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P. Fisher
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P. Fisher the 1 last update 2020/07/16 , ,
D. L. Scott
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D. L. Scott
Rheumatology, Volume 40, Issue 9, September 2001, Pages 1052‚Äď1055, https://doi.org/10.1093/rheumatology/40.9.1052
Published:
01 September 2001
Article history
Received:
19 October 2000
Revision received:
12 April 2001
Published:
01 September 2001
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Abstract

Objective.‚ÄāTo test the hypothesis that homeopathy is effective in reducing the symptoms of joint inflammation in rheumatoid arthritis (RA).

Method.‚ÄāThis was a 6‚Äźmonth randomized, cross‚Äźover, double‚Äźblind, placebo‚Äźcontrolled, single‚Äźcentre study set in a teaching hospital rheumatology out‚Äźpatient 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‚Äźsteroidal anti‚Äźinflammatory drugs (NSAIDs) for ‚Č•3 months or single disease‚Äźmodifying anti‚Äźrheumatic drugs (DMARDs) with or without NSAIDs for ‚Č•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 Patients who were severely disabled, had taken systemic steroids in the previous 6 months or had withdrawn from DMARD therapy in the previous 12 months were excluded.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‚ąí12) and/or 30cH (10‚ąí30) 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.‚ÄāFifty‚Äźeight 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‚Äźfour patients withdrew before completing the trial. Thirty‚Äźone 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'' active therapy (P=0.032 by Wilcoxon rank sum test). Articular index, ESR and morning stiffness were similar with active and placebo homeopathy.

Conclusions.‚ÄāWe 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.

Patients with rheumatoid arthritis (RA) often take alternative treatments [1], including homeopathy [2]. One trial by Gibson et al. [3] published in a mainstream journal provides evidence that homeopathy is effective in RA. A meta‚Äźanalysis of randomized controlled trials (RCTs) of homeopathy [4], which reached a favourable conclusion on its efficacy, identified three other RCTs. Two positive trials [5, 6] were not in mainstream journals, but a negative report was [7]. Another, independent meta‚Äźanalysis has also concluded that there is the 1 last update 2020/07/16 evidence that homeopathic treatments are more effective than placebo therapy [8]. Here we report the results of an RCT of homeopathy in RA. This tested the hypothesis that homeopathy is effective in reducing the symptoms of joint inflammation in RA.Patients with rheumatoid arthritis (RA) often take alternative treatments [1], including homeopathy [2]. One trial by Gibson et al. [3] published in a mainstream journal provides evidence that homeopathy is effective in RA. A meta‚Äźanalysis of randomized controlled trials (RCTs) of homeopathy [4], which reached a favourable conclusion on its efficacy, identified three other RCTs. Two positive trials [5, 6] were not in mainstream journals, but a negative report was [7]. Another, independent meta‚Äźanalysis has also concluded that there is evidence that homeopathic treatments are more effective than placebo therapy [8]. Here we report the results of an RCT of homeopathy in RA. This tested the hypothesis that homeopathy is effective in reducing the symptoms of joint inflammation in RA.

Methods

Between 1986 and 1994 we recruited patients from a single routine rheumatology clinic who had definite or classical RA (American Rheumatism Association criteria), were seropositive for rheumatoid factor and were receiving either stable doses of single non‚Äźsteroidal anti‚Äźinflammatory drugs (NSAIDs) for ‚Č•3 months or single disease‚Äźmodifying anti‚Äźrheumatic drugs (DMARDs) with or without NSAIDs for ‚Č•6 months. Patients who were severely disabled (functional class IV), 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 (designated A and B) were manufactured by Laboratoires Boiron (Lyon, France). One comprised 42 homeopathic medicines in 6cH (10‚ąí12) and/or 30cH (10‚ąí30) dilutions (a total of 59 preparations) manufactured to French National Pharmacopoeia standards. The other comprised identical pillules to which only unmedicated pharmaceutical ethanol was added. The A and B series were packed and labelled identically. The manufacturer retained the master code identifying active and placebo series.

