Authors:
Associate Prof. Gernot Keyßer (University Hospital Halle - Saale), Prof. Olga Seifert, Prof. Andreas Michalsen, Dr. Inna Frohne (University Hospital Düsseldorf), Dr. Mandy Gläß (Vogelsang-Gommern Rheumatology Clinic), Assistant Prof. Alexander Pfeil (University Hospital Jena), Prof. Monika Reuß-Borst (Rheumatology Practice, Bad Bocklet), Assistant Prof. Dr. Oliver Sander (University Hospital Düsseldorf), Dr. Olaf Schultz (Baden-Baden Rheumatology Clinic), Commission for Complementary Therapies and Nutrition
Meaning of the term: Homeopathy: “similar suffering” (from the Ancient Greek homóios, meaning “of the same kind,” “similar,” and páthos, meaning “suffering,” “pain”). A treatment method in alternative medicine whose theory was developed by the German physician Samuel Hahnemann (born 1755 in Meissen; died 1843 in Paris) in the 18th and 19th centuries.
The principles of homeopathy are:
1.) The principle of similarity, or the simile principle, as the most important fundamental assumption: “Let like be cured by like” (Latin: similia similibus curentur): homeopathic remedies should be able to induce symptoms in healthy individuals that are similar to those from which the patient suffers.
2.) Homeopathic drug trials on healthy volunteers, in which homeopathic remedies are administered and the symptoms are recorded to establish remedy profiles
3.) The assessment of the individual clinical picture through a homeopathic anamnesis. Components of this anamnesis include spontaneous reporting, guided questioning, indirect questioning, and biographical anamnesis
4.) The system of potentization: It is based on Hahnemann’s assumption that minimizing the dose can increase its efficacy by unleashing hidden dynamic forces
The principles mentioned in 1.) and 4.) do not stand up to scientific scrutiny.
1 Linke-Cordes, M, in: Checklist for Complementary Medicine. Roman Huber and Andreas Michalsen (eds.), Karl F. Haug Verlag, Stuttgart, 2014, p. 176 et seq.
The evidence for the efficacy of homeopathic therapy (HT) is generally weak [13]; effects are largely explained by placebo effects [20]. Cochrane reviews on the effects of homeopathic therapy for respiratory infections in children [7], attention-deficit/hyperactivity disorder (ADHD) [2], irritable bowel syndrome [16], influenza and influenza-like symptoms [23], and dementia [14] found no effects; regarding HT for chemotherapy side effects, marginal effects were described for two dermatological agents [9]. A systematic review on the use of HT in dermatology yielded negative results [21]. In a journal dedicated to homeopathy, an evaluation of over 300 publications on homeopathic studies concluded that the quality of the studies was inadequate, and that evidence of an effect beyond placebo effects was still lacking [12]. A review of all systematic reviews available at the time of publication also failed to provide evidence of efficacy [3].
Rheumatoid Arthritis (RA)
Two early controlled studies by the same author, both involving small sample sizes, reported positive effects of homeopathic treatment (HT) compared to placebo [5] or salicylates [6]. The effect size is of questionable relevance, and the methodology does not meet current standards. Another controlled study demonstrated that the effect of homeopathic treatment was attributable to the in-depth medical history interview, but not to the homeopathic medications themselves [1]. Another randomized, controlled trial showed no effect after three months [4]. Worth mentioning are two studies in which either highly diluted antibodies against TNF-alpha [22] or highly diluted inflammatory cytokines [8] are described as potential homeopathic remedies for RA, although no relevant clinical data are available to support this.
Spondyloarthropathies (SpA)
A German-language publication was unable to demonstrate any effect of a homeopathic preparation in patients with axial SpA in a double-blind, randomized study [19].
Fibromyalgia syndrome (FMS)
A meta-analysis of clinical studies on complementary medicine for FMS was unable to issue a recommendation for homeopathy due to poor data quality [17]. A German guidelines committee for the evaluation of complementary and alternative therapies for FMS failed to reach a consensus on homeopathy; therefore, neither a positive nor a negative recommendation was issued [11].
Joint-related pain
In a placebo-controlled study, homeopathic remedies failed to reduce postoperative analgesic use following knee joint surgery [15].
Knee osteoarthritis
The current guideline on knee osteoarthritis states: “No conclusion can be drawn regarding homeopathy for knee osteoarthritis based on the available studies.” (https://www.awmf.org/uploads/tx_szleitlinien/033-004l_S2k_Gonarthrose_2018-01_1-verlaengert_01.pdf)
Other rheumatic diseases
A PubMed search yielded no publications under the keywords “homeopathic” or “homeopathy” in combination with “lupus,” “scleroderma,” “myositis,” “giant cell arteritis,” “systemic vasculitis,” and “polymyalgia rheumatica”
Based on the above discussion, it follows that no relevant positive effects are to be expected from homeopathic therapy (HT) for inflammatory joint diseases, systemic autoimmune diseases, and fibromyalgia syndrome.
