Homeopathic and conventional treatment for atopic eczema in children (ADEV) - a comparative trial with long-term follow-up

Homeopathic and conventional treatment for atopic eczema in children - a comparative trial with long-term follow-up


Background: One in five children visiting a homeopathic physician suffers from atopic eczema.

Objectives: We aimed to examine the long-term effectiveness, safety and costs of homoeopathic vs. conventional treatment in usual medical care of children with atopic eczema.

Methods: In this prospective multi-centre comparative observational non-randomized rater-blinded study, 135 children (48 homoeopathy, 87 conventional) with mild to moderate atopic eczema were included by their respective physicians. Depending on the specialisation of the physician, the primary treatment was either standard conventional treatment or individualized homeopathy as delivered in routine medical care. The main outcome of the study was the SCORAD (SCORing Atopic Dermatitis) at 6 months evaluated by a blinded rater. Further outcomes included quality of life, conventional medicine consumption, safety and disease related costs at 6, 12 and 36 months after baseline. A multilevel ANCOVA was used, with physician as random effect and the following fixed effects: age, gender, baseline value, severity score, social class and parents' expectation.

Results: The adjusted SCORAD showed no significant differences between the groups at both 6 months (homoeopathy 22.49 + or - 3.02 [mean + or - SE] vs. conventional 18.20 + or - 2.31, p = 0.290) and 12 months (17.41 + or - 3.01 vs. 17.29 + or - 2.31, p = 0.974). Adjusted costs were higher in the homoeopathic than in the conventional group: for the first 6 months EUR 935.02 vs. EUR 514.44, p = 0.026, and for 12 months EUR 1,524.23 vs. EUR 721.21, p = 0.001. Quality of life was not significantly different between both groups. After 36 months the adjusted mean SCORAD showed no significant differences between the groups (13.7 95% CI [7.9-19.5] vs. 14.9 [10.4-19.4], p=0.741). The SCORAD response rates at 36 months were similar in both groups (33% response: homoeopathic 63.9% vs. conventional 64.5%, p=0.94; 50% response: 52.0% vs. 52.3%, p=0.974) and total costs were higher in the homoeopathic versus the conventional group (months 31-36 200.54 Euro [132.33-268.76] vs. 68.86 Euro [9.13-128.58], p=0.005).

Conclusions: Taking patient preferences into account, while being unable to rule out residual confounding, in this observational study with long-term follow-up, the effects of homoeopathic treatment were not superior to conventional treatment for children with mild to moderate atopic eczema, but involved higher costs.

Comment: 

This study is observational and does not provide evidence on homeopathic drugs.


Publications:

Roll S, Reinhold T, Pach D, Brinkhaus B, Icke K, Staab D, Jäckel T,
Wegscheider K, Willich SN, Witt CM. Comparative effectiveness of homoeopathic vs.conventional therapy in usual care of atopic eczema in children: long-term medical and economic outcomes. PLoS One. 2013;8(1):e54973. 

Witt C, Brinkhaus B, Pach D, Reinhold T, Wruck K, Roll S, Jackel T, Staab D, Wegscheider K, Willich S. Homoeopathic versus conventional therapy for atopic eczema in children: medical and economic results. Dermatology, 2009. 219(4):329-340.

 

Principle investigator:
Witt, MD, MBA

Research associates:
Brinkhaus, MD

Statistics:
Roll, PhD
Wegscheider, PhD

Data management:
Icke

Study nurse:
Eden

Project duration:
2008-2011

Project status:
completed

Funding:
Robert Bosch Foundation