Background:
It has been hypothesised that randomised, placebo-controlled clinical trials (RCTs)
of classical (individualised) homeopathy often fail because placebo effects are substantially
higher than in conventional medicine.
Objectives:
To compare placebo effects in clinical trials on homeopathy to placebo effects on
trials of conventional medicines.
Methods:
We performed a systematic literature analysis on placebo-controlled double-blind
RCTs on classical homeopathy. Each trial was matched to three placebo-controlled double-blind
RCTs from conventional medicine (mainly pharmacological interventions) involving the
same diagnosis. Matching criteria included severity of complaints, choice of outcome
parameter, and treatment duration. Outcome was measured as the percentage change of
symptom scores from baseline to end of treatment in the placebo group. 35 RCTs on
classical homeopathy were identified. 10 were excluded because no relevant data could
be extracted, or less than three matching conventional trials could be located.
Results:
In 13 matched sets the placebo effect in the homeopathic trials was larger than the
average placebo effect of the conventional trials, in 12 matched sets it was lower
(P = 0.39). Additionally, no subgroup analysis yielded any significant difference.
Conclusions:
Placebo effects in RCTs on classical homeopathy did not appear to be larger than
placebo effects in conventional medicine.
Keywords
Homeopathy - Randomised placebo-controlled trials - Placebo effect - Systematic review