Homeopathy in the treatment of fibromyalgia—A comprehensive literature-review and meta-analysis

Boehm, Katja; Raak, Christa; Cramer, Holger; Lauche, Romy; Ostermann, Thomas

doi:10.1016/j.ctim.2014.06.005

Cited by 28 publications

(23 citation statements)

References 25 publications

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“…The highest quality, including only one trial, provided some evidence that guided imagery may be effective in reducing pain (−1.52; −2.17 to −0.87) 90. Two reviews of homeopathy included four trials and 163 participants 97 98. Both contained a review including only four randomised trials, each of which showed some benefit of homeopathy, on some outcomes.…”

Section: Resultsmentioning

confidence: 99%

EULAR revised recommendations for the management of fibromyalgia

et al. 2016

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Objective The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were 'expert opinion'. Methods A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pharmacological/nonpharmacological management for fibromyalgia. A review, in May 2015, identified eligible publications and key outcomes assessed were pain, fatigue, sleep and daily functioning. The Grading of Recommendations Assessment, Development and Evaluation system was used for making recommendations. Results 2979 titles were identified: from these 275 full papers were selected for review and 107 reviews (and/or meta-analyses) evaluated as eligible. Based on metaanalyses, the only 'strong for' therapy-based recommendation in the guidelines was exercise. Based on expert opinion, a graduated approach, the following four main stages are suggested underpinned by shared decision-making with patients. Initial management should involve patient education and focus on nonpharmacological therapies. In case of non-response, further therapies (all of which were evaluated as 'weak for' based on meta-analyses) should be tailored to the specific needs of the individual and may involve psychological therapies (for mood disorders and unhelpful coping strategies), pharmacotherapy (for severe pain or sleep disturbance) and/or a multimodal rehabilitation programme (for severe disability). Conclusions These recommendations are underpinned by high-quality reviews and meta-analyses. The size of effect for most treatments is relatively modest. We propose research priorities clarifying who will benefit from specific interventions, their effect in combination and organisation of healthcare systems to optimise outcome.

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Section: Resultsmentioning

confidence: 99%

EULAR revised recommendations for the management of fibromyalgia

et al. 2016

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“…Two individual reviews of homoeopathy for FM were identified [28, 29]. Four multiple CAM reviews [30–34] also assessed homoeopathy.…”

Section: Resultsmentioning

confidence: 99%

“…The review and meta-analysis by Boehm et al [29] identified the same four RCTs and one controlled clinical trial (CCT) [40] (alongside ten case reports, three observational studies). A meta-analysis of three RCTs [36–38] ( n = 139) revealed effects of homoeopathy on tender point count (SMD = −0.42; 95% CI −0.78 to −0.05, P = 0.03, I 2 = 0%), compared to placebo.…”

Section: Resultsmentioning

confidence: 99%

“…Nine reviews reported using two data extractors and achieving study consensus. Just one review did not report conducting a risk of bias assessment [45], and two [29, 45] did not apply the quality assessment appropriately in light of the findings. Only one included an ‘excluded studies’ table [48].…”

Section: Resultsmentioning

confidence: 99%

“…in FIQ pain scores. In completers, sample greater reduction in MPQ scores ( P < 0.05)NoJadad score plus additional assessment from Cochrane ROBNRBoehm [29]2014Germany1. Fisher [35]2.…”

Section: Methodsmentioning

confidence: 99%

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An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools

et al. 2017

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BackgroundFibromyalgia (FM) is a chronic, debilitating pain disorder. Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine (CAM). Two previous overviews of systematic reviews of CAM for FM have been published, but they did not assessed for risk of bias in the review process.MethodsFive databases Medline, Embase, AMED (via OVID), Web of Science and Central were searched from their inception to December 2015. Reference lists were hand-searched. We had two aims: the first was to provide an up-to-date and rigorously conducted synthesis of systematic reviews of CAM literature on FM; the second was to evaluate the quality of the available systematic review evidence using two different tools: AMSTAR (Shea et al. BMC Med Res Methodol 15; 7:10, 2007) and a more recently developed tool ROBIS (Whiting et al. J Clin Epidemiol 69:225-34, 2016) specifically designed to assess risk of bias in systematic reviews. Any review that assessed one of eight CAM therapies for participants diagnosed with FM was considered. The individual studies had to be randomised controlled trials where the intervention was compared to placebo, treatment as usual or waitlist controls to be included. The primary outcome measure was pain, and the secondary outcome measure was adverse events.ResultsWe identified 15 reviews that met inclusion criteria. There was low-quality evidence that acupuncture improves pain compared to no treatment or standard treatment, but good evidence that it is no better than sham acupuncture. The evidence for homoeopathy, spinal manipulation and herbal medicine was limited.ConclusionsOverall, five reviews scored 6 or above using the AMSTAR scale and the inter-rater agreement was good (83.6%), whereas seven reviews achieved a low risk of bias rating using ROBIS and the inter-rater agreement was fair (60.0%). No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM. There is limited evidence for topical Capsicum, but further research is required. There is some evidence to support the effectiveness of acupuncture for FM, but further high-quality trials are needed to investigate its benefits, harms and mechanisms of action, compared with no or standard treatment.Systematic review registrationPROSPERO CRD42016035846.

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Qualität der Studien zur Medizin insgesamt nicht besser als zur Homöopathie

Kruse

2020

Monatsschr Kinderheilkd

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Homeopathy in the treatment of fibromyalgia—A comprehensive literature-review and meta-analysis

Cited by 28 publications

References 25 publications

EULAR revised recommendations for the management of fibromyalgia

EULAR revised recommendations for the management of fibromyalgia

An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools

Qualität der Studien zur Medizin insgesamt nicht besser als zur Homöopathie

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