUNEL assay. Similarly, the effect of homoeopathic medicines on apoptosis was measured by microarray analysis. Activity of Ruta 200C was compared with that of the mother tincture. RESULTS Ruta 200C produced morphological changes in the Dalton's lymphoma ascites tumor cells and induced DNA laddering. Carcinosinum 200C increased apoptotic gene p53 and Ruta 200C decreased antiapoptotic gene Bcl2. Administration of potentiated homoeopathic drugs to tumor-bearing mice induced TUNEL-positive cells in the tumor, showing increased apoptosis of tumor cells. Microarray analysis of cells treated with homoeopathic drugs indicated that many enzymes related to apoptosis were increased by homoeopathic drugs. CONCLUSION These data indicate that apoptosis is one of the mechanisms of tumor reduction of homeopathic drugs. A comparison of potentiated drugs with their mother tincture indicated that the potentiated drugs have biological activity similar to that of their mother tincture in spite of ultradilution.
Collapse
|
9
|
Jäger T, Scherr C, Simon M, Heusser P, Baumgartner S. Development of a test system for homeopathic preparations using impaired duckweed (Lemna gibba L.). J Altern Complement Med 2011; 17:315-23. [PMID: 21476829 DOI: 10.1089/acm.2010.0246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES A bioassay with arsenic-stressed duckweed (Lemna gibba L.) was developed to study potentially regulative effects of homeopathic preparations. We compared potentized substances (nine different potency levels between 17 x and 33 x ) with two controls (unsuccussed and succussed water) regarding their influence on number- and area-related growth rate and color of fronds (leaves). Screening included 11 potentized substances: Arsenicum album, gibberellic acid, nosode, arsenic(V), phosphorus, Conchae, Acidum picrinicum, Argentum nitricum, Crotalus horridus, Hepar sulfuris, and Mercurius vivus naturalis. DESIGN Duckweed was stressed with arsenic(V) for 48 hours. Afterwards, plants grew in either potentized substances or water controls for 6 days. Growth rate and color of fronds were determined with a computerized image analysis system for different time intervals (days 0-2, 2-6, 0-6). A systematic negative control experiment with unsuccussed water was used to investigate the stability of the bioassay. All experiments were randomized and blinded. RESULTS Arsenicum album and nosode potencies increased frond number-related growth rate compared to controls (succussed water controls or pooled water controls [succussed and unsuccussed], p < 0.05, t test). Regarding color classification, no effects were observed. CONCLUSIONS The experimental setup with L. gibba stressed by arsenic(V) provides a valuable tool to investigate regulative effects of potentized substances. In order to verify the effects of Arsenicum album and nosode potencies, further independent replication experiments are necessary.
Collapse
Affiliation(s)
- Tim Jäger
- Institute of Complementary Medicine KIKOM, University of Bern, Switzerland.
