psoriasis
I am sure that many of my readers have no idea what ‘Slinding Cupping Therapy’ is. It is a TCM therapy that, according to the authors of this paper, receives much appreciation for treating plaque psoriasis. This study was designed to test the hypothesis that sliding cupping therapy is non-inferior to narrowband ultraviolet B (NBUVB) therapy in improving disease severity in patients with plaque psoriasis.
This prospective trial recruited 60 patients with plaque psoriasis who were randomized to receive either sliding cupping intervention or NBUVB treatment. The cup was moved 30 times for each skin lesion until the target skin area turned purple. The initial dose (mJ/cm2) of ultraviolet radiation b (UVB) was determined based on sun-reactive skin types I through VI, which ranged from 300 mJ/cm2 to 800 mJ/cm2. Both treatments were performed 3 times per week for 8 weeks. The primary endpoint was the percentage reduction in Psoriasis Area and Severity Index (PASI) score at week 8, with secondary endpoints, including Physician’s Global Assessment (PGA), body surface area, visual analogue scale scores, and quality of life measures.
The total response rates were 69% (18/26) and 79% (19/24) for patients receiving sliding cupping intervention and those receiving NBUVB treatment, respectively, which showed no significant difference (P = .526). The PASI scores, body surface area, and PGA were reduced in patients with plaque psoriasis at W0, W4 and W8 after either sliding cupping intervention or NBUVB treatment (P <.001), and these reductions were not significantly different between the patients receiving sliding cupping intervention and those receiving NBUVB treatment at W0, W4, W8, and W12. At W8, the mean percentage reduction in PASI was 62.4% (95% CI, 54.9–69.8) in the sliding cupping group and 66.9% (95% CI, 59.6–74.2) in the NBUVB group, with no significant difference between groups. The total response rates were 69.23% (18/26) and 79.17% (19/24), respectively (P = .526). Patients receiving sliding cupping intervention and those receiving NBUVB treatment did not show statistically significant differences in these outcomes at W0, W4, W8, and W12 (P >.05).
The authors concluded that the overall results suggest that sliding cupping therapy exhibits statistically similar efficacy and safety profiles as NBUVB treatment, especially at 8 weeks after treatment.
Sliding cupping therapy is a form of cupping in which cups producing mild suction are placed on oiled skin and then moved along the body surface, generating a “reverse massage” that lifts rather than compresses the subcutaneous tissues. The negative pressure is thought to increase local blood flow and lymphatic drainage, reduce perceived muscle tension, and temporarily improve range of motion, though high‑quality clinical evidence for most claimed benefits remains limited.
The treatment is used mainly by massage therapists, physiotherapists, and TCM practitioners in musculoskeletal and sports‑rehab settings, as well as in wellness and spa‑oriented clinics; it is commonly applied to the back, shoulders, neck, limbs, and along fascial lines or acupuncture meridians, often for pain, stiffness, “trigger‑point”‑type tension, and post‑exercise recovery. The popularity of this therapy is best characterised as a niche within broader cupping and fascial‑release practice rather than a mainstream standard treatment.
The new study is a text-book example of how to mislead people with seemingly reliable research. The fact that it was grossly under-powered – and not the effectiveness of the sliding cupping therapy – is obviously the cause of the lack of a difference between the effective therapy (NBUVB) and the sliding quackery.
Let me give you an example: say, we compare antibiotics (A) to homeopathy (H) as treatments for bacterial pneumonia. We treat 10 patientsin each group, and 8 of them recover in group A within a week, while in the H-group the amount is 6 (many patients recover even without an effective treatment). We run statistical tests which tell us that the difference is not significant. Thus we falsely conclude that homeopathy is as effective as antibiotics in the treatment of pneumonia. The 2 treatments were, in fact, not equal but the lack of power of the small study failed to detect the existing difference.
It seems rather obvious to me that a similar thing has happened with the above study. Its authors are to be congratulated for cheating so slyly that neither the editors nor the reviewers of the journal ‘Medicine’ managed to see through their simple litte trick.
Psoriasis is an immune-mediated inflammatory skin disease. By more than a decade of clinical validation, Jueyin granules (JYG) have demonstrated multi-target synergistic immunomodulatory and anti-inflammatory effects, offering a characteristic Traditional Chinese Medicine (TCM) therapeutic approach for psoriasis.
