Homeopathic treatment of children with atopic eczema: a prospective observational study with two years follow-up.

Sir, Homeopathy is practised in many regions of the world (1), especially in high-income countries where it ranks the most popular among traditional, complementary, or alternative medicines (1–3). One out of 5 children in a German homeopathic physicians' practice suffered from atopic eczema (AE) (4). Meta-analyses of placebo-controlled studies including only diagnoses other than AE have shown inconsistent results (5, 6). The only random-ized placebo-controlled study on AE (7) was stopped due to recruitment problems and drop-outs. In a prospective observational study we investigated the treatment and possible effects in 3981 consecutive patients (1130 children and 2851 adults) who consulted a physician for classical homeopathic therapy. This paper presents the subgroup of children with AE (ICD-9: 691.8, ICD-10: L20.8), followed up for 24 months. For more details and methods see (8). RESuLTS We included 225 children (Table I) in this intention-to-treat analysis with a disease duration of AE of 3.6 ± 3.8 years. On average the last homeopathic medication was documented after 11.8 ± 10.1 months; however, the majority of patients (69%) continued homeopathic care at the end of the study. Over the course of the study patients received 7.3 ± 6.4 homeopathic prescriptions, most frequently Calcium carbonicum (8.2%), Tubercu-linum (7.2%), and Medorrhinum (6.8%). In total, 137 different homeopathic remedies were used. The strongest improvement in diagnoses and medical complaints was seen in the first 3 months, and it continued during the full observation period (Table II). Physicians' severity assessments tended to be more positive than patients' assessments, still all changes since baseline were of large effect size (Cohen's d 1.76–2.56). After 24 months, the AE as well as the other baseline diagnoses were considerably relieved, while reductions in use of conventional medicines were observed (Table I). DISCuSSION The patients with AE in our study suffered from long-term disease. The severity of disease and quality of life improved substantially and the uses of conventional medication and health services decreased markedly. The methodological strengths of our study include consecutive patient enrolment, high follow-up rates, and the participation of about 1% of all certified homeopathic physicians in Germany. In contrast to randomized trials , our study describes patients from everyday practice with multiple morbidities and a wide range of lifestyles. This ensures a high degree of external validity that allows extrapolation to usual medical care. Our study was designed to evaluate homeopathic treatment in patients with various diagnoses that disallowed the use …