Authors' objectives: The purpose of this evidence note is to describe the available high quality evidence on clinical and cost effectiveness of homeopathic remedies in relation to migraine and osteoarthritis. The inclusion criteria were any systematic review, meta-analysis or RCT on homeopathy in migraine and osteoarthritis.

Authors' recommendations: Published systematic reviews of homeopathy for migraine provide limited evidence on clinical effectiveness. The four available RCTs compared different homeopathic medicines with placebo in small numbers of patients. Only one of the four RCTs found homeopathy to be superior to placebo. No RCTs were identified that compared homeopathy with an active treatment control group therefore the evidence reviewed cannot inform conclusions on the clinical effectiveness of homeopathy compared with standard treatment. Published systematic reviews of homeopathy for osteoarthritis also provide limited evidence on clinical effectiveness. The four available RCTs compared different homeopathic medicines with different active control treatments variously administered orally, topically or by intra-articular injection in small numbers of patients. One RCT found no difference in pain outcomes between oral homeopathy and paracetamol; another found oral NSAID treatment superior to homeopathy and the latter no different to placebo. A topical homeopathy preparation gave similar pain relief as a topical NSAID in one trial; and in another, an intra-articular homeopathy preparation gave similar pain relief as hyaluronic acid injections. Published systematic reviews of homeopathy for migraine and osteoarthritis contain very little or no information on safety. Secondary evidence on adverse effects of homeopathy in general highlights the lack of reporting of adverse effects in clinical trials, and the lack of attention to harmful effects in systematic reviews of clinical effectiveness. Systematic reviews to date indicate that published case reports provide insufficient evidence to support reliable conclusions about causality. This rapid review did not identify any evidence on the cost effectiveness of homeopathy for migraine, and found only one cost-minimisation analysis of one homeopathic preparation for osteoarthritis that is not generalisable to the UK. The secondary sources reviewed raise important questions about the methodological quality of the research evidence on homeopathy for migraine and osteoarthritis published to date. There is a need for higher quality primary and secondary research to inform decisions on the provision of homeopathy services for specific medical conditions, including those for migraine and osteoarthritis.

Project Status: Completed

URL for project: http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/shtg/shtg_work_programme/homeopathy.aspx

Year Published: 2014

URL for published report: http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/shtg_-_evidence_notes/evidence_note_53.aspx

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Scotland, United Kingdom

Organisation Name: Scottish Health Technologies Group

Contact Address: Scottish Health Technologies Group, Delta House, 50 West Nile Street, Glasgow, G1 2NP Tel: 0141 225 6998

Contact Name: his.shtg@nhs.scot

Contact Email: his.shtg@nhs.scot

Copyright: Healthcare Improvement Scotland