Homeopathy in childhood asthma

Li, A. M., Bush, A., Wilson, N. M., Dantas, F., Brien, S. B., Lewith, G., Fisher, P., Chatfield, K., Mathie, R., Leckridge, R. and White, A. (2003) Homeopathy in childhood asthma. Thorax, 58 (9), 826-828. (doi:10.1136/thorax.58.9.826).

Abstract

We read with interest the article by White et al on the use of homeopathy as an adjunct in the treatment of childhood asthma.1 We also obtained negative findings in an open study in which we assessed the effects of homeopathy on spirometry and exhaled nitric oxide (eNO) in children with stable asthma.

Twelve asthmatic children (4 boys, median age 13.5 years, range 7–18) who satisfied the following inclusion criteria were recruited: (1) stable asthma with no clinical indication for change in treatment, on any dose of inhaled corticosteroid and any other asthma medications; (2) raised eNO level at the start of the study despite clinical stability; (3) identifiable sensitivity to house dust mite (HDM, n=3) or cat and HDM (n=9) by history and skin prick test (SPT); (4) no hospital admission or emergency department attendance for asthma in the previous 3 months; (5) no history of consumption of oral corticosteroid in the previous 3 months; (6) no homeopathic treatment within the previous 6 months, allergen desensitisation within the previous year, or HDM avoidance measures or removal of household pet to which the subject had a positive SPT in the previous 3 months.

At baseline all recruited patients underwent SPT if this had not been done within the previous 2 years, eNO measurement (NIOX, Aerocrine, Sweden), and spirometric testing (Vitalograph, Buckingham, UK) measuring forced expiratory volume in 1 second (FEV1). The mean of three best efforts was recorded and the result was expressed as percentage predicted. The homeopathic remedy was prescribed according to the child’s SPT result. This was a preparation of HDM or cat dander (or both, if appropriate) in the form of two lactose globules. The preparation was made up according to the principles laid out in the British Homeopathic Pharmacopoeia. The patients were told to take the globules daily for the next 4 weeks while continuing with the same conventional asthma treatment. A diary was given to each child to encourage compliance and to document any breakthrough symptoms or side effects from the remedy during the study period. The subjects were told to return for eNO measurement and spirometric assessment after 4 weeks (visit 1) on the homeopathic remedy, and to return again 4 weeks later (visit 2) to assess the response after stopping the remedy. The spirometric test results of one patient from the first and second visits were missing.

No side effects were reported and all subjects were compliant with the homeopathic remedy. Using the Wilcoxon signed ranks test, there was no significant difference at baseline and at visits 1 and 2 in FEV1 (86% (interquartile range (IQR) 81.1–93.3) v 89% (85.0–100.0) v 85% (74.0–89.0), respectively) and eNO (54 ppb (IQR 36.2–99.6) v 68 ppb (37.0–87.0) v 76 ppb (43.6–131.4), respectively). This could be because of the small sample size or because the homeopathic remedy genuinely did not have any anti-inflammatory effect.

This study provides important baseline data for the calculation of the sample size needed to carry out a randomised, placebo controlled, double blind study. A sample size of 65 subjects per treatment arm would have 80% power to detect a difference of 10% in mean FEV1, assuming a standard deviation of difference of 28.86, using a paired t test with a two sided significance level of 0.05.

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Contributors

Author: S. B. Brien

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