Recent systematic reviews of homoeopathy

The recent meta-analysis by Linde et al¹ represents a significant step forward in evaluating the efficacy of homoeopathy. It has been criticised inter alia for including heterogeneous arrays of conditions as well as treatments and for including studies of dubious validity. Several systematic reviews were conducted in an attempt to overcome these shortcomings. A re-analysis of the methodologically best trials of “true” homoeopathy suggested that its clinical effects are equal to placebo.² A systematic review of all trials of homoeopathy as a treatment of DOMS (the condition most often submitted to controlled trials) yielded no convincing overall result in favour of homoeopathy.³ A systematic review of all controlled trials of homoeopathic Arnica also did not favour active treatment over placebo.⁴ Finally, a systematic review of all trials comparing homoeopathic with conventional treatments did not show compelling evidence in favour of homoeopathy.⁵ It is concluded that these new publications cast considerable doubt on the efficacy of homoeopathy.

References

1. Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges LV, Jonas W. Are the clinical effects of Homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997; 350: 834–43. [Abstract]
2. Ernst E. Are highly dilute homoeopathic remedies placebos? Perfusion 1998; 11: 291–2.
3. Ernst E, Barnes J. Are homoeopathic remedies effective for delayed-onset muscle soreness? A systematic review of placebo-controlled trials. Perfusion 1998; 11: 4–8.
4. Ernst E, Pittler M. The efficacy of homoeopathic arnica. A systematic review of placebo-controlled trials. Arch Surg, (in press)
5. Ernst E. Classical homoeopathy versus conventional treatments: a systematic review. Perfusion, (inpress)