| | | | | | | | | |
Collapse
|
10
|
Furnham A, Chanda P. Does homoeopathy work? Part II: A review of recent scientific papers. ACTA ACUST UNITED AC 2010. [DOI: 10.1211/fact.13.3.0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
11
|
Isopathic treatment effects of Arsenicum album 45x on wheat seedling growth--further reproduction trials. HOMEOPATHY 2010; 98:198-207. [PMID: 19945675 DOI: 10.1016/j.homp.2009.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 09/18/2009] [Accepted: 09/28/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND Two experimental studies on wheat preintoxicated with Arsenic trioxide yielded a significant shoot growth increase after an isopathic application of Ars-alb 45x. One independent reproduction trial however, yielded an effect inversion: wheat shoot growth was significantly decreased after application of Ars-alb 45x. AIMS In this study we investigated the role of three potential confounding factors on the experimental outcome: geographical location of the experiments, influence of the main experimenter, and seed sensitivity to Arsenic poisoning. Laboratory-internal reproducibility was assessed by meta-analysis. MATERIAL AND METHODS Wheat poisoned with Arsenic trioxide was cultivated in vitro in either Ars-alb 45x, water 45x, or unpotentised water. Treatments were blinded and randomised. Shoot length was measured after 7 days. The stability of the experimental set-up was assessed by systematic negative control (SNC) experiments. RESULTS The SNC experiments did not yield significant differences between the three groups treated with unpotentised water. Thus the experimental set-up seemed to be stable. We did not observe any shoot growth increase after a treatment with Ars-alb 45x in any of the newly performed experiments. In contrast, the meta-analysis of all 17 experiments performed (including earlier experiments already published) yielded a statistically significant shoot growth decrease (-3.2%, p=0.017) with isopathic Ars-alb 45x treatment. This effect was quantitatively similar across all five series of experiments. CONCLUSIONS Ultramolecular Ars-alb 45x led to statistically significant specific effects in arsenic poisoned wheat when investigated by two independent working groups. Effect size and effect direction differ, however. The investigated factors (geographical location, experimenter, seed sensitivity to Arsenic poisoning) did not seem to be responsible for the effect inversion. Laboratory external reproducibility of basic research into homeopathic potentisation remains a difficult issue.
Collapse
|
12
|
Baumgartner S, Wolf M, Skrabal P, Bangerter F, Heusser P, Thurneysen A, Wolf U. High-field 1H T1 and T2 NMR relaxation time measurements of H2O in homeopathic preparations of quartz, sulfur, and copper sulfate. Naturwissenschaften 2009; 96:1079-89. [DOI: 10.1007/s00114-009-0569-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Revised: 04/11/2009] [Accepted: 05/18/2009] [Indexed: 10/20/2022]
|
13
|
|
14
|
Abstract
Many pediatric patients and their families use dietary supplements and homeopathy. They do not always disclose this information to their health care practitioners. It is important that health care practitioners are aware of the research available in these areas and discuss the use of these products openly with their patients. As part of that dialogue, clinicians need to consider what level of effectiveness is acceptable to support the use of these products by their patients. This risk-benefit appraisal should consider safety, effectiveness, the medical condition being treated, and the personal beliefs and preferences of patients and their families.
Collapse
Affiliation(s)
- Paula Gardiner
- Department of Family Medicine, Boston University Medical Center, 1 Boston Medical Center Place, Dowling 5 South, Boston, MA 02118, USA.
| | | |
Collapse
|
15
|
Fibromyalgia: an update for oral health care providers. ACTA ACUST UNITED AC 2007; 104:589-602. [DOI: 10.1016/j.tripleo.2007.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Revised: 05/05/2007] [Accepted: 05/11/2007] [Indexed: 11/22/2022]
|
16
|
Abstract
Homeopathy is a holistic method of treatment that uses ultralow doses of highly diluted natural substances originating from plants, minerals, or animals and is based on the principle of "like cures like." Despite being occasionally challenged for its scientific validity and mechanism of action, homeopathy continues to enjoy the confidence of millions of patients around the world who opt for this mode of treatment. Contrary to skeptics' views, research on home-opathy using modern tools mostly tends to support its efficacy and advocates new ideas toward understanding its mechanism of action. As part of a Point-Counterpoint feature, this review and its companion piece in this issue by Moffett et al (Integr Cancer Ther. 2006;5:333-342) are composed of a thesis section, a response section in reaction to the companion thesis, and a rebuttal section to address issues raised in the companion response.
