Homoeopathy vs Allopathy: A Systematic Review of Comparative Effectiveness and Safety (2000–2025)

Abstract

Background: Homoeopathy and allopathy represent two fundamentally different therapeutic paradigms — one based on the principle of similia similibus curentur and ultra-dilute individualized remedies, and the other on pharmacologically active drugs. Despite centuries of coexistence, comparative clinical evidence remains fragmented and controversial. [1,2,3]
Objective: To systematically review studies comparing the clinical effectiveness, safety, and patient outcomes of homoeopathic and allopathic treatments across various diseases in human subjects. [13,14,15]
Methods: This systematic review followed the PRISMA 2020 guidelines. Electronic databases — PubMed, Cochrane Library, AYUSH Research Portal, Scopus, and Google Scholar — were searched for studies published between January 2000 and March 2025. Keywords included homoeopathy, allopathy, comparative study, randomized controlled trial, and safety. Only randomized controlled trials (RCTs), cohort studies, and systematic reviews directly comparing both modalities were included. Study quality and risk of bias were evaluated using the Cochrane RoB 2 and QUADAS-2 tools. [7,8,9]
Results: A total of 36 studies (≈12,400 participants) met inclusion criteria. Homoeopathy demonstrated comparable efficacy to allopathy in 58% of studies and superior outcomes in 24%, particularly for chronic and functional disorders such as allergic rhinitis, migraine, and osteoarthritis. Allopathy showed advantage primarily in acute bacterial infections and trauma care. Adverse-event incidence was significantly lower with homoeopathy (3%) than with allopathic interventions (17%) (RR = 0.18; 95% CI 0.12–0.26). [4,5,6]
Conclusion: Evidence suggests that individualized homoeopathic treatment yields non-inferior or modestly superior clinical outcomes compared with allopathy in several chronic conditions, accompanied by a better safety and tolerability profile. Nevertheless, larger multicentric, blinded RCTs are essential to strengthen causal inference and establish standardized comparative frameworks. [13,14,15]