Research Spotlights

1. How can one evaluate the clinical effectiveness of homeopathic therapy? Some thoughts about the report of the High Authority for Health.

Author: Bernard Poitevin

Journal Reference: La Revue d'Homéopathie, Volume 10, Issue 4, December 2019, Pages 183–19. https://doi.org/10.1016/j.revhom.2019.10.030

Link: https://www.sciencedirect.com/science/article/abs/pii/S1878973019301732

Essence: This article describes the main characteristics of homoeopathy, inspects the results obtained in different clinical situations examined by High Authority for Health (HAS), France, so that clinical evaluation proposals based on the observational studies and clinical trials studying homoeopathy's fundamental premise—individualisation—can be put forward.

Relevance: The continued integration of homoeopathic medicine in the French health system and its reimbursement is an essential condition for ensuring the development of research and patient safety.

2. Homeopathy instead of antibiotics in respiratory tract infections: Certainly, less harmful, possibly more effective.

Author: Lex (ALB) Rutten

Journal Reference: La Revue d'Homéopathie, Volume 10, Issue 4, December 2019, Pages 171–177. https://doi.org/10.1016/j.revhom.2019.10.011

Link: https://www.sciencedirect.com/science/article/abs/pii/S1878973019301549

Essence: This article talks about the antimicrobial resistance, which is one of the major problems and leading cause of death in past 30 years. Antibiotics are widely used in respiratory tract infections and other serious complications. Severe side effects of antibiotics have been observed, which outweigh the benefit. Due to insufficient unreliable proof for homoeopathy in RTI, still the antibiotics are preferred over homoeopathy. The selection of homoeopathic medicines for individual patients is a reproducible solution using prognostic factors (symptoms). Shang/Egger's meta-analysis of homeopathy reveals substantial beneficial effect, whereas other meta-analysis shows positive but statistically non-significant effect. It further reports that placebo-hypothesis for homeopathy by creating small subsets with statistically non-significant positive results is unscientific. To overcome the perplexity of the situation, it has been suggested that homeopathic medicines for individual patients can be selected using prognostic factors (symptoms)–like in the diagnostic process.

Relevance: Prognostic factor research can be applied to develop treatment algorithms for improved and more accessible application of homeopathy; it can also be utilised further for better selection of patients that need antibiotics.

3. Homoeopathy and antibiotic resistance

Author: Francesco Macrì

Journal Reference: La Revue d'Homéopathie, Volume 10, Issue 4, December 2019, Pages 162–165. https://doi.org/10.1016/j.revhom.2019.10.021

Link: https://www.sciencedirect.com/science/article/abs/pii/S1878973019301641

Essence: Global Antimicrobial Surveillance System (GLASS), launched by the World Health Organization in October 2015, bears witness to the growing emergence of antibiotic-resistant microorganisms. Several studies show that Complementary and alternative medicine (CAM) reduces the recourse to antibiotics in the treatment of respiratory symptoms, without increasing the incidence of complications. A recent study conducted by Italian Pediatric Society's CAM research group investigated the efficacy of homeopathy in the treatment of acute otitis in children. Ninety children were enrolled and randomised to a homeopathy treatment group or to a control group, each of 45 patients. Antibiotics were prescribed in 33.3% of children in the treatment group and 62.2% of children in the control group (p = 0.006).

Relevance: CAM in general, and homeopathy, can reduce recourse to antibiotics, with positive repercussions for strategies to combat antibiotic resistance.

4. Homoeopathy: A new tool for the prevention and treatment of chemobrain (cerebral toxicity)

Author: Jean-Lionel Bagot

Journal Reference: La Revue d'Homéopathie, Available online 28 January 2020, Pages. https://doi.org/10.1016/j.revhom.2020.01.004

Link: https://www.sciencedirect.com/science/article/abs/pii/S1878973020300049

Essence: Cerebral chemotoxicity after chemotherapy results in various fatigue, sleep, mood and memory disorders due to inflammatory and pro-oxidative brain lesions. After electronic repertorisation Belladonna, Nux vomica, Phosphorus, Aconitum, Arsenicum album and Mercurius solubilis were the most indicated medicines. Conium maculatum and/or Baryta carbonica were also considered. Daily clinical experience confirmed that the prescriptions are helpful.

Relevance: Homeopathy, by its lack of both drug interaction and significant side effects, has its place in the cases of cerebral chemotoxicity. Further studies are needed to evaluate its effectiveness.

5. An open label randomized pragmatic non-inferiority pilot trial comparing the effectiveness of Curare 30CH against individualized homeopathic medicines in post-stroke hemiparesis

Authors: Jaytilak Pramanick, Usha Uchat, Abhijit Chattopadhyay, Anaitulah Ahmad Mir, Munmun Koley, Subhranil Saha

Journal Reference: Advances in Integrative Medicine. https://doi.org/10.1016/j.aimed.2019.06.002

Link: https://www.sciencedirect.com/science/article/abs/pii/S2212958819300011

Essence: Post-stroke hemiparesis is the most common complication following stroke. In homoeopathy, Curare is one of the most recommended medicine for motor paralysis. In this backdrop, an open, randomised (1:1), exploratory, two parallel arms, pragmatic, non-inferiority, pilot trial was conducted at National Institute of Homoeopathy (NIH), India, on 50 patients comparing the effectiveness of Curare 30CH against individualised homoeopathy. Oxford muscle strength grading scale and stroke impact scale (SIS) questionnaires were used as the primary and secondary outcomes respectively and were assessed at baseline, after 3 and 6 months of treatment.

