Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series  Commentary: Larger trials are needed

doi:10.1136/bmj.321.7259.471

BMJ 2000;321:471-476 ( 19 August )

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Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series

Morag A Taylor, research associate, ^a David Reilly, honorary senior lecturer in medicine, ^a Robert H Llewellyn-Jones, lecturer, ^b Charles McSharry, principal immunologist, ^c Tom C Aitchison, senior lecturer in statistics. ^d

^a University Department of Medicine, Glasgow Royal Infirmary, Glasgow G31 2ER, ^b Department of Psychological Medicine, University of Sydney, New South Wales 2006, Australia, ^c University Department of Immunology, Western Infirmary, Glasgow G11 6NT, ^d Department of Statistics, University of Glasgow, Glasgow G12 8QQ

Correspondence to: D Reilly, Academic Departments, Glasgow Homoeopathic Hospital, Glasgow G12 0XQ davidreilly1{at}compuserve.com

Objective: To test the hypothesis that homoeopathy isa placebo by examining its effect in patients with allergic rhinitisand so contest the evidence from three previous trials in thisseries.
Design: Randomised, double blind, placebo controlled,parallel group, multicentrestudy.
Setting: Four general practices and a hospital ear,nose, and throat outpatientdepartment.
Participants: 51 patients with perennial allergicrhinitis.
Intervention: Random assignment to an oral 30c homoeopathicpreparation of principal inhalant allergen or toplacebo.
Main outcome measures: Changes from baseline in nasal inspiratorypeak flow and symptom visual analogue scale score over third andfourth weeks afterrandomisation.
Results: Fifty patients completed the study. The homoeopathygroup had a significant objective improvement in nasal airflowcompared with the placebo group (mean difference 19.8 l/min, 95%confidence interval 10.4 to 29.1, P=0.0001). Both groups reportedimprovement in symptoms, with patients taking homoeopathy reportingmore improvement in all but one of the centres, which had morepatients with aggravations. On average no significant differencebetween the groups was seen on visual analogue scale scores. Initialaggravations of rhinitis symptoms were more common with homoeopathythan placebo (7 (30%) v 2 (7%), P=0.04). Addition of these resultsto those of three previous trials (n=253) showed a mean symptomreduction on visual analogue scores of 28% (10.9 mm) for homoeopathycompared with 3% (1.1 mm) for placebo (95% confidence interval4.2 to 15.4, P=0.0007).
Conclusion: The objective results reinforce earlier evidencethat homoeopathic dilutions differ fromplacebo.

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