Aim of this study was to assess the efficacy and safety of oral JYG in treating psoriasis with blood-heat syndrome. Participants with body surface area (BSA) score less than 10 were allocated to receive JYG or placebo treatment in a 1:1 ratio through central area division and block randomization. The primary outcome is reduction of the psoriasis area severity index (PASI) score and proportion of participants achieving a greater than 50 % reduction in PASI scores (PASI50) at week 8.
Between November 2019 and April 2022, 195 participants were randomly assigned to receive JYG (n = 99) or a placebo (n = 96) at five centers. The JYG group demonstrated significantly greater reductions in PASI and BSA scores than the placebo group at week 8 (both P < 0.001) and maintained these improvements at week 16 (P < 0.001 and P = 0.005, respectively). By week 8, 51.09 % of participants in the JYG group achieved PASI50, compared to 20.65 % in the placebo group (P < 0.001). However, there were no statistical differences in dermatology life quality index (DLQI), visual analog scale (VAS) scores, or relapse rate.
The authors concluded that this study provides conclusive evidence that JYG is a safe and effective treatment for patients with mild-to-moderate psoriasis. The current findings support its use as a complementary and alternative therapy for psoriasis.
I think this paper needs a few explanations:
- What are Jueyin granules? This is a formula consisting of eight Chinese herbs (Haliotis diversicolor, Flos Lonicerae Japonicae, Radix Rehmanniae exsiccate, cortex moutan, Herba Hedyotisdiffusae, Folium isatidis, Smilax china L. and Radix Curcumae)
- What is the history? The formula was developed in the 1950s by Han Xia, a Chinese surgeon, and have been used to treat psoriasis for over 50 years by Yueyang Hospital of Integrated Traditional Chinese and Western Medicine.
- How did he develop it? We don’t know.
- Is the formula available outside China? No, not to the best of my knowledge.
- How reliable is this new trial? As we have discussed repeatedly on this blog, there are good reasons to mistrust Chinese studies.
- If we accept the findings nonetheless, are the conclusions valid? No! Firstly, this study cannot establish the safety of the formula. Secondly, a single trial cannot ‘conclusively’ establish the effectiveness of a therapy.
- Why does a respected journal publish such a dubious study? SERACH ME!
Yesterday, I posted the account of a WHO summit on so-called alternative medicine (SCAM). I deliberately abstained from any comment. Yet, the arguments put forward do certainly deserve some critical evaluation. In particular, I feel that this paragraph needs discussing:
The WHO says its Summit on Traditional Medicine is essentially about repeating this sifting process for traditional remedies used in other parts of the world. It aims to apply rigorous scientific analysis to all them in order to properly assess their claimed benefits and potential harms. By 2034, it says, it will publish a definitive list of which traditional treatments work – and which don’t. “Working on traditional medicine doesn’t mean we will use shortcuts or endorse things that are unproven,” Dr Sylvie Briand, the WHO’s Chief Scientist, told The Telegraph at the conference in New Delhi. The aim was first to document what traditional treatments existed around the world “and then see what could be more useful to address the disease of this century”.
To many readers such words (which are voiced regularly) might seem entirely reasonable. Yet, they clearly are not! So, let me pick them apart.
Applying rigorous scientific analysis to all SCAMs in order to properly assess their claimed benefits and potential harms. This plan looks fine – but only if you know little bit about the subject:
- It is obvious that not every nonsensical idea merits proper assessment. Many can be rejected out of hand by simply using common sense. A Peruvian man’s piercing ululation, for instance, might not require scientific testing – or, to put it bluntly, testing nonsense will result in nonsense and is a waste of money.
- It is a demonstrable fact that many other SCAMs have already been assessed properly and most have been found wanting. In my recent book, for example, I have evaluated 202 SCAMs and found only a handfull that pass muster. The problem for the WHO and other such organisations or individuals is not that the evidence is unavailable, but that they elect to ignore it.
- And that leads to a further important point. What the WHO and other organisations or individuals call “to properly assess” might not coincide with what scientists would consider a critical evaluation of the best available evidence. As we have seen with depressing regularity on this blog, biased assessments inevitably result in false-positive conclusions.
