SELECTED ARTICLES FROM THE RECENT LITERATURE 2004
11/18/04
Are complementary / alternative treatments effective in asthma?
Summary
Background - It has been estimated that complementary/alternative medicine ( CAM ) approaches are used by 1/3 - 1/2 of all asthmatics at one time or another. But is there convincing evidence that any of them are effective in improving asthma outcomes?
Findings - Markham and Wilkinson of the Charles Stuart Univ in Australia carried out a systematic review of all randomized clinical trials of CAM approaches in asthma between 1997 and 2002. After careful review and screening, they found 15 studies that met inclusion criteria for study design. They concluded that these studies showed minimal or no significant differences between the various CAM approaches tried when compared to placebo or sham therapy. They speculated that these interpretations may have been due in part to the sizable placebo effect and/or small sample size in some of these studies. Provocative findings about effects of CAM on immune function in 2 studies bear further investigation in larger well-designed studies. Reference
J Asthma 2004;41:131-39
Editor's Comments
These findings are generally similar to previous meta-analyses of studies of CAM approaches in asthma. That does not mean that there may not be some effect in selected populations. However, the strong placebo effect in patients who volunteer for such studies (and "want" the CAM approaches to benefit them) make interpretation difficult. Further investigation may be warranted but not at the cost of patients avoiding medications with proven efficacy in asthma. Also, one must keep in mind that some herbal CAM meds may interact with prescription meds with deleterious effects.
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