Collapse
|
17
|
Katz P, Lee F. Racial/Ethnic Differences in the Use of Complementary and Alternative Medicine in Patients With Arthritis. J Clin Rheumatol 2007; 13:3-11. [PMID: 17278941 DOI: 10.1097/01.rhu.0000255579.59597.d2] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine use of complementary and alternative medicine (CAM) by individuals with osteoarthritis (OA) from 4 ethnic groups, differences in CAM use among groups, and correlates of CAM use. METHODS Data were obtained from individuals from 4 ethnic groups (African, Asian, and Hispanic Americans, and Caucasians) participating in trials assessing celecoxib efficacy. A questionnaire assessing CAMs specifically used to help arthritis was administered at screening. Use of 42 specific therapies within 7 categories-alternative medical systems, mind-body interventions, manipulation and body-based methods, energy therapies, and 3 types of biologically based therapies--was queried. RESULTS More than 80% of subjects reported that they used some CAM for arthritis in the past month. In contrast, 50% reported the use of prescription medicines, and 52% reported the use of over-the-counter medicines. Dietary practices were the most common type of CAM (71.5%), followed by mind-body interventions (42.4%), topical agents (38.1%), use of supplements or herbs (32.9%), and manipulation and body-based methods (21.4%). African Americans were more likely to report any CAM use than other groups (89.1% versus 83.1% [Asian], 81.1% [Hispanic], 77.7% [Caucasian]). African and Asian Americans more commonly reported the use of mind-body interventions in general, and prayer in particular. African Americans were also most likely to report the use of topical agents. Asian Americans were most likely to report use of alternative medical systems, manipulation methods, and supplements. Caucasians were least likely to report use of dietary practices. CONCLUSION Individuals with OA commonly use CAM. Use of these therapies varies by racial/ethnic group. Some CAMs may be effective for symptom relief, while others may interact with prescription medications, suggesting that routine queries by physicians concerning CAM use would be beneficial.
Collapse
Affiliation(s)
- Patricia Katz
- Department of Medicine, University of California, San Francisco, California 94143-0920, USA.
| | | |
Collapse
|
18
|
Munar A, Gamboa OA, Ortiz NI. Homeopathy for osteoarthritis. Hippokratia 2007. [DOI: 10.1002/14651858.cd006402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Andres Munar
- National University of Colombia; Research Subdivision, National Institute of Cancerology, Academic Group of Alternative Therapeutics; Cr. 12 No. 10-19 Sur Ap. 301 Bogota Colombia
| | - Oscar A Gamboa
- National Institute of Cancerology; Spec. Statistic, Research Subdivision; Cr. 53 No. 69-17 Bogota Colombia
| | - Nathalia I Ortiz
- National Institute of Cancerology; Spec. Public Health Management, Research Subdivision; Cr. 3 No. 11-55 Ap. 107 Bogota Colombia
| |
Collapse
|
19
|
Walach H, Jonas WB, Ives J, van Wijk R, Weingärtner O. Research on homeopathy: state of the art. J Altern Complement Med 2006; 11:813-29. [PMID: 16296915 DOI: 10.1089/acm.2005.11.813] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In this paper, we review research on homeopathy from four perspectives, focusing on reviews and some landmark studies. These perspectives are laboratory studies, clinical trials, observational studies, and theoretical work. In laboratory models, numerous effects and anomalies have been reported. However, no single model has been sufficiently widely replicated. Instead, researchers have focused on ever-new models and experiments, leaving the picture of scattered anomalies without coherence. Basic research, trying to elucidate a purported difference between homeopathic remedies and control solutions has also produced some encouraging results, but again, series of independent replications are missing. While there are nearly 200 reports on clinical trials, few series have been conducted for single conditions. Some of these series document clinically useful effects and differences against placebo and some series do not. Observational research into uncontrolled homeopathic practice documents consistently strong therapeutic effects and sustained satisfaction in patients. We suggest that this scattered picture has to do with the fourth line of research: lack of a good theory. Some of the extant theoretical models are reviewed, including placebo, water structure, silica contamination, energy models, and entanglement models. It emerges that local models, suggesting some change in structure in the solvent, are far from convincing. The nonlocal models proposed would predict that it is impossible to nail down homeopathic effects with direct experimental testing and this places homeopathy in a scientific dilemma. We close with some suggestions for potentially fruitful research.
