BMJ 2002;324:520 ( 2 March )

Primary care

Use of ultramolecular potencies of allergen to treat asthmatic people allergic to house dust mite: double blind randomised controlled clinical trial

Editorial by Feder and Katz

G T Lewith, senior research fellow and honorary consultant physician, ^a A D Watkins, honorary lecturer, ^a M E Hyland, professor of health psychology, ^b S Shaw, senior lecturer in statistics, ^c J A Broomfield, research nurse, ^a G Dolan, research assistant, ^a S T Holgate, clinical professor of immunopharmacology and honorary consultant physician. ^a

^a Medical Specialties, Southampton General Hospital, Southampton, Hampshire SO16 6YD, ^b Department of Psychology, University of Plymouth, Plymouth, Devon PL4 8AA, ^c School of Mathematics and Statistics, University of Plymouth

Correspondence to: G Lewith GL3{at}soton.ac.uk

Objective: To evaluate the efficacy of homoeopathic immunotherapy on lung function and respiratory symptoms in asthmatic people allergic to house dust mite.
Design: Double blind randomised controlled trial.
Setting: 38 general practices in Hampshire and Dorset.
Participants: 242 people with asthma and positive results to skin prick test for house dust mite; 202 completed clinic based assessments, and 186 completed diary based assessments.
Intervention: After a four week baseline assessment, participants were randomised to receive oral homoeopathic immunotherapy or placebo and then assessed over 16 weeks with three clinic visits and diary assessments every other week.
Outcome measure: Clinic based assessments: forced expiratory volume in one second (FEV₁), quality of life, and mood. Diary based assessments: morning and evening peak expiratory flow, visual analogue scale of severity of asthma, quality of life, and daily mood.
Results: There was no difference in most outcomes between placebo and homoeopathic immunotherapy. There was a different pattern of change over the trial for three of the diary assessments: morning peak expiratory flow (P=0.025), visual analogue scale (P=0.017), and mood (P=0.035). At week three there was significant deterioration for visual analogue scale (P=0.047) and mood (P=0.013) in the homoeopathic immunotherapy group compared with the placebo group. Any improvement in participants' asthma was independent of belief in complementary medicine.
Conclusion: Homoeopathic immunotherapy is not effective in the treatment of patients with asthma. The different patterns of change between homoeopathic immunotherapy and placebo over the course of the study are unexplained.

What is already known on this topic Homoeopathic remedies probably have an effect that is greater than placebo Some of the better quality homoeopathic studies involve homoeopathic doses of allergens used to treat allergic disease What this study adds In this study homoeopathic remedies were no better than placebo in the treatment of asthmatic patients who are allergic to house dust mite

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© BMJ 2002
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