By 2034, the WHO will publish a definitive list of which traditional treatments work and which don’t. This might look encouragingly ambitious but it is not. On the conreary, it is discouragingly naive and totally impossible. Let me use just one of the many hundred SCAM modalities, acupuncture, to explain this in more detail:
- There are dozens of different types of acupuncture, e.g. traditional, Western, Korean, Japanese, needle, ear, body, scalp, tongue, electro, etc., etc.
- Acupuncture is touted as a panacea; this means each form of acupuncture would need to be tested in clinical trials of thousands of different conditions.
- Moreover, there are uncounted different treatment schedules with acupuncture.
- Even if rigorous, one trial can never enough for a firm verdict. To make sure that the result of one single trial is not a fluke, we need several independent replications.
- Combining all these imponerabilities would require thousands clinical trials and many decades before one could claim that one has established that this form of acupuncture works for this condition, and that form of acupuncture does not.
- In case the eventual verdict for acupuncture for any given condition is negative, some clever dick would surely emerge and claim, “but, of course, you did not do the test correctly! So, your verdict is mistaken”
- Add to this the fact that hundreds of different SCAM modalities exist and most of them claim to be a cure-all, we would not need a decade but several centuries to arrive at the embarrassingly naive aim of the WHO.
Considering these problems, I fear, that the ‘WHO Summit on Traditional Medicine’ might be full of good will [to be entirely honest, I am not even sure that this is true!] but this and similarly ignorant, naive and promotional initiatives certainly are leading us up an expensive, wasteful and dangerous garden path.
PS
Oh, I almost forgot!
To criticize is easy, some will say.
Why does Ernst not show us how it should be done properly?
How do we arrive at a point where we can say: THIS SCAM WORKS FOR THIS CONDITION, AND THAT SCAM DOES NOT?
The proper way of achieving this goal is to do what we do in all medicine and remember that the onus of proof lies on the shoulders of those who make the therapeutic claim. In other words, if acupuncturists claim that a certian type of acupuncture can effectively treat asthma, for example, let them come up with the evidence! Until the evidence is on the table, the claim should be viewed as unproven which means the treatment cannot be recommended.
Simple!
Previous randomized controlled trials (RCTs) suggested that gut microbiota-based therapies may be effective in treating autoimmune diseases, but a systematic summary is lacking. This systematic review was aimed at filling the gap.
The literature searches identified total of 80 RCTs. They related to 14 types of autoimmune disease:
- celiac sprue,
- SLE,
- lupus nephritis (LN),
- RA,
- juvenile idiopathic arthritis (JIA),
- spondyloarthritis,
- psoriasis,
- fibromyalgia syndrome,
- MS,
- systemic sclerosis,
- type 1 diabetes mellitus (T1DM),
- oral lichen planus (OLP),
- Crohn’s disease,
- ulcerative colitis.
The results showed that gut microbiota-based therapies may improve the symptoms and/or inflammatory factor of:
- celiac sprue,
- SLE,
- LN,
- JIA,
- psoriasis,
- PSS,
- MS,
- systemic sclerosis,
- Crohn’s disease,
- ulcerative colitis.
However, gut microbiota-based therapies may not improve the symptoms and/or inflammatory factor of spondyloarthritis and RA. Gut microbiota-based therapies may relieve the pain of fibromyalgia syndrome, but the effect on fibromyalgia impact questionnaire score is not significant. Gut microbiota-based therapies may improve HbA1c in T1DM, but its effect on total insulin requirement does not seem to be significant. Probiotics did not seem to increase the incidence of adverse events.
The authors concluded that gut microbiota-based therapies may improve several autoimmune diseases (celiac sprue, SLE and LN, JIA, psoriasis, fibromyalgia syndrome, PSS, MS, T1DM, Crohn’s disease, and ulcerative colitis).
This sounds promissing, perhaps even a bit too good to be true?
To answer this question, It seems important to look at the quality of the primary studies:
- Twenty-nine RCTs failed to describe the random sequence generation methods.
- Seventeen RCTs were not blinded and their results contained subjective indicators.
- Seven RCTs were rated as high risk of bias.
And what about other caveats?
