German homeopathy has had a free ride for about 200 years. But, since a few years, critics have started voicing their opposition pointing out that homeopathy lacks evidence of effectiveness. Sales figures, previously in excess of 600 million Euros, have thus started to decline. As a result the homeopathic industry has begun to fight back – as previously discussed, not always by honest or fair means.
Now, a new development has taken place; a manufacturer of homeopathic remedies, Hevert, has sent legal letters to several critics of homeopathy in an attempt to stop them stating that homeopathy is not effective beyond placebo. Failing to abide by this demand would be punishable with a huge find of 5 100 Euros.
After I learnt about this, I had a look on the website of Hevert and found an article detailing the evidence on homeopathy. I think it makes certain things more understandable.
The article concedes that the evidence for homeopathy is often of poor quality and not entirely positive. One problem, the article claims, is the fact that these analyses are usually sponsored by interested parties and that independent, reviews financed through public funds have not been available.
Das Hauptproblem liegt darin, dass die klinische Homöopathieforschung bisher fast ausschließlich über Gelder von komplementärmedizinischen Stiftungen bzw. über die homöopathischen Arzneimittelhersteller selbst finanziert wird. Das heißt, dass eine mit öffentlichen Forschungsgeldern unterstützte systematische Erforschung der klinischen Wirksamkeit von homöopathischen Arzneimitteln bisher nicht stattgefunden hat….
Could it be that Hevert is not well-informed about this point? The fact is that there are now numerous such analyses. Here are the key passages from some of these ‘official verdicts’:
“The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available”
Russian Academy of Sciences, Russia
“Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.”
National Health and Medical Research Council, Australia
“These products are not supported by scientific evidence.”
Health Canada, Canada
“Homeopathic remedies don’t meet the criteria of evidence-based medicine.”
Hungarian Academy of Sciences, Hungary
“The incorporation of anthroposophical and homeopathic products in the Swedish directive on medicinal products would run counter to several of the fundamental principles regarding medicinal products and evidence-based medicine.”
Swedish Academy of Sciences, Sweden
“There is little evidence to support homeopathy as an effective treatment for any specific condition”
National Centre for Complementary and Integrative Health, USA
“There is no good-quality evidence that homeopathy is effective as a treatment for any health condition”
National Health Service, UK
“Homeopathic remedies perform no better than placebos, and the principles on which homeopathy is based are “scientifically implausible””
House of Commons Science and Technology Committee, UK
“Homeopathy has not definitively proven its efficacy in any specific indication or clinical situation.”
Ministry of Health, Spain
“… homeopathy should be treated as one of the unscientific methods of the so called ‘alternative medicine’, which proposes worthless products without scientifically proven efficacy.”
National Medical Council, Poland
“… there is no valid empirical proof of the efficacy of homeopathy beyond the placebo effect.”
Federaal Kenniscentrum voor de Gezondheidszorg, Belgium
The Hevert article also points out that systematic reviews assessing homeopathy globally are perhaps not ideal, the article claims, and therefore systematic reviews targeted at specific conditions might be preferable and, indeed yield positive findings.
Mittlerweile geht man bei der Auswertung von klinischen Studien sinnvollerweise mehr dazu über, nicht mehr „die Homöopathie“ als Ganzes auf die Probe zu stellen, sondern kleinere Metaanalysen zu festen Indikationen durchzuführen, da dies eindeutigere Ergebnisse liefert….
Again, I suspect that the firm Hevert is not well-informed. I, for instance, have published about a dozen of such reviews which they fail to cite in their article. Let me copy the abstracts of just 4 examples here:
Homeopathy is often advocated for patients with eczema.
This article systematically reviews the evidence from controlled clinical trials of any type of homeopathic treatment for any type of eczema.
Electronic searches were conducted 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 patients with eczema were considered. Their methodological quality was estimated using the Jadad score.
