Friday, July 27, 2012

Big Pharma Vs Homeopathy

The battle between big pharmaceuticals and Homoeopathy 
by Clive Stuart
       In August 2005 the medical journal "The Lancet" published a
study suggesting that any positive effects from Homeopathic treatment
were due to a placebo response, in other words a person gets better
because they believe in the medication or the practitioner or both. The
study was a meta-analysis. This type of study is a comparison of many
clinical trials carried out in the past. An editorial in the same
journal titled "The end of Homeopathy" advised Doctors to be "bold and
honest" with their patients about Homeopathy's lack of benefit. Strong
stuff indeed, especially as the last major meta-analysis of Homeopathy
published in the same journal in 1997 concluded that the positive
effects of Homeopathy were not down to the placebo effect. Why then the
mad rush to declare the end of a system of medicine that has shown it's
efficacy in many high quality studies?

        Homeopathy has been around for a couple of hundred years.
Widely used in America and Europe in the 1800's, it has enjoyed a
spectacular resurgence in the last twenty to thirty years. In the UK
where it is recognised by Act of Parliament there are a total of four
Homeopathic hospitals. In India it is practised almost as widely as
conventional medicine. Studies have shown it to work equally well for
animals with many veterinarian surgeons using it for their patients.

       One of the reasons for it's popularity is that it is a very safe
form of treatment. This is due to the fact that the remedies used are
highly dilute and thus free of any toxic side effects. It has been
postulated that Homeopathic remedies stimulate the body's homeostatic
or self-balancing mechanism. The choice of Homeopathic remedy is based
on a totality of the patients symptoms including mental and physical
symptoms. The philosophy is very different to the reductionist approach
of modern medicine where disease is generally reduced to one
dysfunctional organ or system.

       Little research has been carried out to explain just how
homeopathy works but it's efficacy is well documented. This is borne
out by many high quality studies published in peer reviewed medical
journals showing the positive effects of Homeopathy above and beyond
those of placebo. Just one month before the negative Lancet paper was
published a study appeared in the "European Journal of Paediatrics"
giving scientific evidence that Homeopathy was effective in the
treatment of ADHD (Attention Deficit Hyperactivity Disorder). Should
Doctors not be "bold and honest" with their patients about this fact ?

As Homeopaths we see our patients with ADHD respond well to Homeopathic
treatment but our anecdotal evidence means nothing to conventional
practitioners without scientific fact to back it up. That scientific
fact is now available in this latest study. Doctors therefore owe it to
their patients to acquaint themselves with the ADHD research and
recommend Homeopathy as a safe and effective alternative to amphetamine
based drugs such as Ritalin. One month before the ADHD research a
German comparative cohort study of 493 people was published in
"Complementary Therapies in Medicine". The aims of this study were to
evaluate the effectiveness of Homeopathy versus conventional treatment
in routine care. The study concluded that patients on Homeopathic
treatment had a better outcome overall compared with patients on
conventional treatment. With this in mind why then did the editor of
the Lancet Dr. Richard Horton lock on to one negative study among many
positive ones to launch a highly vehement attack on Homeopathy? Surely
a balanced statement calling for more research into Homeopathy would
have been more in keeping with good science. 
        Horton is well known for his opposition to Homeopathy as is one
of the principal authors of the paper Prof. Matthias Egger. Egger
stated at the outset that he did not expect to find any difference
between Homeopathy and placebo. It now appears that he found what he
wanted to find. As scientists from around the world dissected the study
more disturbing facts came to light. Only 8 out of the 110 studies on
Homeopathy were used. The authors admitted that many of the 110 studies
showed positive results for Homeopathy, yet these studies were thrown
out after the authors had decided they were "lower quality". Respected
scientists subsequently branded the paper "junk science" saying it was
deeply flawed and biased but by now Horton and Eggers hatchet job on
Homeopathy was beginning to bear fruit. News media around the world
were awash with "Homeopathy no better than dummy pills", all the while
fuelled by journalists of a sceptical bent who were keen to offer
misplaced reverence to the Lancet study. Unfortunately the rebuttals
and rebukes of the study by those in the scientific community never got
the same publicity as the Lancet soundbites. These critiques included
letters to the Lancet itself that were rejected for publication.