- The effect sizes vary but are often small.
- There is much heterogeneity.
- For some of the conditions there are only very few trials
- There is no uniform, plausible mode of action.
In summary, while these findings are no doubt interesting, I recommend taking them with a pinch of salt.
This study investigated whether vitamin D and marine-derived long-chain omega 3 fatty acids reduce autoimmune disease risk. A nationwide, randomized, double-blind, placebo-controlled trial with a two-by-two factorial design was conducted in the US. In total, 25 871 participants (12 786 men ≥50 years and 13 085 women ≥55 years at enrollment) took part.
Participants were given
- vitamin D (2000 IU/day),
- matched placebo,
- omega 3 fatty acids (1000 mg/day),
- matched placebo.
Participants self-reported all incident autoimmune diseases from baseline to a median of 5.3 years of follow-up; these diseases were confirmed by extensive medical record review. Cox proportional hazard models were used to test the effects of vitamin D and omega 3 fatty acids on autoimmune disease incidence. The primary endpoint was all incident autoimmune diseases confirmed by medical record review: rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis, and all others.
Participants were followed for a median of 5.3 years. 18 046 self-identified as non-Hispanic white, 5106 as black, and 2152 as other racial and ethnic groups. The mean age was 67.1 years. For the vitamin D arm, 123 participants in the treatment group and 155 in the placebo group had a confirmed autoimmune disease (hazard ratio 0.78, 95% confidence interval 0.61 to 0.99, P=0.05). In the omega 3 fatty acids arm, 130 participants in the treatment group and 148 in the placebo group had a confirmed autoimmune disease (0.85, 0.67 to 1.08, P=0.19). Compared with the reference arm (vitamin D placebo and omega 3 fatty acid placebo; 88 with confirmed autoimmune disease), 63 participants who received vitamin D and omega 3 fatty acids (0.69, 0.49 to 0.96), 60 who received only vitamin D (0.68, 0.48 to 0.94), and 67 who received only omega 3 fatty acids (0.74, 0.54 to 1.03) had confirmed autoimmune disease.
The authors concluded that vitamin D supplementation for five years, with or without omega 3 fatty acids, reduced autoimmune disease by 22%, while omega 3 fatty acid supplementation with or without vitamin D reduced the autoimmune disease rate by 15% (not statistically significant). Both treatment arms showed larger effects than the reference arm (vitamin D placebo and omega 3 fatty acid placebo).
This is the best trial of dietary supplements that I have seen for a very long time. Yet, the authors caution: Because participants were older adults, the results might not generalize to autoimmune diseases that primarily have their onset in younger people. However, the pathogenesis of many of the specific autoimmune diseases observed (eg, rheumatoid arthritis and psoriasis) is similar in younger adults. The trial tested only one dose and formulation of each supplement. The relatively low number of participants with a confirmed diagnosis of most individual diseases, and the challenge of confirming diagnosis of autoimmune thyroid disease based on medical records, limited statistical power to detect an effect on individual disease outcomes and subgroups of a priori interest. Given the latency of autoimmune disease onset, longer follow-up could be informative, and participants are being followed in an open label extension study.
As regular readers know, I am not easily impressed – but today I am.
Realgar, α-As4S4, is an arsenic sulfide mineral, also known as “ruby sulphur” or “ruby of arsenic”. It is a soft, sectile mineral occurring in monoclinic crystals, or in granular, compact, or powdery form, often in association with the related mineral, orpiment (As2S3).
In Traditional Chinese Medicine (TCM), realgar is often used in combination with herbs. An investigation found a total of 191 different, realgar-containing traditional Chinese patent medicines, and about 87% of them were for oral application. Realgar is said to:
counteract toxic pathogen both externally and internally. For abscess swelling and sores, it can be used singly or in compound prescription for external application mostly. When taken internally, it is combined with blood-activating and abscess-curing herbs to obtain the action of activating blood to relieve swelling, removing toxicity to cure sores. For example, it is combined with Ru Xiang, Mo Yao and She Xiang in Xing Xiao Wan from Wai Ke Quan Sheng Ji. For itching of skin due to scabies and ringworm, it is often combined with dampness-astringing and itching-relieving herbs to obtain actions of killing parasites and curing ringworm, astringing dampness and relieving itching. For instance, it is combined with the same dose of Bai Fan in powder mixed with clear tea for external application in Er Wei Ba Du San from Yi Zong Jin Jian. For poisonous insect bite, it is mixed with sesame oil and then applied on the afflicted sites.