A list of all homeopathic medicines likely to be indicated in RA had been for 1 last update 2020/07/16 drawn up based on the list published by Gibson et al. [3], standard reference works [9, 10] and clinical experience. The medicines chosen comprised: Antimodum crudum (6cH), Apis mellifica (6cH, 30cH), Arnica montana (6cH, 30cH), Arsenicum album (6cH, 30cH), Aurum metallicum (30cH), Bellis perennis (6cH), Berberis vulgaris (6cH), Byronia alba (6cH, 30cH), Calcarea carbonica (6cH, 30cH), Calcarea fluronica (6cH, 30cH), Calcarea phosphorica (6cH), Caulophyllum thalictroides (6cH), Causticum (6cH, 30cH), Cimicifuga racemosa (6cH, 30cH), Dulcamara (6cH, 30cH), Ignatia amara (6cH), Kalmia latitolia (6cH, 30cH), Kalium bichromicum (6cH, 30cH), Kalium carbonicum (30cH), Kalium phosphoricum (6cH), Lachesis mutus (30cH), Ledum palustre (6cH, 30cH), Lycopodium clavatum (30cH), Magnesia phosphorica (6cH), Medorrhinum (30cH), Natrum muriaticum (30cH), Natrum sulphuricum (30cH), Nux vomica (6cH, 30cH), opium (30cH), Psorinum (30cH), Pulsatilla vulgaris (6cH, 30cH), Rhodendron chrysanthum (6cH), Rhus toxicodendron (6cH, 30cH), Ruta graveolens (6cH, 30cH), Sepia officinalis (30cH), Silicea (6cH, 30cH), Staphysagria (30cH), sulphur (6cH, 30cH), Thuja occidentalis (30cH), Tuberculinum bovinum (30cH), Viola odorata (6cH) and Zincum metallicum (6cH).A list of all homeopathic medicines likely to be indicated in RA had been drawn up based on the list published by Gibson et al. [3], standard reference works [9, 10] and clinical experience. The medicines chosen comprised: Antimodum crudum (6cH), Apis mellifica (6cH, 30cH), Arnica montana (6cH, 30cH), Arsenicum album (6cH, 30cH), Aurum metallicum (30cH), Bellis perennis (6cH), Berberis vulgaris (6cH), Byronia alba (6cH, 30cH), Calcarea carbonica (6cH, 30cH), Calcarea fluronica (6cH, 30cH), Calcarea phosphorica (6cH), Caulophyllum thalictroides (6cH), Causticum (6cH, 30cH), Cimicifuga racemosa (6cH, 30cH), Dulcamara (6cH, 30cH), Ignatia amara (6cH), Kalmia latitolia (6cH, 30cH), Kalium bichromicum (6cH, 30cH), Kalium carbonicum (30cH), Kalium phosphoricum (6cH), Lachesis mutus (30cH), Ledum palustre (6cH, 30cH), Lycopodium clavatum (30cH), Magnesia phosphorica (6cH), Medorrhinum (30cH), Natrum muriaticum (30cH), Natrum sulphuricum (30cH), Nux vomica (6cH, 30cH), opium (30cH), Psorinum (30cH), Pulsatilla vulgaris (6cH, 30cH), Rhodendron chrysanthum (6cH), Rhus toxicodendron (6cH, 30cH), Ruta graveolens (6cH, 30cH), Sepia officinalis (30cH), Silicea (6cH, 30cH), Staphysagria (30cH), sulphur (6cH, 30cH), Thuja occidentalis (30cH), Tuberculinum bovinum (30cH), Viola odorata (6cH) and Zincum metallicum (6cH).

The St Bartholomew'' placebo therapy than 3 months'' therapy (mean values and 95% confidence intervals).

Fig.‚ÄČ1.

Changes in visual analogue scale (VAS) pain scores in patients receiving placebo followed by active homeopathy and vice versa during 6 months'' study period, this almost certainly represents the reversion to the mean seen in any analysis of valid complaint completers. Such falls would not be seen if the results had been evaluated by an ‚Äėintention to treat analysis‚Äô.

Despite several years of intense debate we have not been able to identify the reason the placebo group showed a significant improvement in their pain scores. One approach is to discount the finding because it is small and can be eradicated by applying a Bonferroni correction for multiple statistical tests. An alternative explanation could be a worsening of symptoms in some patients given homeopathic treatment. This is well described in the initial phase of treatment of allergic rhinitis patients with homeopathic therapies [11, 12]. We have not identified any manner by which the homeopathist may have unconsciously but positively influenced the placebo response to one treatment series and have therefore excluded this as a mechanism.

There has been intense controversy surrounding the analysis of RCTs of homeopathy. This is shown in the extensive criticism of one meta‚Äźanalysis [13], the major concerns raised in response [14] to an article about homeopathy by Vickers and Zollman [15] and in the statistical analysis of trials of homeopathy in other disorders [16]. They also highlight the difficulties in resolving whether blinding influences the results of RCTs in homeopathy, an issue previously dissected by Langman [17]. We have spent 15‚ÄČyr planning, undertaking and reporting this study. During this period Ritchie articular index, valid complaint completer analyses and cross‚Äźover trials have all become unfashionable. While our methods are dated, their validity is unlikely to have changed. Over these years we have come to believe that conventional RCTs are unlikely to capture the possible benefits of homeopathy. We believe that a new investigational approach is needed which fulfils Vandenbroucke'' symptoms and less relevant to have concerns about whether this is due to a ‚Äėgenuine‚Äô effect or to influencing the placebo response.

