Complementary Tuberculosis care: adding homeopathy to the standard antibiotic treatment
Article: Chand KS, Manchanda RK, Mittal R, Batra S, Banavaliker JN, De I. Homeopathic treatment in addition to standard care in multi drug resistant pulmonary tuberculosis: a randomized, double blind, placebo controlled clinical trial. Homeopathy. 2014;103(2):97-107. doi:10.1016/j.homp.2013.12.003
Like the study I went over last week, this study looks at whether adding homeopathic treatment to antibiotic treatment in tuberculosis improves outcomes. The study was done in India and they looked at drug-resistant tuberculosis in particular. Multi drug resistant tuberculosis, at least in this paper, was defined as resistance to 2 medicines: isoniazid and rifampicin. Doctors tested the bacterium itself when someone is diagnosed. The standard of care for these patients is a group of antibiotics that are taken for 2 years or more, but this regime, according to this paper, only has a 48% success rate.
So this group took 120 people with multi drug-resistant tuberculosis and gave them the standard of care regime, but also gave half homeopathic treatment and half got placebo. They looked at improvement or worsening of chest x-rays, subjective symptoms, some blood values and weight. Their primary endpoint was whether the bacterium could still be cultured in the sputum however. It was double blinded. There were two homeopaths and a “senior consultant”, whatever that means” who examined the patient, determined the remedy, and then gave a prescription. The patient then was allocated to treatment or placebo and would pick up their remedy – but not know if it was actually the remedy or placebo. Weirdly though (they don’t explain this in the paper), they only allowed a prescription of 12 remedies. I am going to guess it was to help with the blinding issue (if you have 1000 potential remedies, you need 1000 matching placebo in order to keep the blinding accurate). But that does potentially limit your success. If someone needed Drosera, they wouldn’t have been able to take Drosera, they would have been prescribed something else instead. This is a massive limiting factor to me. They also dosed only 1-2x per week, which, as a homeopath that routinely uses daily dosing, I think could have limited their success.
Their primary endpoint, whether the bacterium could be cultured in the sputum or not, had no statistically significant difference between groups. There was no statistical difference between groups for most of the outcomes. However, there was a statistically significant difference in the chest x ray outcomes. Like, a very significant difference. Using the Bonferroni method (which is highly, highly conservative) of adjusting p values still yields a highly significant result for chest x-ray endpoints. In other words, we can be very sure that the homeopathic treatment resulted in chest xray changes beyond what is seen with antibiotic treatment alone. We therefore have some great evidence for complementary care.