Thursday, February 17, 2005

Oscillococcinum for influenza

Today, as I recover from the throes of my recent influenza or influenza-like-illness, I opened a package that has been sitting on my desk for a week, that came in the mail. It contained a free sample of oscillococcinum, the accompanying material claims that it is proven to reduce the severity and duration of the flu if given at the early onset of symptoms.
What is Oscillococcinum? The box says Anas barbarie hepatis et cordis extractum, aka heart and liver extract from the Muscovy Duck.
I did a Medline search and found this:
The Cochrane Database of Systematic Reviews,Volume (4),2004, Homoeopathic Oscillococcinum for preventing and treating influenza and influenza-like syndromes,Vickers, AJ; Smith, C. Here are some excerpts:
Conclusions: Though promising, the data are not strong enough to make a general recommendation to use Oscillococcinum for first-line treatment of influenza and influenza-like syndrome. Further research is warranted but required sample sizes are large. Current evidence does not support a preventative effect of Oscillococcinum-like homeopathic medicines in influenza and influenza-like syndromes.

That is a little different from the study quoted in the literature that came with my free sample, Casonova et al 1983. This is what the Cochrane review says about that study in particular:
The main difficulty is that one of the trials, Casanova (Casanova 1984), was not published in a standard medical journal, contains little experimental detail, does not report withdrawals and analyses a suspiciously round number of patients. Moreover, the difference between groups in the meta-analysis only just reaches statistical significance. It is arguable that a question as scientifically controversial as whether homeopathic medicines are always equivalent to placebo would require more statistically robust data.

A final word on the implications for further research from this study:
It is open to debate whether further research is warranted on homeopathic medicines to prevent influenza and influenza-like syndrome. Using the control event rate from the meta-analysis of Attena (Attena 1995) and Nollevaux (Nollevaux 1990) (24%), a minimal, clinically significant difference of five per cent and a power of 90 per cent gives 1457 patients per group. Such a trial would require significant resources, the investment of which is questionable given the equivocal nature of the current data.


My free sample is now in the trash, but for some the placebo effect may be worthwhile if it is cheap and safe. However what I find interesting is the homeopathic rationale for this treatment, 'let like be cured by like' based on the fact that these migratory waterfowl are the major reservoirs for the virus. It is also interesting that the method of producing this medicine dilutes it so extensively that a typical dose doesn't even contain a single molecule of the active ingredient(Kayne SB. Homoeopathic pharmacy 1997;Churchill Livingstone, Edinburgh.). If the 'like cures like' model were effective, I would think stopping in at KFC a couple of times a week would really do the trick.

Here is a story from Homeowatch that gives the history of this product's use and makes note of the fact that even the scientific name of the duck is wrong. It makes the use of this stuff seem just plain silly.

posted by Clay @ 2/17/2005 02:14:00 PM   8 comments

8 Comments:

At 6:46 PM, Blogger joe said...

"I wouldn't take 18 grams of anything" Joe

 
At 5:44 PM, Blogger Clay said...

What about your daily dose of Metamucil?

 
At 12:11 PM, Blogger Internal Medicine Doctor said...

great post. Good research.

I often get this question form my patients in clinic. It's amazing how much proven method they require in order to take one Zocor tablet, but they'll take loads of anything else that's been "deemed" proven by the latest actor on television.

 
At 11:41 AM, Anonymous Anonymous said...

I have used homeoepathy for 40 years but I would not touch this stuff as the duck would have had to have had the flu so that "like could cure like". Poor duck dead. Only thing it could cure is healthy duck-itis.

 
At 4:57 PM, Anonymous Anonymous said...

YOU'RE ALL STUPID. I've been using this stuff for several years and it works great.

KEY: take it at the first cough, sneeze or sore throat with a clean mouth (nothing eaten within 15 minutes including liquids).

IF YOU SMOKE OR DRINK HEAVILY NOTHING HELPS HOMEOPATHICALLY.

 
At 1:56 PM, Anonymous Anonymous said...

Guys, my oppinion is that all this miraculous homeopathy is indeed "ienierjietic" :D working at a "subtle" level, as there is no chemistry in it, but I also suspect a fraud: in fact, I believe the subtle intervention on the energetic bodies that then reflects on the material body is made by a human 'operator' and not by the remedium (not the same would be in allopathy). I read sometimes that 'some' people (that we here call bioenergeticians/paranormals) can diagnose and then heal the pacients, 'repairing' their energetic body. We can assume then that anybody could do it if "awaken", using those abilities.
And if some of them are more powerful/awaken than others, how do we know that we, doctors, don`t use involuntary such abilities. Of course, we use aspirin and paracetamol :D as a vector.

This is the idea I try to argument in my last article on dincolodemedicina.wordpress.com
(this means "beyond medicine") - unfortunately only available in romanian at the moment.

Another dream of the clay ball.. (aka the human)

In fact,
"The doctor with the treatment, God with the cure"

Till then, we have a life of studying plants, roots and chemicals that sometimes do "something" to the suffering pacient.

dr` s voice

 
At 7:31 AM, Blogger Unknown said...

My wife was bedridden with the flu, looked pale and like death for two days. I ran into oscillococcinum while purchasing motrin, bought some, gave her the oscillo. She bounced back within an hour, was seated and alert for the first time in days. I thought the stuff must be meth in a box, it worked so well. I have no idea whether this was placebo, miracle drug, or what, but it works, I have seen it outperform any of the commercial American cold and flu remedies.

 
At 5:24 PM, Blogger Net Admin said...

Every trial with Oscilloccinum shows that it reduces the severity of the flu by about 6 hours. Every trial also shows it does nothing to prevent the flu. Critics may claim this to be insignificant. However, facts are facts. It is doing something. The quote you made about further studies refers to a preventive trial. Larger studies with this product are warranted and needed. Two other well designed trials also showed it reduces the severity of the flu. They are smaller than the Vickers study but are well designed none the less.


4) Ferley JP, Zmirou, D'Adhemar D, Balducci E,
"A Controlled evaluation of a homeopathic preparation
in the treatment of influenza-like syndromes".
British Journal of Clinical Pharmacology, 1989, 27; 329-335.

5) Papp R, Shuback G, Beck E, Burjard G, Bengel J,
Lehri S, Belon P
"Oscillococcinum in patients with influenza like syndromes

: a palcebo controlled double-blind evaluation."
British Homeopathic Journal. April 1998, Vol. 87, pp 69-76.

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