One randomized and two nonrandomized clinical trials met the inclusion criteria. All were methodologically weak. None demonstrated the efficacy of homeopathy.
The evidence from controlled clinical trials therefore fails to show that homeopathy is an efficacious treatment for eczema.
Homoeopathy is often advocated for fibromyalgia (FM) and many FM patients use it. To critically evaluate all randomised clinical trials (RCTs) of homoeopathy as a treatment for FM, six electronic databases were searched to identify all relevant studies. Data extraction and the assessment of the methodological quality of all included studies were done by two independent reviewers. Four RCTs were found, including two feasibility studies. Three studies were placebo-controlled. None of the trials was without serious flaws. Invariably, their results suggested that homoeopathy was better than the control interventions in alleviating the symptoms of FM. Independent replications are missing. Even though all RCTs suggested results that favour homoeopathy, important caveats exist. Therefore, the effectiveness of homoeopathy as a symptomatic treatment for FM remains unproven.
To assess the evidence of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments.
Systematic literature searches were conducted through January 2006 in MEDLINE, EMBASE, AMED, CINAHL, Cochrane Central, British Homeopathic Library, ClinicalTrials.gov, and the UK National Research Register. Bibliographies were checked for further relevant publications. Studies were selected according to predefined inclusion and exclusion criteria. All double-blind, placebo-controlled randomized clinical trials of any homeopathic intervention for preventing or treating childhood and adolescence ailments were included. According to the classification of the World Health Organization, the age range defined for inclusion was 0 to 19 years. Study selection, data extraction, and assessment of methodological quality were performed independently by 2 reviewers.
A total of 326 articles were identified, 91 of which were retrieved for detailed evaluation. Sixteen trials that assessed 9 different conditions were included in the study. With the exception of attention-deficit/hyperactivity disorder and acute childhood diarrhea (each tested in 3 trials), no condition was assessed in more than 2 double-blind randomized clinical trials. The evidence for attention-deficit/hyperactivity disorder and acute childhood diarrhea is mixed, showing both positive and negative results for their respective main outcome measures. For adenoid vegetation, asthma, and upper respiratory tract infection each, 2 trials are available that suggest no difference compared with placebo. For 4 conditions, only single trials are available.
The evidence from rigorous clinical trials of any type of therapeutic or preventive intervention testing homeopathy for childhood and adolescence ailments is not convincing enough for recommendations in any condition.
Many cancer patients use homeopathic approaches to increase their body’s ability to fight cancer, improve their physical and emotional well-being, and alleviate their pain resulting from the disease or conventional treatments. Homeopathy is highly controversial as there is no plausible mode of action for these highly diluted remedies. The aim of this systematic review is to summarize and critically evaluate the efficacy of homeopathic remedies used as a sole or additional therapy in cancer care. We have searched the literature using the databases: Amed (from 1985); CINHAL (from 1982); EMBASE (from 1974); Medline (from 1951); and CAMbase (from 1998). Randomised and non-randomised controlled clinical trials including patients with cancer or past experience of cancer receiving single or combined homeopathic interventions were included. The methodological quality of the trials was assessed by Jadad score. Six studies met our inclusion criteria (five were randomised clinical trials and one was a non-randomised study); but the methodological quality was variable including some high standard studies. Our analysis of published literature on homeopathy found insufficient evidence to support clinical efficacy of homeopathic therapy in cancer care.
I hasten to add that all of these analyses were funded by public (University) money and not by the industry.
I suspect that Hevert have overlooked all this evidence (no problem, we all can do mistakes!) and therefore, I offer herewith to help them correcting the omissions. In particular, I offer to give an instructive, evidence-based lecture to their staff followed by an in-depth discussion and correction of their website. As homeopathy is under pressure in Germany, I would not even insist on a fee. All I would ask is this: abandon all legal actions against critics of homeopathy; these legal actions are ill-advised and will turn out to be a mere waste of your dwindling profits.