Homeopathic medications are generally considered well-tolerated, but they are not free of adverse effects [18]. A significant problem with the use of homeopathy could be the delay in initiating adequate rheumatological therapy [10].
Homeopathic therapy is not recommended for patients with inflammatory and degenerative joint diseases, systemic autoimmune diseases, and FMS.
1. Brien S, Lachance L, Prescott P et al. (2011) Homeopathy has clinical benefits in patients with rheumatoid arthritis that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial. Rheumatology (Oxford) 50:1070-1082
2. Coulter MK, Dean ME (2007) Homeopathy for attention deficit/hyperactivity disorder or hyperkinetic disorder. Cochrane Database Syst Rev:CD005648
3. Ernst E (2002) A systematic review of systematic reviews of homeopathy. Br J Clin Pharmacol 54:577-582
4. Fisher P, Scott DL (2001) A randomized controlled trial of homeopathy in rheumatoid arthritis. Rheumatology (Oxford) 40:1052-1055
5. Gibson RG, Gibson SL, Macneill AD et al. (1980) Homeopathic therapy in rheumatoid arthritis: evaluation by a double-blind clinical therapeutic trial. Br J Clin Pharmacol 9:453-459
6. Gibson RG, Gibson SL, Macneill AD et al. (1978) Salicylates and homeopathy in rheumatoid arthritis: preliminary observations. Br J Clin Pharmacol 6:391-395
7. Hawke K, Van Driel ML, Buffington BJ et al. (2018) Homeopathic medicinal products for preventing and treating acute respiratory tract infections in children. Cochrane Database Syst Rev 4:CD005974
8. Jacques C, Floris I, Lejeune B (2021) Ultra-Low Dose Cytokines in Rheumatoid Arthritis: “Three Birds with One Stone” as the Rationale for the 2LARTH((R)) Micro-Immunotherapy Treatment. Int J Mol Sci 22
9. Kassab S, Cummings M, Berkovitz S et al. (2009) Homeopathic medicines for adverse effects of cancer treatments. Cochrane Database Syst Rev:CD004845
10. Keysser G (2008) [Outcome of a patient with rheumatoid arthritis treated with homeopathic drugs without DMARD therapy]. Med Klin (Munich) 103:36-37
11. Langhorst J, Heldmann P, Henningsen P et al. (2017) [Complementary and alternative treatments for fibromyalgia syndrome: Updated guidelines 2017 and overview of systematic review articles]. Schmerz 31:289-295
12. Mathie RT (2015) Controlled clinical studies of homeopathy. Homeopathy 104:328-332
13. Mathie RT, Ramparsad N, Legg LA et al. (2017) Randomized, double-blind, placebo-controlled trials of non-individualized homeopathic treatment: systematic review and meta-analysis. Syst Rev 6:63
14. McCarney R, Warner J, Fisher P et al. (2003) Homeopathy for dementia. Cochrane Database Syst Rev:CD003803
15. Paris A, Gonnet N, Chaussard C et al. (2008) Effect of homeopathy on analgesic intake following knee ligament reconstruction: a phase III single-center randomized placebo-controlled study. Br J Clin Pharmacol 65:180-187
16. Peckham EJ, Cooper K, Roberts ER et al. (2019) Homeopathy for the treatment of irritable bowel syndrome. Cochrane Database Syst Rev 9:CD009710
17. Perry R, Leach V, Davies P et al. (2017) An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools. Syst Rev 6:97
18. Posadzki P, Alotaibi A, Ernst E (2012) Adverse effects of homeopathy: a systematic review of published case reports and case series. Int J Clin Pract 66:1178-1188
19. Schirmer KP, Fritz M, Jackel WH (2000) [Effectiveness of Formica rufa and autologous blood injection in patients with ankylosing spondylitis: a double-blind randomized study]. Z Rheumatol 59:321-329
20. Shang A, Huwiler-Muntener K, Nartey L et al. (2005) Are the clinical effects of homeopathy placebo effects? A comparative study of placebo-controlled trials of homeopathy and allopathy. Lancet 366:726-732
21. Simonart T, Kabagabo C, De Maertelaer V (2011) Homeopathic remedies in dermatology: a systematic review of controlled clinical trials. Br J Dermatol 165:897-905
22. Sizova LV (2011) Treatment of early arthritis using Arthrofoon (ultra-low doses of antibodies to tumor necrosis factor-alpha). Indian J Pharmacol 43:724-725
23. Vickers AJ, Smith C (2006) Homeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes. Cochrane Database Syst Rev:CD001957
Last updated: April 18, 2023