An Open-Label Observational Trial to Evaluate the Possible Effects of Individualized Homoeopathic Medicines in Symptomatic Nasal Polyp

Introduction: Nasal polyps presenting with chronic rhino-sinusitis (CRS) is a commonly encountered condition characterized by nasal obstruction, loss of sense of smell (anosmia), postnasal drip, headache, and sleep disorders. Possibly 60-65% of the populations suffering from CRS has predisposition to nasal polyps. Homoeopathic literature claims to offer successful treatment of nasal polyps; but scarcely subjected to systematic research. Materials and Methods: A prospective, open, non-randomized, single arm, observational trial of pre-post comparison design was conducted on 44 patients suffering from symptomatic nasal polyps. Sino-nasal outcome test (SNOT-20) and European Quality of Life (EQ-5D-5L) questionnaires were taken as the primary and secondary outcome measures respectively; assessed at baseline and after 3 months. Individualized homoeopathic medicines were prescribed on ‘totality of symptoms’. Intention to treat sample was subjected to statistical analysis. Data distribution was examined. Non-parametric Wilcoxon signed rank test and post hoc parametric paired t test were used accordingly. P values less than 0.05 were considered as statistically significant. Results: Forty four patients were enrolled; 4 dropped out. Skiagrams revealed complete regressions of polyps in 23 (58%) cases. Statistically significant improvements were observed in both the subjective patient-rated outcomes – mean reduction of SNOT-20 scores by 19.9 [sd 15.5; 95% CI 15.5 to 24.2; P < 0.001], EQ-5D-5L questionnaire score by 0.9 [sd 2.6; 95% CI 0.1 to 1.7; P = 0.029]; and EQ-5D-5L VAS by 14.4 [sd 4.7; 95% CI 12.9 to 15.9; P < 0.001]. Conclusion: Homoeopathic medicines showed promising treatment effect in symptomatic nasal polyps. Randomized trials are warranted

HOMEOPATHIC TREATMENT OF HEADACHES AND MIGRAINE: A META-ANALYSIS OF THE RANDOMIZED CONTROLLED TRIALS

Background: Homeopathy seems scientifically implausible and is the most controversial forms of CAM therapies. This review aims to summarize treatment effects of individualized homeopathy in headaches and migraine. Methods: Relevant studies were identified by a comprehensive literature search in electronic databases, reference list of relevant papers, and contacts with experts. Randomized controlled trials comparing individualized homeopathic treatment strategy with placebo were eligible. Information on patients, methods, interventions, outcomes, and results was extracted in a standardized manner and quality was assessed using a checklist and scoring system. Trials providing sufficient data were pooled in a quantitative meta-analysis. Risk ratio above 1 indicated benefit. Bias effects were examined in funnel plot model. Results: A total of four randomized placebo-controlled trials involving 390 patients were considered for the analysis. Methodological quality of the trials was variable. The combined risk ratio for the four studies entered into the meta-analysis was 1.58 (95% CI 0.8 to 3.1) [when corrected for publication bias it becomes 0.98 (0.5, 1.9), i.e. negative], showing positive trend, but no statistically significant difference in favor of homeopathy. Conclusion: The results of our meta-analysis are not compatible with the notion that homeopathy has significant effect beyond placebo. However, the evidences are not convincing because of methodological inconsistencies and are too insufficient to arrive at a definite conclusion. Further replications are warranted provided the trials are rigorous and systematic. Systematic review registration number: CRD42013004714; date May 29, 2013 [PROSPERO