This herb can kill parasites so it is indicated for intestine track parasites. For roundworm induced abdominal pain, it is often combined with other roundworm-killing herbs to reinforce action. For instance, it is combined with Qian Niu Zi and Bing Lang, etc. in Qian Niu Wan from Shen Shi Zun Sheng Shu. For anus pruritus caused by pinworm, it can be made into gauze strip by mixing with vaseline, and then inserted into the anus.
In addition, according to some ancient formulas, this herb can dispel phlegm and check malaria for internal application, so it can also be indicated for epilepsy, asthma and malaria.
Longtime topical over-dose or oral intake of realgar can cause chronic arsenic poisoning and even death. Chinese authors recently published the case of a 35-year-old Chinese man, who was diagnosed with severe psoriasis and died of fatal acute arsenic poisoning after he applied a local folk prescription ointment containing mainly realgar to the affected skin for about 4 days. The autopsy showed multiple punctate haemorrhages over the limbs, pleural effusion, oedematous lungs with consolidation, mild myocardial hypertrophy and normal-looking kidneys. The histopathological examination of renal tissue showed severe degeneration, necrosis and desquamation of renal tubular epithelial cells, presence of protein cast and a widened oedematous interstitium with interstitial fibrosis. The presence of arsenic in large amount in the ointment (about 6%), in blood (1.76 μg/mL), and in skin (4.71 μg/g), were confirmed analytically. The authors also review 7 similar cases in literature.
My advice is that, when you see recommendations by TCM practitioners like this one
you think again and consider that TCM really is not a form of healthcare that can be trusted to be safe.
I have repeatedly cautioned about the often poor quality of research into alternative medicine. This seems particularly necessary with studies of acupuncture, and especially true for such research carried out in China. I have also frequently noted that certain ‘CAM journals’ are notoriously prone to publishing rubbish. So, what can we expect from a paper that:
- is on alternative medicine,
- focusses on acupuncture,
- is authored by Chinese researchers,
- was published in the Journal of Alternative and Complementary Medicine (JACM)?
The answer is PROBABLY NOT A LOT!
As if for confirming my prediction, The JACM just published this systematic review. It reports pairwise and network meta-analyses to determine the effectiveness of acupuncture and acupuncture-related techniques for the treatment of psoriasis. A total of 13 RCTs were included. The methodological quality of these studies was ‘not rigorous’ according to the authors – in fact, it was lousy. Acupoint stimulation seemed to be more effective than non-acupoint stimulation. The short-term treatment effect was superior to the long-term effect (as one would expect with placebo). Network meta-analysis suggested that acupressure or acupoint catgut embedding generate superior effects compared to medications. It was noted that acupressure was the most effective treatment of all the acupuncture-like therapies.
The authors concluded that acupuncture-related techniques could be considered as an alternative or adjuvant therapy for psoriasis in short term, especially of acupressure and acupoint catgut embedding. This study recommends further well-designed, methodologically rigorous, and more head-to-head randomized trials to explore the effects of acupuncture-related techniques for treating psoriasis.
And what is wrong with that?
EVERYTHING!
- The review is of very poor quality.
- The primary studies are even worse.
- The English language is defective to the point of being not understandable.
- The conclusions are misleading.
Correct conclusions should read something like this: Due to the paucity and the poor quality of the clinical trials, this review could not determine whether acupuncture and similar therapies are effective for psoriasis.
And then there is, of course, the question about plausibility. How plausible is the assumption that acupuncture might affect a genetic autoimmune disease like psoriasis. The answer, I think, is that the assumption is highly unlikely.
