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Rapid response to:


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

BMJ 2000; 321 doi: (Published 19 August 2000) Cite this as: BMJ 2000;321:471

Rapid Response:

Was it really allergic rhinitis?

Can we really believe that the objective improvement resulted from
the administration of 1Gm of lactose-sucrose globules,(whatever they are)
at 8hourly intervals for only one day, 'impregnated' with either a 30c
dilution of the allergen or placebo?

Examination of the baseline clinical characteristics given in Table
1 could provide an explanation. 8 in the homeopathic group (HG) and 12 in
the placebo group(PG) had previously been ineffectively treated with
topical steroids, while 3 of the HG and 5 of the PG had been treated
effectively. In the HG 8 had had immunotherapy, 3 effectively, and 5 of
the PG, 2 effectively, but immunotherapy has been impossible in the UK
since 1986. In the HG 5 had had surgery, one with benefit, and in the PG 6
had surgery, 2 with benefit. Then 35 were allergic to mites, but 10 to
house dust, presumably not to mites, which is most unusual.

Topical steroids are effective in true allergic rhinitis, confirmed
by the presence of many eosinophil cells in the mucosal smear or blown
specimen. Absence of eosinophils goes with lack of response to topical
steroids, so the diagnosis of allergic rhinitis in this group is in
serious doubt. It would appear that these results were obtained in a
miscellaneous group of volunteers, dominated by 36 females.

Competing interests: No competing interests

21 August 2000
H Morrow Brown
Emeritus Consultant Physician and Allergist
Highfield House Highfield Gardens Derby DE22 1HT