Medical doctors who had objections to the methodology used in the study
asked for the identification of the eight trials used in the final
analysis but the authors explicitly refused. Added to this was the fact
that the journal had recently refused to publish a large UK study which
showed high levels of effectiveness for Homeopathy andyou have all the
transparency of a brick. 
        One has to wonder if there was some agenda behind all of this.
Could pharmaceutical companies have had some influence ? It would
hardly be a surprise as these companies are losing huge chunks of
market share to Homeopathy and Complementary medicine in general. Then
again it could just be actions borne out of sheer frustration at the
success of Homeopathy, frustration that will no doubt be enhanced by
the recent 6 year study from the Bristol Homeopathic Hospital in the
UK. This was the study that the Lancet would not publish. 6,500
patients took part in the study which was published in the peer
reviewed JACM (Journal of Alternative and Complementary medicine). 70%
of patients with chronic diseases such as arthritis, asthma, chronic
fatigue syndrome and severe eczema reported that Homeopathy had a
positive effect on their symptoms. This figure rose to 89% for young
asthma patients who experienced an improvement in their symptoms.
Overall 75% of patients reported feeling "better" or "much better".
Although this was an observational study and not a double blind trial
it is of great importance in showing the effectiveness of Homeopathy.
It can also be said that conventional medicine would be greatly pleased
with outcomes similar to these.

         Sceptics have always used the argument that Homeopathy can
only work by placebo because the remedies are too dilute to have any
physical effect. If there was any credence to that argument then the
patients in the Bristol study must have been on "extra strength"
placebo because of the sheer volume of positive results. Certainly
ultra-dilutions have been a major stumbling block for Homeopathy being
accepted by conventional scientists despite there being research
suggesting the contrary. One such scientist was Prof. Madeline Ennis, a
pharmacologist at Queen's University Belfast and an avowed sceptic of
Homeopathy. She published a paper that was based on a high quality and
groundbreaking study that tested ultra-dilute solutions of histamine
and it's effects on certain types of white blood cells called
basophils. When the histamine was diluted to homeopathic levels and
past the point where any molecules of histamine could remain, the
ultra-dilutions still had an effect on the basophils. The results were
replicated in 3 other laboratories across Europe and published in the
respected "Inflammation Research"(vol 53, p181). Ennis would have to
concede that she had failed to disprove Homeopathy. She said in her
paper "We are unable to explain our findings and are reporting them to
encourage others to investigate this phenomenon".

       Ennis is to be commended for her integrity in publishing
findings that were difficult for both her and science to accept and
explain. Others in the same field could learn from her example and
remove themselves from the comfort zone of accepted scientific fact to
embrace new possibilities.

      As stated previously the bulk of clinical research shows the
placebo argument to be an erroneous one. To the research can be added
the fact that Homeopathy has been shown to be effective for babies and
animals. Here the chances for "power of suggestion" would seem remote.
For animals to be susceptible to the placebo effect, their vets would
need to develop the same powers of communication as Doctor Doolittle.

As Homeopaths we see many patients who have come to us after not having
had improvement from other medical treatments. If these people were
susceptible to the placebo effect, why then did it not happen with the
other treatments ? I have been a Registered Homeopath in full time
practice for 10 years in the UK and New Zealand. Nearly all of my work
comes from referrals. This is because people recommend what has worked
for them personally. If the opposite were true, Homeopathy would have
died a death a long time ago.

The public needs to be made aware when bias and selective research are
fed to them under the guise of medical science. Homeopathy does not
fear scientific scrutiny and evaluation as long as it is carried out
ona level playing field with truth and integrity. I have much respect
for modern medicine but it is by no means the only way to restore the
sick to health. We all need to work together for the good of the
patient. Doctors, Osteopaths, Homeopaths, Acupuncturists etc. all have
their place and need to work with each other as parts of a cohesive
whole. Divisiveness and one-upmanship have no place in healthcare. 
Clive Stuart is a Registered Homoeopath in Tauranga, New Zealand 

1 comment:

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