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Rheumatology 2000; 39: 714-719
© 2000 British Society for Rheumatology

A randomized controlled trial comparing topical piroxicam gel with a homeopathic gel in osteoarthritis of the knee

R. A. van Haselen and P. A. G. Fisher

The Royal London Homoeopathic Hospital, Great Ormond Street, London WC1N 3HR, UK

Objective. To evaluate the efficacy and safety of a homeopathic gel vs an NSAID (piroxicam) gel in the treatment of osteoarthritis of the knee.

Method. One hundred and eighty-four out-patients with radiographically confirmed symptomatic osteoarthritis of the knee were entered into a pragmatic, randomized, double-blind controlled trial and treated with 1 g of gel three times daily for 4 weeks. Main outcome measures were pain on walking as a Visual Analogue Score (VAS) and a single-joint Ritchie index.

Results. One hundred and seventy-two of the 184 enrolled patients had endpoints for the main outcome parameters. The pain reduction was 16.5 mm VAS in the homeopathy group (n = 86) and 8.1 mm in the piroxicam group (n = 86); the difference between treatment groups was 8.4 mm (95% confidence interval 0.8–15.9), and after adjustment for pain at baseline it was 6.8 mm (95% confidence interval –0.3 to 13.8). There was no significant difference between treatment groups in the single-joint Ritchie index (P = 0.78). Adverse events occurred in 28 patients (12 homeopathy group, 5 withdrawn; 16 piroxicam group, 9 withdrawn); 18 of the events involved a local reaction (7 homeopathy group, 2 withdrawn; 11 piroxicam group, 5 withdrawn).

Conclusion. The homeopathic gel was at least as effective and as well tolerated as the NSAID gel. The presence of a clinically relevant difference between treatment groups cannot be excluded. The homeopathic gel supplemented by simple analgesics if required may provide a useful treatment option for patients with osteoarthritis.

KEY WORDS: Homeopathy, Topical NSAIDs, SRL® gel, piroxicam gel, Randomized controlled trial.

Correspondence to: R. A van Haselen.


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