Collapse
Affiliation(s)
- Harald Walach
- University College Northampton, School of Social Sciences, UK.
| | | | | | | | | |
Collapse
|
20
|
Lee CO. Homeopathy in cancer care: Part II--Continuing the practice of "like curing like". Clin J Oncol Nurs 2004; 8:327-30. [PMID: 15208834 DOI: 10.1188/04.cjon.327-330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Colleen O Lee
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
21
|
Affiliation(s)
- Crystal Rosser
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
22
|
Weiner DK, Ernst E. Complementary and Alternative Approaches to the Treatment of Persistent Musculoskeletal Pain. Clin J Pain 2004; 20:244-55. [PMID: 15218409 DOI: 10.1097/00002508-200407000-00006] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To review common complementary and alternative treatment modalities for the treatment of persistent musculoskeletal pain in older adults. METHODS A critical review of the literature on acupuncture and related modalities, herbal therapies, homeopathy, and spinal manipulation was carried out. Review included 678 cases within 21 randomized trials and 2 systematic reviews of herbal therapies: 798 cases within 2 systematic reviews of homeopathy; 1,059 cases within 1 systematic review of spinal manipulation for low back pain, and 419 cases within 4 randomized controlled trials for neck pain. The review of acupuncture and related modalities was based upon a paucity of well-controlled studies combined with our clinical experience. RESULTS Insufficient experimental evidence exists to recommend the use of traditional Chinese acupuncture over other modalities for older adults with persistent musculoskeletal pain. Promising preliminary evidence exists to support the use of percutaneous electrical nerve stimulation for persistent low back pain. While some herbals appear to have modest analgesic benefits, insufficient evidence exists to definitively recommend their use. Drug-herb interactions must also be considered. Some evidence exists to support the superiority of homeopathic remedies over placebo for treating osteoarthritis and rheumatoid arthritis. The benefits of spinal manipulation for persistent low back and neck pain have not been convincingly shown to outweigh its risks. DISCUSSION While the use of complementary and alternative modalities for the treatment of persistent musculoskeletal pain continues to increase, rigorous clinical trials examining their efficacy are needed before definitive recommendations regarding the application of these modalities can be made.
Collapse
Affiliation(s)
- Debra K Weiner
- Department of Medicine, Division of Geriatric Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213-3313, USA.
| | | |
Collapse
|
23
|
Abstract
OBJECTIVES The purpose is to examine what is known about the efficacy of selected complementary and alternative medicine (CAM) therapies for pain from arthritis and related conditions based on systematic reviews and meta-analyses. METHODS Results specifically related to pain were retrieved from review articles of acupuncture, homeopathy, herbal remedies, and selected nutritional supplements. RESULTS Evidence exists to support the efficacy of reducing pain from osteoarthritis (OA) for acupuncture; devil's claw, avocado/soybean unsaponifiables, Phytodolor and capsaicin; and chondroitin, glucosamine, and SAMe. Strong support exists for gamma linolenic acid (GLA) for pain of rheumatoid arthritis (RA). CONCLUSIONS Despite support for some of the most popular CAM therapies for pain from arthritis-related conditions, additional high quality research is needed for other therapies, especially for herbals and homeopathy.
Collapse
Affiliation(s)
- Karen L Soeken
- Complementary Medicine Program, University of Maryland School of Nursing, Kernan Hospital Mansion, 2200 Kernan Drive, Baltimore, MD 21207, USA.
| |
Collapse
|
24
|
Abstract
Despite the advances in conventional pain treatment, patients with chronic pain are often disappointed with Western medicine. Brian Berman considers how complementary medicine may be able to help
Collapse
Affiliation(s)
- Brian M Berman
- Center for Integrative Medicine, University of Maryland School of Medicine, James L Kernan Hospital, 2200 Kernan Drive, Baltimore, MD 21207, USA.
