Risposta IAVH alla meta-analisi di Doehring and Sundrum sull’utilizzo dell’omeopatia in allevamento
Proof of the effectiveness of homeopathy in animals
In organic agriculture, the use of homeopathic remedies in Europe is explicitly recommended: they should be preferred over conventional medicine, according to the corresponding EU organic regulations of the European Commission. While farmers experience daily success with homeopathy, the skeptics are looking for scientific evidence. In this context, the International Association for Veterinary Homeopathy (IAVH) commented on the review by Doehring and Sundrum, published in Veterinary Record (1) in December 2016, in terms of objective reporting.
Scientific studies and, last but not least, a meta-analysis of randomized controlled trials provide, though limited, evidence for the effectiveness of veterinary homeopathy versus placebo (4, 6, 11).
Further studies of high quality are required – as in many areas of medicine. There are also studies onthe mode of action of homeopathy (2, 8, 9, 13, 14) as well as a YouTube video of Bell, 2016, containing a solid summary (3).
In a randomized, placebo controlled, double-blind study (4) for the homeopathic treatment of
diarrhoea in piglets caused by the bacterium Escherichia coli (E. coli), it was already shown in 2010 that the homeopathically treated group had significantly fewer piglets with E. coli diarrhoea. In addition, the severity of the disease was lower and diarrhoea, if it occurred, of a shorter duration. Homeopathic remedies were used as replacement to antibiotics in the case of E. coli diarrhoea in neonatal piglets. The study was classified as high-quality by Doehring and Sundrum, as well as by Mathie and Clausen. The repeatability of this study is currently being examined in other study centers.
AMR Action Plan
It is important to note that in the recently published documents on the antimicrobial resistance (AMR) Action Plan of the EU Commission, CAM (complementary, alternative medicine), homeopathy included, is mentioned as a potential approach to solutions to AMR, and their demand for further research in CAM is particularly relevant in terms of the importance of the AMR problem in humans and animals. In addition, in an annex to the RAND Survey on antibiotic resistance, submitted by the European Committee for Homeopathy, numerous homeopathic studies on infectious diseases in humans and animals are listed and described.
In his meta-analysis from 2013 (7), Robert Hahn (Head of Research, Södertälje Hospital Sweden, Professor of Anesthesia & Intensive Care, Linköping University) has stated that, in order to demonstrate that homeopathy in humans does not show effectiveness, more than 90% of the available clinical studies must be excluded or scientifically untenable statistical methods must be applied. At this point, a Cochrane Review (5) has to be mentioned, with 1016 systematic reviews on conventional therapies being investigated, with 44% positive, 7% negative results and 49% of the reviews reporting that the evidence did not support either benefit or harm.
Review by Doehring and Sundrum – critical points
In the recently published review conducted by Doehring and Sundrum (1), critical points should be noted: for example, in only 13 out of 48 studies was homeopathic therapy performed by a veterinarian with sound homeopathic training. Correct choice of remedy is the crux of effectiveness of homeopathy! Whereas this review by Doehring and Sundrum was thoughtful about research of homeopathy in a farm context in general, it has no additional value beyond that of the prior literature (10-12) in making any comments about the effectiveness of homeopathy. More research is clearly required, as the authors recommend, but it seems a step too far for them to state, ‘replacing or reducing antibiotics with homeopathy currently cannot be recommended’. Hence, the contribution of this paper and the advice it offers to the reader and the EU needs to be questioned. Of course, numerous further scientific studies have to be carried out in veterinary homeopathy. As with antibiotic studies, external factors must always be taken into account in farm animal practice in studies. Obtaining financial support for conducting an independent research is a major challenge both in conventional medicine and in homeopathy.
International, interdisciplinary cooperation
The European Homeopathy Congress took place in Vienna from 17-19 November 2016 with 480 participants from well over 30 different countries. Veterinarians (International Association for Veterinary Homeopathy, IAVH), human doctors and pharmacists (European Committee for
Homeopathy, ECH), and patient representatives (European Federation of Homeopathic Patients’ Associations, EFPHA) jointly organized the congress. Conventional medicine and homeopathy in mutual synergy was a key theme at the congress. Presentations like on State-of-the-art in the treatment of cancer patients and of orthopedic & internal emergencies in horses in combination with numerous presentations on human and veterinary homeopathic studies and on the classical homeopathic treatment of humans and animals in practice as well as a political and pharmaceutical discussion made the congress unique. Following the press conference, positive articles were to be read in two Austrian newspapers (15,16).
The International Association for Veterinary Homeopathy (IAVH) has 745 active members and offers the possibility of obtaining the IAVH certificate. In all training courses on veterinary homeopathy, the principle that conventional medicine and homeopathy are always complementary to the well-being of the patient is fulfilled.
This is also the recommendation of the WHO strategy for CAM (complementary, alternative medicine) 2014-2023, which asks for the integration of CAM into health systems. Finally, Dr. Alojz Peterle, member of the European Parliament, is quoted from his videomessage, which he provided for the political discussion at the first European homeopathy congress in Vienna: “To me homeopathy stands for a holistic, complete, cost-effective and safe approach to promote health, prevent and treat disease.We are obviously facing a growing number of health related challenges: an aging population, rising levels of diseases such as cancer, diabetes and heart disease … and the anti-microbial resistance. … European citizens increasingly recognize the benefits of homeopathy and its inherent holistic approach to care. … For these reasons … , we need to incorporate ways in which homeopathycan contribute to sustainable healthcare systems in Europe including its role in health maintenance, reduction of use of antibiotics, less invasive and more costeffective treatment of illness, which are also some of objectives of the EU Health Strategy 2014-2020.
… The time is ripe to seriously consider homeopathyas both innovation and added value for European citizens and animals.”
· The recent review by Doehring and Sundrum (1) on efficacy of homeopathy in livestock published in the Veterinary Record does not tell us anything new about the evidence base in homeopathy.
· This review’s findings (1) are broadly consistent with the findings of a previous, high-quality, review by Mathie and Clausen (10), published 2014 in the same journal, which clarified that further veterinary research is needed before firm conclusions can be drawn and any clinical recommendations can be made. This need for further research was subsequently confirmed by another high-quality review by the same authors (12).
· A meta-analysis by Mathie and Clausen (11) showed that overall there is a positive trend in the evidence on veterinary homeopathy which is robust upon sensitivity analysis: i.e. the positive trend is unchanged whether one considers only the highest quality trials or all existing trials regardless of quality.
· The evidence base of veterinary homeopathy comprises a relatively small number of studies ‘scattered’ across a wide range of clinical conditions and species. The repetition of positive studies is currently underway.
· The positive studies showing effectiveness of homeopathy in animals demonstrate that homeopathy may have a role to play in livestock: e.g. as a replacement for antibiotics for treating E.coli diarrhoea in piglets (4).
· Considering the global threat of anti-microbial resistance, such promising areas deserve investment in further research, in particular high-quality randomized clinical trials.
(1) Doehring C, Sundrum A. Efficacy of homeopathy in livestock according to peer-reviewed
publications from 1981 to 2014, Veterinary Record; 179: 628.
(8) Khuda-Bukhsh AR et al. (2011). Modulation of Signal Proteins: A Plausible Mechanism to Explain How a Potentized Drug Secale Cor 30C Diluted beyond Avogadro’s Limit Combats Skin Papilloma in Mice. Evidence-Based Complementary and Alternative Medicine; Article ID 286320, 12 pages, 2011. doi:10.1093/ecam/nep084