In the above review, most of the 13 primary RCTs were from China. One of the few studies not conducted in China is this one:
56 patients suffering from long-standing plaque psoriasis were randomized to receive either active treatment (electrostimulation by needles placed intramuscularly, plus ear-acupuncture) or placebo (sham, ‘minimal acupuncture‘) twice weekly for 10 weeks. The severity of the skin lesions was scored (PASI) before, during, and 3 months after therapy. After 10 weeks of treatment the PASI mean value had decreased from 9.6 to 8.3 in the ‘active’ group and from 9.2 to 6.9 in the placebo group (p < 0.05 for both groups). These effects are less than the usual placebo effect of about 30%. There were no statistically significant differences between the outcomes in the two groups during or 3 months after therapy. The patient’s own opinion about the results showed no preference for ‘active’ therapy. It was also clear from the answers that the blinded nature of the study had not been discovered by the patients. In conclusion, classical acupuncture is not superior to sham (placebo) ‘minimal acupuncture‘ in the treatment of psoriasis.
Somehow, I trust these conclusions more than the ones from the review!
And somehow, I get very tired of journal editors failing to do their job of rejecting papers that evidently are embarrassing, unethical rubbish.
For many years, I have been impressed with the high quality and originality of chiropractic research. Here is the abstract of a particularly remarkable, new investigation.
The purpose of this study was to compare characteristics, likelihood to use, and actual use of chiropractic care for US survey respondents with positive and negative perceptions of doctors of chiropractic (DCs) and chiropractic care.
From a 2015 nationally representative survey of 5422 adults (response rate, 29%), we used respondents’ answers to identify those with positive and negative perceptions of DCs or chiropractic care. We used the χ2 test to compare other survey responses for these groups.
Positive perceptions of DCs were more common than those for chiropractic care, whereas negative perceptions of chiropractic care were more common than those for DCs. Respondents with negative perceptions of DCs or chiropractic care were less likely to know whether chiropractic care was covered by their insurance, more likely to want to see a medical doctor first if they were experiencing neck or back pain, less likely to indicate that they would see a DC for neck or back pain, and less likely to have ever seen a DC as a patient, particularly in the recent past. Positive perceptions of chiropractic care and negative perceptions of DCs appear to have greater influence on DC utilization rates than their converses.
CONCLUSION:
We found that US adults generally perceive DCs in a positive manner but that a relatively high proportion has negative perceptions of chiropractic care, particularly the costs and number of visits required by such care. Characteristics of respondents with positive and negative perceptions were similar, but those with positive perceptions were more likely to plan to use-and to have already received-chiropractic care.
END OF ABSTRACT
I bet you are dying to learn who the authors of this impressive article are. Here is the full list and their affiliations:
Weeks WB1, Goertz CM2, Meeker WC3, Marchiori DM4.
- 1Chair, Clinical and Health Services Research Program, Palmer Center for Chiropractic Research, Davenport, IA; Professor, The Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH. Electronic address: [email protected].
- 2Vice Chancellor, Research and Health Policy, Palmer College of Chiropractic, Palmer Center for Chiropractic Research, Davenport, IA.
- 3President, Palmer College of Chiropractic West Campus, San Jose, CA.
- 4Chancellor, Palmer College of Chiropractic, Davenport, Iowa.
Not just inexperienced novices then! The authors belong to the crème de la crème of the chiropractic establishment and research!!!
In comparison, I feel like a mere beginner. But let me nevertheless try to design my own study along similar lines. It is so brilliant that I might even get the Nobel Prize for it. Here we go:
The purpose of my study would be to compare characteristics, likelihood to use, and actual use of spectacles for survey respondents with positive and negative perceptions of spectacles and opticians***. From a nationally representative survey of about 5000 adults, I would use the respondents’ answers to identify those with positive and negative perceptions of spectacles and opticians. My results would show that positive perceptions of opticians are more common than those for spectacles, whereas negative perceptions of spectacles are more common than those for opticians. Respondents with negative perceptions of opticians or spectacles were less likely to know whether spectacles were covered by their insurance, more likely to want to see a medical doctor first, if they were experiencing poor eye-sight, less likely to indicate that they would see an optician for poor eye-sight, and less likely to have ever seen an optician as a patient, particularly in the recent past. Positive perceptions of spectacles and negative perceptions of opticians appear to have greater influence on optician utilization rates than their converses. From these data, I would conclude that my sample generally perceive opticians in a positive manner but that a relatively high proportion has negative perceptions of spectacles, particularly the costs and number of visits required for getting them. Characteristics of respondents with positive and negative perceptions were similar, but those with positive perceptions were more likely to plan to use – and to have already received – care from opticians.