| |
Collapse
|
25
|
Abstract
BACKGROUND The claims made for the clinical effects of homeopathy are controversial. The results of several meta-analyses of clinical trials are positive, but they fail in general to highlight specific medical conditions that respond well to homeopathy. AIMS This review examines the cumulative research from randomised and/or double-blind clinical trials (RCTs) in homeopathy for individual medical conditions reported since 1975, and asks the question: What is the weight of the original evidence from published RCTs that homeopathy has an effect that is statistically significantly different from that in a comparative group? METHOD Analysis of the 93 substantive RCTs that compare homeopathy either with placebo or another treatment. RESULTS 50 papers report a significant benefit of homeopathy in at least one clinical outcome measure, 41 that fail to discern any inter-group differences, and two that describe an inferior response with homeopathy. Considering the relative number of research articles on the 35 different medical conditions in which such research has been carried out, the weight of evidence currently favours a positive treatment effect in eight: childhood diarrhoea, fibrositis, hayfever, influenza, pain (miscellaneous), side-effects of radio- or chemotherapy, sprains and upper respiratory tract infection. Based on published research to date, it seems unlikely that homeopathy is efficacious for headache, stroke or warts. Insufficient research prevents conclusions from being drawn about any other medical conditions. CONCLUSIONS The available research evidence emphasises the need for much more and better-directed research in homeopathy. A fresh agenda of enquiry should consider beyond (but include) the placebo-controlled trial. Each study should adopt research methods and outcome measurements linked to a question addressing the clinical significance of homeopathy's effects.
Collapse
Affiliation(s)
- R T Mathie
- Faculty of Homeopathy, 15 Clerkenwell Close, London, EC1R 0AA, UK.
| |
Collapse
|
26
|
Abstract
Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice.
Collapse
Affiliation(s)
- E Ernst
- Department of Complementary Medicine, School of Sport & Health Sciences, University of Exeter, 25 Victoria Park Road, Exeter EX2 4NT UK.
| |
Collapse
|
27
|
Abstract
The research evidence on the effectiveness of homoeopathy presented in a recent issue of Effective Health Care is reviewed.
Collapse
Affiliation(s)
- S O'Meara
- NHS Centre for Reviews & Dissemination, University of York, York YO10 5DD, UK.
| | | | | | | | | |
Collapse
|
28
|
Abstract
We have reviewed several types of alternative therapy used in the treatment of rheumatic diseases. The data provided by most available research does not show significant results of these therapies in comparison with Western treatment protocols. However, there has been some symptomatic relief reported by patients who have turned to these alternative remedies. Alternative medicine is not without potential harm or danger, especially in the herbal remedies used. Acupuncture is a relatively safe means of therapy, and even though its effect in rheumatic diseases has not been very impressive in terms of influence on the course of disease or laboratory parameters, it has provided some symptomatic relief where pain was involved. Even though acupuncture has not been very effective in rheumatic conditions, there are other published claims for success in migraines, electro-acupuncture in depression, in the prevention of post-operative nausea and vomiting, and for nausea caused by chemotherapy as well as for analgesia in childbirth. Since the public demand for alternative types of therapy is increasing, and since people will go to alternative medicine therapists, it makes sense for medical doctors to become acquainted with these subjects.
