MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Benign prostate hypertrophy (BPH) affects many men aged 50 and older. It is caused by an enlargement of the prostate resulting in difficulties to urinate and to fully empty the bladder. There are several conventional treatment options, including life-style changes that are effective. In addition, a myriad of alternative therapies are being promoted, most of which are of doubtful effectiveness. Recently, a homeopathy-promoter, Dr Jens Behnke, triumphantly tweeted a trial of homeopathy for BPH allegedly proving that homeopathy does work after all. There is no conceivable reason why homeopathic remedies should have any effect on this (or any other) condition. Therefore, I decided to have a closer look at this paper.

The objective of this 5-centre, three-armed, open, randomised study was to evaluate the effectiveness of Homoeopathic Constitutional remedy (HC) and Homoeopathic Constitutional + Organ remedy (HCOM) in comparison to Placebo (PL) in patients suffering from BPH using International Prostate Symptom Score (IPSS), ultrasonographic changes in prostate volume, post-void residual urine, uroflowmetry and in WHO Quality of Life (QOL)-BREF. Patients were randomised into three groups in 2:2:1 ratio and were followed up for 6 months. The statistical analysis was done with modified intention-to-treat principle (mITT).

Of 461 patients screened, 254 patients were enrolled in the study and 241 patients were analysed as per mITT. The mean changes in IPSS and QOL due to urinary symptoms from baseline to end of study showed a positive trend in all the three groups. However, in the HC group, the changes were more prominent as compared to the other two groups. There was no difference between HC and HCOM groups and they were equally effective in terms of managing lower urinary tract symptoms due to BPH. With regard to secondary outcome, there was no difference between the groups. The psychological, social and environmental domains of WHOQOL-BREF have shown positive trend, but there was no statistically significant difference in intervention groups.

The authors concluded that statistical significance was found in the IPSS in all the three groups but only in HC and not in any of the objective parameters.

The paper is so badly written that I struggle to make sense of it. However, the above graph seems clear enough. The changes are perhaps statistically significant (which I find odd and cannot quite understand) but they are certainly not clinically relevant. Most likely, they are due to the fact that this study was not blind, meaning that patients and investigators were aware of the group allocations. This suggests to me that this study

  • is dubious in more than one way,
  • tests a hypothesis that lacks plausibility,
  • yields a result that is clinically irrelevant.

In other words, it does not amount to anything remotely resembling a proof of homeopathy’s efficacy.

3 Responses to Homeopathy for benign prostate hypertrophy (BPH)? No, afraid not!

  • As a lay person, even I understand that sometimes it is important to undertake research, even if the hypothesis seems implausible. Why? Because you just never know and knowing is what science seeks to determine.

    But then two things must be in place (one would think). First, the writer has to be clear. When writing about how was the research carried out and the results that were found, every effort must be made to ensure good grammar, diction, syntax, spelling, etc. After all, if people don’t understand it, what’s the point? Clarity would also allow—again, one would think—to enable the work to replicated, adding to its credibility.

    The second—and, I would argue, most important—thing, is that there be honesty.

    It boggles even my lay mind how much utter crap is present in some of these studies. If the expert researchers can’t at least accomplish these two things—clarity and honesty—how are the rest of us supposed to make use of the information?

    Sure, this is simplistic. But shouldn’t it at least start here?

    • To answer the question in Ron’s penultimate paragraph – the paper was published in the Indian Journal of Research in Homeopathy. ‘Expert researchers’ would not have written such a paper.

      Modern homeopaths know perfectly well what the requirements are if they are to be taken seriously. And they have known for a very long time. James Lind had published his ‘Treatise on the Scurvy’ in 1763, using controlled trials and John Haygarth described placebo controlled trials in 1799. Hanemann would have been aware of these developments.

      Hanemann could have used progressive scientific methods in his researches, but he did not.
      Modern homeopaths are aware of the views of mainstream commentators and current standards – but they sinmply ignore them. Although for marketing purposes, ego fulfilment and self-aggrandisement, homeopaths use all the panoply of regular medical practice – ‘colleges’, ‘research’, ‘publications’ – they have failed to progress and are mired in a faith system. As has long been recognised:

      “Homoeopathy has proved lucrative, and so long as it continues to be so will surely exist – as surely as astrology, palmistry and other methods of getting a living out of the weakness and credulity of mankind and womankind. It always does very great harm to the community to encourage ignorance, error, or deception in a profession which deals with the life and health of our fellow creatures.” Oliver Wendell Holmes Snr, 1842

      “Like all quackeries, homeopathy has been supported by the shallow, weak and credulous, on one side, and the charlatan and the rogue on the other. Such alliances are invariably broken when either the eyes of the one are opened, or the rapacity of the other is not gratified.” The Lancet, 1857.

      As for BPH – I don’t take medicine, but when I awake at 4 a.m. and can’t get back to sleep, I find a check on my iPhone to read the Professor’s latest musings does wonders!

      • Thank you for your clear and thoughtful response, Richard. I appreciate it.

        I think I learn more in 10 minutes from one Dr. Ernst’s post/replies than I do the rest of the day.

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