ARIA update: I - systematic review of complementary and alternative medicine for rhinitis and asthma
Link to abstract here.
Bottom-line conclusion: Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence.
Method: To provide evidence-based recommendations, the literature was searched by using MedLine and the Cochrane Library to March 2005 (Key words: Asthma [OR] Rhinitis, [AND] Complementary [OR] Alternative Medicine, [OR] Herbal, [OR] Acupuncture, [OR] Homeopathy, [OR] Alternative Treatment). Randomized trials, preferably double-blind and published in English, were selected. The articles were evaluated by a panel of experts. Quality of reporting was assessed by using the scale validated by Jadad.
Results: The methodology of clinical trials with complementary-alternative medicine was frequently inadequate. Meta-analyses provided no clear evidence for the efficacy of acupuncture in rhinitis and asthma. Some positive results were described with homeopathy in good-quality trials in rhinitis, but a number of negative studies were also found. Therefore it is not possible to provide evidence-based recommendations for homeopathy in the treatment of allergic rhinitis, and further trials are needed. A limited number of studies of herbal remedies showed some efficacy in rhinitis and asthma, but the studies were too few to make recommendations. There are also unresolved safety concerns.
| Specialist Library Quality Assessment: |
| The review was clearly focused in terms of the population and range of interventions to be examined. The study design inclusion criteria stipulated randomised controlled trials to ensure methodological rigour, and included trials were assessed with a reliable scoring system (Jadad) by a panel of experts. The literature search covered both Medline and the Cochrane Library without language restrictions and reference lists were followed up to identify additional studies. Additional databases, in particular CINAHL and AMED, would have ensured a more comprehensive search. Publication bias is possible as it is not clear whether unpublished studies were sought. None of the results of included trials were combined, an in the absence of a test for heterogeneity it is not possible to judge whether the narrative discussion of results was appropriate. The conclusions follow from the results and the authors' recommendation for further trials in order to make evidence based recommendations is justified. |
Citation: Passalacqua G, et al. ARIA update: I - systematic review of complementary and alternative medicine for rhinitis and asthma. Journal of Allergy and Clinical Immunology 2006;117:1054-62.
Access: Full-text online access to this article requires subscription to the journal. NHS staff please contact your local NHS library for further assistance.