Collapse
|
29
|
Abstract
Especially in the United States, homeopathy has not become integrated into mainstream medical practice; this is partly because of the historical paucity of quality published research studies or quality educational programs. More recently, there have been better-designed studies in reputable journals, although historically most studies have been inconclusive or of poor methodology. The confusion around homeopathy in the United States exists for several reasons: 1. One of the main reasons for the relative disinterest or opposition to homeopathy is that even well-designed clinical studies on homeopathy leave the reader without any protocol-driven tools to take into daily practice. Individualization of treatment, or, as it is called today, differential therapeutics, is the main requirement of successful homeopathic prescribing. Only well-trained homeopathic practitioners are able to carry out such a task. In many articles that reported positive outcomes for homeopathy, numerous homeopathic remedies had been prescribed for the same diagnostic category. Critics suggest that the pooling of data from trials using different therapeutic agents to assess the overall success of homeopathic prescribing is incorrect. Research protocols that employ combination remedies, in which a medication contains several homeopathic remedies, fall into the same category. 2. Many of the positive and negative studies published are flawed with numerous methodologic problems. One of the most common problems is a lack of objective validated outcome measures. Another common problem is a small sample size. In most positive and negative meta-analyses published to date, research data are pulled together artificially based on either a diagnostic category or a particular remedy. Frequently the concentration of the remedy used and the conditions to which it has been applied are different. Ernst and Pittler published a letter with a critique of the methodology used in one of the meta-analyses of clinical trials of homeopathy. Most importantly, professional homeopaths and conventional scientists criticize the choice of remedy or the condition to which it was applied or both. The design and follow-up in migraine studies has been criticized extensively by one of the world's leading homeopaths, Vithoulkas (personal communication, 1997). Most of the Arnica studies have been designed with either an inappropriate dosing regimen or an inappropriately chosen procedure. In most positive studies on homeopathy, the outcome measures were subjective and poorly quantifiable. 3. Few well-designed studies have been reproduced by independent research teams. This situation exists for two major reasons: lack of sufficient funding and lack of a sufficient number of well-trained homeopaths qualified and interested to participate in research. 4. More rigorous educational programs on homeopathy for professionals need to be encouraged. Most of the existing programs are designed for consumers; academic continuing medical education-quality courses are needed. Meanwhile, while the debate around homeopathy still continues in conventional medical circles, the general public has been using the services of homeopathic practitioners and homeopathic remedies increasingly. In many countries, homeopathy and other complementary modalities have been integrated successfully into a larger armamentarium for the modern physician. According to a study published in 1995 in the Journal of the American Board of Family Practice, 69% of family practice physicians expressed interest in learning more about homeopathy. Increasing public and professional interest calls for attempts to study homeopathy in a more systematic way and to provide quality academic overview for medical practitioners. The growing number of complementary and alternative medicine centers affiliated with major teaching hospitals should provide a solid interface between evidence-based biologic medicine and many emerging complementary and alternative medicine modalities, including homeopathy.
Collapse
Affiliation(s)
- Woodson C Merrell
- Continuum Center for Health and Healing, Beth Israel Medical Center, New York, New York, USA.
| | | |
Collapse
|
30
|
Abstract
OBJECTIVE To test the hypothesis that homeopathy is effective in reducing the symptoms of joint inflammation in rheumatoid arthritis (RA). METHOD This was a 6-month randomized, cross-over, double-blind, placebo-controlled, single-centre study set in a teaching hospital rheumatology out-patient clinic. The participants of the study were 112 patients who had definite or classical RA, were seropositive for rheumatoid factor and were receiving either stable doses of single non-steroidal anti-inflammatory drugs (NSAIDs) for > or =3 months or single disease-modifying anti-rheumatic drugs (DMARDs) with or without NSAIDs for > or =6 months. Patients who were severely disabled, had taken systemic steroids in the previous 6 months or had withdrawn from DMARD therapy in the previous 12 months were excluded. Two series of medicines were used. One comprised 42 homeopathic medicines used for treating RA in 6cH (10(-12)) and/or 30cH (10(-30)) dilutions (a total of 59 preparations) manufactured to French National Pharmacopoeia standards, the other comprised identical matching placebos. The main outcome measures were visual analogue scale pain scores, Ritchie articular index, duration of morning stiffness and erythrocyte sedimentation rate (ESR). RESULTS Fifty-eight patients completed the trial. Over 6 months there were significant decreases (P<0.01 by Wilcoxon rank sum tests) in their mean pain scores (fell 18%), articular indices (fell 24%) and ESRs (fell 11%). Fifty-four patients withdrew before completing the trial. Thirty-one changed conventional medication, 10 had serious intercurrent illness or surgery, 12 failed to attend and three withdrew consent. Placebo and active homeopathy had different effects on pain scores; mean pain scores were significantly lower after 3 months' placebo therapy than 3 months' active therapy (P=0.032 by Wilcoxon rank sum test). Articular index, ESR and morning stiffness were similar with active and placebo homeopathy. CONCLUSIONS We found no evidence that active homeopathy improves the symptoms of RA, over 3 months, in patients attending a routine clinic who are stabilized on NSAIDs or DMARDs.
