Efficacy of individualized homoeopathic medicines in treatment of atopic dermatitis in adults: a double blind, randomized, placebo controlled trial

Atopic Dermatitis (AD) is a chronic, relapsing, pruritic, inflammatory skin disease having significant impact on the quality of life (QoL) and public health costs. Despite the fact that the evidences favouring homeopathy in AD is unconvincing, and based mostly on experience or anecdotal data, it is still highly popular. We evaluated whether individualized homeopathic medicines (IH) have significant effect beyond placebo in treatment of AD. A double-blind, randomized (1:1), two parallel arms, placebo-controlled trial (n=60) was conducted at D. N. De Homoeopathic Medical College and Hospital, West Bengal. Primary outcomes were patient-oriented scoring of AD (PO-SCORAD); secondary outcomes were dermatological life quality index (DLQI), and AD burden score for adults (ADBSA); measured at baseline, and every month, up to 3 months. Effect sizes (Cohen’s d, means adjusted for differences of baseline values) were calculated on intention-to-treat sample to detect group differences. Nine patients dropped out (IH: 3, Placebo: 6). Though intra-group changes were significant, between-group differences in PO-SCORAD, DLQI and ADBSA scores were non-significant (all P > 0.05, unpaired t test) except DLQI at month 1 (mean difference 1.3, 95% confidence interval (CI) 0.2 to 2.2, P = 0.019, unpaired t test, Cohen’s d = 0.6). Group difference on DLQI after 3 months (mean difference 1.9, 95% CI -0.1 to 3.9, P = 0.064, unpaired t test, Cohen’s d = 0.5) was near significant. Although the improvements produced by IH were higher than placebo, group differences were mostly non-significant. The trial being underpowered and of short duration, cautious interpretation is necessary.