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Critics argue that homeopathy is something like a super-placebo, saying that homeopathy has the ability to evoke large nonspecific health effects. It is said that the long interview carried out by an empathetic practitioner during diagnosis may explain why people report improvements in their health.
The research team therefore investigated whether contextual effects in classical homeopathy are higher than in conventional medicine. For this they compared the changes in the placebo groups of RCTs from classical homeopathy and matching conventional trials.
The authors performed a systematic literature analysis on placebo-controlled doubleblind RCTs on classical homeopathy. Each trial was matched to three placebo-controlled double-blind RCTs from conventional medicine (mainly pharmacological interventions) involving the same diagnosis. Matching criteria included severity of complaints, choice of outcome parameter, and treatment duration. Outcome was measured as the percentage change of symptom scores from baseline to end of treatment in the placebo group. 35 RCTs on classical homeopathy were identified. 10 were excluded because no relevant data could be extracted, or less than three matching conventional trials could be located.
The results showed that in 13 matched sets the placebo effect in the homeopathic trials was larger than the average placebo effect of the conventional trials, in 12 matched sets it was lower (P = 0.39). Additionally, no subgroup analysis yielded any significant difference.
The authors conclude that placebo effects in placebo-controlled double-blind clinical trials (RCTs) on classical homeopathy did not appear to be larger than placebo effects in conventional medicine.
Nuhn T, Lüdtke R, Geraedts M (2010). Placebo effect sizes in homeopathic compared to conventional drugs – a systematic review of randomised controlled trials. Homeopathy, 99: 76–82.
It is a technical document as a response to requests and recommendations made by relevant World Health Assembly resolutions, by Member States, as well as international conferences of drug regulatory authorities, and is a part of the implementation of the WHO Traditional Medicine Strategy and the WHO Medicines Strategy.
WHO states that homeopathy is used worldwide, but that the national regulatory framework and the place of homeopathy within the health care system differ from country to country.
The document aims to provide guidance to Member States on technical aspects of the production and manufacture of homeopathic medicines that potentially have implications for their safety. This is of relevance for establishing national quality standards and specifications for homeopathic medicines, as well as for controlling their quality. The document does not address issues of efficacy or clinical utilization.
The terms used in this document are defined and annexed as a reference.
The document can be downloaded from the WHO website here.
In a report published 22 February 2010, the Science and Technology Committee of the United Kingdom House of Commons concludes that homeopathy is not efficacious (that is, it does not work beyond the placebo effect), that explanations for why homeopathy would work are scientifically implausible and that further clinical trials of homeopathy could not be justified. Furthermore, it concludes that the NHS should cease funding homeopathy and that the Medicines and Healthcare products Regulatory Agency (MHRA) should no longer license homeopathic medicines. The full report as well as all written and oral evidence that was submitted to the Committee is available here.
Remarkably, just 4 of the 14 members of the Science and Technology Committee voted on this report: 3 for, one against. One of its three signatories has stridently campaigned against homeopathy and continued to do so even in the period between the hearings and the publication of the report.
The European Committee for Homeopathy finds the conclusions and recommendations of the Science and Technology Committee completely unfounded. The report is highly tendentious and fundamentally flawed, consistently misrepresenting the scientific evidence to the detriment of homeopathy and making unfounded and pejorative allegations against those who advocate or practise homeopathy.
The report ignores large areas of evidence which were mentioned in written submissions and oral evidence such as systematic reviews and meta-analyses of randomised controlled trials of homeopathy for specific conditions and groups of conditions, and systematic reviews of biological models of homeopathic responses. The evidence suggests that homeopathy is effective in a number of specific conditions, and there are a number of reproducible biological models of homeopathy.
The European Committee for Homeopathy fully endorses the robust and comprehensive response by the British Homeopathic Association. Their rebuttals are accessible at their website here.
In 1999 the US National Cancer Institute (NCI) evaluated a cancer treatment protocol developed at the P. Banerji Homeopathic Research Foundation (PBHRF) in Kolkata, India. The ‘Banerji protocol’ used specific ultra-diluted natural substances to treat patients with different cancers. The NCI reviewed 10 patients treated on the Banerji protocol. In four of the cases with lung and esophageal cancers, the NCI confirmed partial responses. All patients reviewed had appropriate pathology and imaging studies to confirm diagnosis and response. The patients only received the remedies prescribed at the PBHRF clinic and did not receive any additional conventional treatment, such as surgery, radiation, or chemotherapy. After rigorous evaluation, the NCI concluded that there was sufficient evidence of efficacy to warrant further research of the Banerji protocol.
Considering the growing interest in Banerji protocol remedies among patients at the M.D. Anderson Cancer Center of the University of Texas, most of whom have advanced breast cancer, a team of researchers decided to evaluate the in-vitro effect of those remedies.
The result of this study has just been published in the International Journal of Oncology. The study has demonstrated that four ultra-diluted homeopathic medicines exerted preferential cytotoxic effects against two breast cancer cell lines (MCF-7 and MDA-MB-231), causing cell cycle delay/arrest and apoptosis. These effects were accompanied by altered expression of the cell cycle regulatory proteins, including downregulation of phosphorylated Rb and upregulation of the CDK inhibitor p27, which were likely responsible for the cell cycle delay/arrest as well as induction of the apoptotic cascade that manifested in the activation of caspase 7 and cleavage of PARP in the treated cells.
The experiments were conducted in triplicate and repeated at least twice in each case of remedy. The researchers commented that the homeopathic remedies appeared to have similar activity to the activity of paclitaxel (Taxol), the most commonly used chemotherapeutic drug for breast cancer, without the toxic effect on the normal cells. The findings demonstrate biological activity of these products when presented at ultra-diluted doses.
Banerji P, Campbell DR (2008): Cancer patients treated with the Banerji protocols utilising homoeopathic medicine: A Best Case Series Program of the National Cancer Institute USA. Oncology Reports, 20: 69-74.
To be downloaded here.
Frenkel M et al. (2010): Cytotoxic effects of ultra-diluted remedies on breast cancer cells, International Journal of Oncology, 36: 395-403.
To be downloaded here.
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The article can be downloaded here.