*** instead of opticians and spectacles, I might also opt for other things like
- acupuncturists and needles,
- aroma-therapists and essential oils,
- herbalists and herbs,
- fast food restaurants and hamburgers,
- politicians and politics,
- priests and religion,
- etc., etc.
YOU MUST AGREE, THIS DESERVES A NOBEL PRIZE!
I thank the authors of the above paper for having inspired me with their ground-breaking science. In case they receive a Nobel Prize before I do, I congratulate them on their extraordinary achievement in designing, conducting and publishing this truly cutting-edge investigation.
An Indian chain of homeopathic clinics, Dr Batra’s, has just opened its first branch in London. The new website is impressive. It claims homeopathy is effective for the following conditions:
Hair loss? Are they serious? Have they not seen pictures of Samuel Hahnemann?
I decided to look into the psoriasis claim a little closer. This is what they state regarding the homeopathic treatment of psoriasis:
Research-based evidences speak clear and loud of the success of homeopathy in treating psoriasis.
A study published in the Journal of the European Academy of Dermatology and Venereology, a conventional medical Journal, showed that psoriasis patients experienced significant improvement in their quality of life and reduction in their psoriasis symptoms with homeopathy. And this was without any kind of side-effects whatsoever. Of the 82 patients involved in the study that went on for 2 years, many had suffered psoriasis for as long as 15 years and had previously unsuccessfully tried conventional treatments.
At Dr. Batra’s we have successfully treated more than 25,000 cases of psoriasis with homeopathy over the last 35 years. Our safe and scientific solutions have brought smiles to many suffering patients of psoriasis. In fact, a study conducted by A.C. Nielson showed that as compared to general practitioners, specialists and local homeopaths, a higher than average improvement is seen at Dr. Batra’s in treatment of skin ailments.
To the reader who does not look deeper, this may sound fairly convincing. Sadly, it is not. The first study cited above was an uncontrolled trial. Here is its abstract:
Design Prospective multicentre observational study. Objective To evaluate details and effects of homeopathic treatment in patients with psoriasis in usual medical care. Methods Primary care patients were evaluated over 2 years using standardized questionnaires, recording diagnoses and complaints severity, health-related quality of life (QoL), medical history, consultations, all treatments, and use of other health services. Results Forty-five physicians treated 82 adults, 51.2% women, aged 41.6 +/- 12.2 (mean +/- SD) years. Patients had psoriasis for 14.7 +/- 11.9 years; 96.3% had been treated before. Initial case taking took 127 +/- 47 min. The 7.4 +/- 7.4 subsequent consultations (duration: 19.4 +/- 10.5 min) cumulated to 169.0 +/- 138.8 min. Patients received 6.0 +/- 4.9 homeopathic prescriptions. Diagnoses and complaints severity improved markedly with large effect sizes (Cohen’s d= 1.02-2.09). In addition, QoL improved (SF-36 physical component score d = 0.26, mental component score d = 0.49), while conventional treatment and health service use were considerably reduced. Conclusions Under classical homeopathic treatment, patients with psoriasis improved in symptoms and QoL.
It is clear that, due to the lack of a control group, no causal inference can be made between the treatment and the outcome. To claim that otherwise is in my view bogus.
I should mention that there is not a single controlled clinical trial of homeopathy for psoriasis that would support the claim that it is effective.
The second study is not listed in Medline. In fact, the only publication of an author by the name of ‘A C Nielson’ is entitled ‘Are men more intuitive when it comes to eating and physical activity?’. Until I see the evidence, I very much doubt that the study cited above produced strong evidence that homeopathy is an effective cure for psoriasis.
Dr Batra’s chain of clinics boasts to provide the best quality and the highest standards of services that percolate down to all levels in an organisation. Everyone in the institute and those associated with it strive for excellence in whatever they do. Measuring the degree of customer satisfaction was the fundamental concept on which this homeopathic institute’s commitment to become a patient-driven institution was built.
Nice words! SHAME THAT THEY HAVE DECIDED TO DILUTE THEIR TRUTH HOMEOPATHICALLY!
