Homeopathy for knee osteoarthritis: Series of three randomized trials and statistical pooling of the results

Introduction: Despite its popularity, scientific research has so far not provided adequate support for homeopathy as a recommendable therapy in knee osteoarthritis (OA). Objective: To differentiate individualized homeopathic medicinal products (IHMPs) from identical-looking placebos in pain management of knee OA. Materials and Methods: Three-month, double-blind, randomized (1:1), parallel-arm, placebo-controlled trials were conducted consecutively on 266 patients with knee OA ( n = 134, 60, and 72). The participants received either verum (IHMPs plus concomitant care [CC]; n = 133) or control (identical-looking placebos plus CC; n =133). Different outcome measures were used: pain 0–10 Numeric Rating Scale (NRS), the Knee Injury and Osteoarthritis Outcome Scale (KOOS) and its subscales, the Measure Yourself Medical Outcome Profile, version 2.0, the EuroQol-5 Dimensions-5 Levels, transformed Western Ontario and McMaster Universities Arthritis Index score from KOOS, and frequency of add-on paracetamol and/or nonsteroidal anti-inflammatory drugs; all measured monthly for 3 months. The obtained results were combined statistically. Results: The results were nonsignificant in one of the trials (pain NRS: mean difference = 0.1, 95% confidence interval [CI]: −0.4 to 0.7; P = 0.655), whereas they were significant in other two; KOOS pain: mean difference = 7.8, 95% CI: 0.6–14.9; P = 0.034; and KOOS pain: mean difference = 11.5, 95% CI: 0.5–17.4; P < 0.001. Combined results were nonsignificant statistically ( P = 0.18), with substantial heterogeneity (I 2 = 84%). Conclusion: The null hypothesis of no difference could not be rejected; robust trials are warranted. Trial Registration: CTRI/2022/04/042070, CTRI/2022/04/041660, and CTRI/2020/10/028711.