Collapse
Affiliation(s)
- P Fisher
- Royal London Homoeopathic Hospital, Great Ormond Street, London, UK
| | | |
Collapse
|
31
|
Linde K, Hondras M, Vickers A, Riet GT, Melchart D. Systematic reviews of complementary therapies - an annotated bibliography. Part 3: homeopathy. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2001; 1:4. [PMID: 11527508 PMCID: PMC45586 DOI: 10.1186/1472-6882-1-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2001] [Accepted: 07/20/2001] [Indexed: 12/26/2022]
Abstract
BACKGROUND Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with homeopathy. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of homeopathy; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pretested form and summarized descriptively. RESULTS Eighteen out of 22 potentially relevant reviews preselected in the screening process met the inclusion criteria. Six reviews addressed the question whether homeopathy is effective across conditions and interventions. The majority of available trials seem to report positive results but the evidence is not convincing. For isopathic nosodes for allergic conditions, oscillococcinum for influenza-like syndromes and galphimia for pollinosis the evidence is promising while in other areas reviewed the results are equivocal. INTERPRETATION Reviews on homeopathy often address general questions. While the evidence is promising for some topics the findings of the available reviews are unlikely to end the controversy on this therapy.
Collapse
Affiliation(s)
- Klaus Linde
- Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universität, München, Kaiserstr. 9, 80801 München, Germany
- Institute for Social Medicine & Epidemiology, Charité Hospital, Humboldt University, Berlin, Germany
| | - Maria Hondras
- Consortial Center for Chiropractic Research, Davenport, Iowa, USA
| | | | - Gerben ter Riet
- NHS Centre for Reviews & Dissemination, University of York, UK
- Department of Epidemiology, Maastricht University, The Netherlands
| | - Dieter Melchart
- Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universität, München, Kaiserstr. 9, 80801 München, Germany
| |
Collapse
|
32
|
Abstract
Fibromyalgia (FM) is a syndrome of chronic widespread musculoskeletal pain that is accompanied by sleep disturbance and fatigue. Clinical treatment usually includes lifestyle modifications and pharmacologic interventions meant to relieve pain, improve sleep quality, and treat mood disorders. These therapies are often ineffective or have been shown in clinical studies to have only short-term effectiveness. Pharmacologic treatments have considerable side effects. Patients may have difficulty complying with exercise-based treatments. Thus, patients seek alternative therapeutic approaches and physicians are routinely asked for advice about these treatments. This article reviews nontraditional treatment alternatives, from use of nutritional and herbal supplements to acupuncture and mind-body therapy. Little is known about efficacy and tolerance of complementary and alternative therapies in FM and other chronic musculoskeletal pain syndromes. Most studies on these treatments have been performed for osteoarthritis, rheumatoid arthritis, or focal musculoskeletal conditions. Clinical trials are scarce; the quality of these trials is often criticized because of small study population size, lack of appropriate control interventions, poor compliance, or short duration of follow-up. However, because of widespread and growing use of alternative medicine, especially by persons with chronic illnesses, it is essential to review efficacy and adverse effects of complementary and alternative therapies.
Collapse
Affiliation(s)
- L J Crofford
- University of Michigan, 1150 West Medical Center Drive, Ann Arbor, MI, 48109-0680, USA.
| | | |
Collapse
|