Eczema Articles

In an article published in the British Journal of Dermatology, Professor Ernst Edzard of Exeter University concludes from the results of his systematic review of controlled clinical trials of homeopathy as a treatment for eczema that there is no evidence to convincingly demonstrate the effectiveness of homeopathic remedies. However, he caveats this because out of 96 studies only three met the basic criteria for his review and all three had flaws that made their results unreliable indicators.

Professor Edzard says:

?Proponents of homeopathy might argue that my evidence does not convincingly demonstrate the effectiveness of homeopathic remedies as absence of evidence is no evidence of an absence of effect! Whilst strictly speaking this is true, one ought to point out that in the best interest of patients it is usually prudent to consider any therapy that is not supported by solid evidence as unproven and such treatments do not normally have a place in routine healthcare.?

The review was undertaken by electronic searches in Medline, Embase and the Cochrane Library, with no restrictions on time or language. In addition the bibliographies of the retrieved articles and our departmental files were hand-searched. All controlled trials of homeopathy in eczema-patients were considered. Their methodological quality was estimated using the Jadad score*. These searches generated 96 hits of which three met the criteria (two non-randomised and one randomised clinical trial). All of them had methodological limitations. Two studies from the same research group(i/ii) were similar in design, they were both not randomised and lacked sufficient detail about treatments administered and both were open to selection and other biases. Inferences about cause and effect were therefore not possible. The randomised, placebo-controlled trial(iii) by Siebenwirth et al was potentially more conclusive. However only 14 of 24 patients completed the study. The results of this study did not indicate that individualised homeopathic treatment is superior to placebo.

* The Jadad Score is a procedure to independently assess the methodological quality of a clinical trial. It is the most widely used such assessment in the world and as of 2008, its seminal paper has been cited in over 3000 scientific works.

References

i) Keil T, Witt CM, Roll S, Vance W, Weber K, Wegscheider K et al. Homeopathic versus conventional treatment of children with eczema; a comparative cohort study. Complement Ther Med 2008;16(1):15-21
ii) Witt CM, Brinkhaus B, Pach D, Reinhold T, Wruck K, Roll S et al. Homeopathic versus conventional treatment theraphy for atopic eczema ni children; medical and economical results. Dermatology 2009; 219:329-240
iii) Siebenworth J, Lüdtke R, Remy W, Rakosi J, Borelli S, Ring J, Effectivness of classical homeopathic treatments in atopic eczema. A randomised placebo-controlled double-blind clinical trial. Forsch Komplementarmed 2009; 16(5):315-323