A Randomized, Double-Blind, Placebo-Controlled, Pilot Trial of Individualized Homeopathic Medicines for Cutaneous Warts

Abstract

Background Though frequently used in practice, research studies have shown inconclusive benefits of homeopathy in the treatment of warts. We aimed to assess the feasibility of a future definitive trial, with preliminary assessment of differences between effects of individualized homeopathic (IH) medicines and placebos in treatment of cutaneous warts. Methods A double-blind, randomized, placebo-controlled trial (n = 60) was conducted at the dermatology outpatient department of D.N. De Homoeopathic Medical College and Hospital, West Bengal. Patients were randomized to receive either IH (n = 30) or identical-looking placebo (n = 30). Primary outcome measures were numbers and sizes of the warts; secondary outcome was the Dermatology Life Quality Index (DLQI) questionnaire measured at baseline, and every month up to 3 months. Group differences and effect sizes were calculated on the intention-to-treat sample. Results Attrition rate was 11.6% (IH, 3; placebo, 4). Intra-group changes were significantly greater (all p < 0.05, Friedman tests) in IH than placebo. Inter-group differences were statistically non-significant (all p > 0.05, Mann-Whitney U tests) with small effect sizes—both in the primary outcomes (number of warts after 3 months: IH median [inter-quartile range; IQR] 1 [1, 3] vs. placebo 1 [1, 2]; p = 0.741; size of warts after 3 months: IH 5.6 mm [2.6, 40.2] vs. placebo 6.3 [0.8, 16.7]; p = 0.515) and in the secondary outcomes (DLQI total after 3 months: IH 4.5 [2, 6.2] vs. placebo 4.5 [2.5, 8]; p = 0.935). Thuja occidentalis (28.3%), Natrum muriaticum (10%) and Sulphur (8.3%) were the most frequently prescribed medicines. No harms, homeopathic aggravations, or serious adverse events were reported. Conclusion As regards efficacy, the preliminary study was inconclusive, with a statistically non-significant direction of effect favoring homeopathy. The trial succeeded in showing that an adequately powered definitive trial is both feasible and warranted. Trial Registration CTRI/2019/10/021659; UTN: U1111–1241–7340

Rapid Recovery of One-Sided Verruca Vulgaris (Common Wart) with Homoeopathic Treatment: A Case Report

“…But in the subsequent edition, a letter to the editor by Gengoux 12 pointed out several deficiencies in the trial especially mentioning 'the worst choice of similimum'. The same question may be raised for the other trials especially the one conducted by Dey et al, 9 where a positive trend toward homoeopathy was shown. The trial was conducted as a student research project and questions related to sufficient expertise for diagnosis of cutaneous warts and selection of correct homoeopathic remedy exist within the trial.…”

“…Different studies including randomised controlled trials have been conducted on this clinical condition with varying results. 6 7 8 9 Significant importance has been laid on the skill of treating homoeopathic physicians as selection of the correct remedy plays an important role in the successful treatment of this clinical condition. This case is being reported as per the Homoeopathy specific HOMCASE guidelines 10 which is a supplement to the standard CARE guidelines for Case Reports of reporting clinical cases.…”

Why homoeopathy is pseudoscience

“…When homoeopaths are confronted with the problem of the insufficient empirical foundation of their doctrine, they often mischaracterise the evidence. Dey et al (2021), for instance, do this in a recent paper. They examined in an RCT whether classical homoeopathy was effective in treating warts and determined that their study was "inconclusive.…”

Cutaneous Warts Treated with Individualised Homoeopathic Medicine: A Case Series

“…However, further rigorous designs and robust clinical trials of a larger sample size are warranted to validate the study's findings and adding more observations on the subject. Thuja occidentalis, Causticum and Natrum muraticum 4 7 8 16 were referenced as effective homoeopathic medicines for warts in the past studies and were also reported as valuable medicines in the homoeopathic literature. These medicines were found effective in treating warts in this case series which will further guide clinicians in its therapeutics and developing augmented prescription criteria for better clinical outcomes of cutaneous warts.…”

“…A mostly tropical country, India has a climate favouring viral infections, including warts. 4 Homoeopathic treatment embraces the core principles of individualisation and follows a holistic constitutional approach in selecting a similar medicine based on the totality of symptoms for every case. According to Master Samuel Hahnemann, founder of homoeopathy, 'It is the sick person that is to be treated, not the pathological name'.…”