The Pharmaceutical Journal
Vol 275 No 7365 p274
3 September 2005

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Homoeopathy effects are no better than placebo

The clinical effects of homoeopathy are placebo effects, according to research published in The Lancet last week (2005;366:726).

Aijing Shang, University of Berne, Switzerland, and colleagues identified 110 placebo-controlled trials of homoeopathic remedies and matched these for disorder and type of outcome with 110 trials of conventional medicines.

The trials covered a range of disorders, including respiratory tract infections, asthma, surgery and anaesthetics, and obstetrics. They ranged in size from 10 to 1,573 participants, with a median of 65.

The researchers estimated treatment effects in the trials and in a subset which they determined to be of high quality (double blind trials with adequate randomisation) and therefore least likely to be affected by bias resulting from inadequate methods and selective publication.

Their analysis showed that the smaller and lower quality trials of both homoeopathy and conventional medicine had more beneficial treatment effects than the larger and higher quality trials. When the researchers only analysed the large, higher quality trials (eight homoeopathy and six conventional medicine trials) the odds ratio for beneficial effect was 0.88 (95 per cent confidence interval, 0.65–1.19) for homoeopathy and 0.58 (95 per cent CI 0.39–0.85) for conventional medicines. An odds ratio below 1 indicates benefit.

“We assumed that the effects observed in placebo controlled trials of homoeopathy could be explained by a combination of methodological deficiencies and biased reporting. Conversely, we postulated that the same biases could not explain the effects observed in comparable placebo-controlled trials of conventional medicine. Our results confirm these hypotheses: when analysis was restricted to large trials of high quality there was no convincing evidence that homoeopathy was superior to placebo, whereas for conventional medicine, an important effect remained,” the researchers conclude.

They propose that further research should concentrate not on placebo-controlled trials of homoeopathy but on the nature of context effects and on the place of homoeopathy in health care systems.


News feature, p277