Arthritis Curehow to Arthritis Cure for Correspondence to: D. L. Scott.

References

1

Arthritis Curehow to Arthritis Cure for Struthers G, Scott DL, Scott DGI. The use of ‚Äėalternative treatments‚Äô by patients with rheumatoid arthritis.

Rheumatol Int
1983
;
3
:
151
‚Äď2.

2

Jonas WB, Linde K, Ramirez G. Homeopathy and rheumatic disease.

Rheum Dis Clin North Am
2000
;
26
:
117
‚Äď23.

3

Gibson RG, Gibson S, MacNeill AD, Watson Buchanan W. Homoeopathic therapy in rheumatoid arthritis: evaluation by double‚Äźblind clinical therapeutical trial.

Br J Clin Pharmacol
1980
;
9
:
453
‚Äď9.

4

Linde K, Clausius N, Ramirez G et al. Are the clinical effects of homeopathy placebo effects? A meta‚Äźanalysis of placebo‚Äźcontrolled trials.

Lancet
1997
;
350
:
834
‚Äď43.

Arthritis Curehow to Arthritis Cure for 5

K√∂hler T. Wirksamkeitsnachweis eines Hom√∂opathikums bei chronischer Polyarthritis‚ÄĒeine randomisierte Doppelblindstudie niedergelassenen √Ąrzten.

Der Kassenarzt
1991
;
13
:
48
‚Äď52.

the 1 last update 2020/07/16 66

Arthritis Curehow to Arthritis Cure for Wiesenauer M, Gaus W. Wirksamkeitsnachweis eines Hom√∂opathikums bei chronischer Polyarthritis. Eine randomisierte Doppelblindstudie bei niedergelassenen √Ąrzten.

Akt Rheumatol
1991
;
16
:
1
‚Äď9.

7

Arthritis Curehow to Arthritis Cure for Andrade LE, Ferraz MB, Atra E, Castro A, Silva MS. A randomized controlled trial to evaluate the effectiveness of homeopathy in rheumatoid arthritis.

Scand J Rheumatol
1991
;
20
:
204
‚Äď8.

8

Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of clinical efficacy of homeopathy. A meta‚Äźanalysis of clinical trials. HMRAG. Homeopathic Medicines Research Advisory Group.

Eur J Clin Pharmacol
2000
;
56
:
27
‚Äď33.

9

Boyd HW.

Introduction to homeopathic medicine
, 2nd edn. Beaconsfield: Beaconsfield Publishers,
1989
.

the 1 last update 2020/07/16 1010

Boericke W.

Handbook of homeopathic material medica
, 9th edn. Philadelphia: Boericke and Rynyon,
1927
.

11

Reilly DT, Taylor MA, McSharry C, Aitchison T. Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model.

Lancet
1986
;
2
:
881
‚Äď6.

12

Taylor MA, Reilly D, Llewellyn‚ÄźJones RH, McSharry C, Aitchison TC. Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series.

Br Med J
2000
;
321
:
471
‚Äď6.

13

Kahn MF. Meta‚Äźanalysis of for 1 last update 2020/07/16 homoeopathy trials.

Lancet
1998
;
351
:
365
.Kahn MF. Meta‚Äźanalysis of homoeopathy trials.
Lancet
1998
;
351
:
365
.

Arthritis Curehow to Arthritis Cure for 14

Ramey for 1 last update 2020/07/16 D. The debate over complementary medicine continues.

Br Med J
2000
;
320
:
1341
‚Äď2.Ramey D. The debate over complementary medicine continues.
Br Med J
2000
;
320
:
1341
‚Äď2.

the 1 last update 2020/07/16 1515

Vickers A, Zollman C. ABC of complementary medicine: homeopathy.

Br Med J
1999
;
319
:
1115
‚Äď8.

16

Colquhoun D. Re‚Äźanalysis of clinical trial of homoeopathic treatment in fibrositis.

Lancet
1990
;
336
:
441
‚Äď2

17

Langman MJ. Homoeopathy trials: reason for good ones but are they warranted?

Lancet
1997
;
350
:
825
‚Äď8.

18

Vandenbroucke JP. Homoeopathy trials: going nowhere.

Lancet
1997
;
350
:
824
‚Äď8.

© British Society for Rheumatology
Issue Section:
Original Papers

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