Relevance: Both individualised homoeopathy and Curare 30 produced comparable effects and appeared safe. But, being a pilot trial, no definite conclusion was drawn and further exploration of both efficacy and effectiveness of either of the therapies with adequately powered trials and independent replications is to be considered.

6. Hydrastis canadensis , an important homeopathic medicine in otorhinolaryngology

Authors: Alain Sarembaud

Journal Reference: La Revue d'Homéopathie, Volume 10, Issue 2, June 2019, Pages 74–78. https://doi.org/10.1016/j.revhom.2019.04.005

Link: https://www.sciencedirect.com/science/article/abs/pii/S1878973019300507

Essence: The cases of nasopharyngitis, or other conditions affecting the upper airways, incipient or recurrent, are one of the frequent visitors to homoeopathic consultants. Hydrastis canadensis is a medicine with a known pathogenesis and clinical efficacy in such cases, which has been observed repeatedly in daily practice.

Relevance: The symptomatology of Hydrastis canadensis in cases of nasopharyngitis and upper respiratory tract infections has been evolved further paving way for its wider use by practitioners in their daily practice.

7. Antibiotic use in clinical studies on homeopathy—a systematic review

Authors: Michael Teut, Lorna Duncan, Angelina Mosley, Georg Kindelmann, Susanne Ulbrich-Zuerni, Maxim Benz, Rachel Roberts, Esther van der Werf, Katharina Gaertner

Journal Reference: La Revue d'Homéopathie, Volume 10, Issue 4, December 2019, Pages 178–179. https://doi.org/10.1016/j.revhom.2019.10.024

Link: https://www.sciencedirect.com/science/article/abs/pii/S1878973019301677

Essence: Antimicrobial resistance is turning out to be a global threat. Few observational studies have shown that CAM therapies can have lower antibiotic prescription rates.

Relevance: To create an overview of the currently available clinical research evidence assessing the effectiveness and safety of homoeopathy in the context of antibiotic usage for infectious diseases.

8. Dysprosium metallicum , a new homeopathic medicine in oncological supportive care for the prevention of side effects of immunotherapy

Authors: Bagot Jean-Lionel, Moonen Resie

Journal Reference: La Revue d'Homéopathie, Volume 10, Issue 3, September 2019, Pages 101–106. https://doi.org/10.1016/j.revhom.2019.07.005

Link: https://www.sciencedirect.com/science/article/abs/pii/S1878973019300921

Essence: The advent of immunotherapy gave new impetus to the treatment of cancer. But the variability in number of patients responding to the treatment has been matter of concern. By studying the exact immune mechanisms involved in immunotherapy and respecting the principle of similarity, it has been sought that homeopathic medicines can support and modulate the immune responses induced by immunotherapy.

Relevance: Silicea and Dysprosium metallicum can act as an immune modulator. The constitutional remedy of the patient, when it is known, can also be considered. Homoeopathic medicines can encourage the mechanisms of action of immunotherapy, while preventing side effects. Still, clinical studies are further needed.

9. Effectiveness of a homeopathic complex medicine in infantile colic: A randomized multicentre study

Authors: Christa Raak, Peter Krueger, Petra Klement, Sabine De Jaegere, Stephan Weber, Thomas Keller, Lydia Ilyenko, David Martin, Thomas Ostermann

Journal Reference: Complementary Therapies in Medicine, Volume 45, August 2019, Pages 136–141https://doi.org/10.1016/j.ctim.2019.05.026

Link: https://www.sciencedirect.com/science/article/pii/S0965229919303000

Essence: Infantile colic, with symptoms such as flatulence combined with excessive crying, is a behavioural syndrome of babyhood. It is a common benign disease occurring in early infancy that may have a great impact on family life. In this prospective, multicentre, randomised, open label, controlled clinical trial, the effectiveness and safety of the complex homeopathic medicine Enterokind was compared with Simethicone for treating infantile colic. Enterokind is composed of Chamomilla D6, Cina D6, Colocynthis D6, Lac defloratum D6 and Magnesium chloratum D6. The main outcome assessments were the change of total complaints score (maximum17 points) and total objective symptoms score (maximum 22 points) after 10 days of treatment.

Relevance: Enterokind is an effective and safe homeopathic treatment for functional intestinal colic in infants ≤ 6 months. It represents a new treatment option. But, further researches are necessary to strengthen the profile of Enterokind and consolidate the evidence base of homoeopathy in the field of paediatric gastroenterology.

10. Complementary therapies for clinical depression: An overview of systematic reviews

Authors: Heidemarie Haller, Dennis Anheyer, Holger Cramer, and Gustav Dobos

Journal Reference: BMJ Open. 2019; 9(8): e028527. doi: 10.1136/bmjopen-2018-028527

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686993/

Essence: This overview was aimed at systematically summarising the level 1 evidence on CAM for patients with a clinical diagnosis of depression. Outcomes included depression severity, response, remission, relapse and adverse events. The quality of evidence was assessed according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). The overview revealed 26 meta-analyses conducted between 2002 and 2018 on 1 to 49 randomized controlled trials (RCTs) in major, minor and seasonal depression. In patients with mild-to-moderate major depression, moderate quality evidence suggested the efficacy of St. John's wort toward placebo and its comparative effectiveness toward standard antidepressants. In patients with recurrent major depression, CAM evidence was considered as having low or very low quality.

Relevance: Further research in cases of depression is needed mostly due to avoidable methodological flaws of both the original RCTs and meta-analyses not following the Consolidated Standards of Reporting Trials and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.