A systematic review and meta-analysis of complementary and alternative medicine in asthma

Asthma is a chronic, inflammatory lung disease affecting around 235 million people worldwide. Conventional medications in asthma are not curative and patients have significant concerns regarding their side effects. Consequently, many asthma patients turn to Complementary and Alternative Medicine (CAM) for a more holistic approach to care. We systematically reviewed the available evidence on the effectiveness of CAM in the management of asthma in adults. We searched MEDLINE, EMBASE, CINAHL, AMED and Cochrane Databases for randomised controlled trials published in English between 1990 to 2016 investigating the effectiveness of oral or topical CAM in asthmatic adults. Quality of the studies was assessed using The Cochrane Risk of Bias Assessment Tool. RevMan 5.3 was used for meta-analysis. In all, 24 eligible trials were identified covering 19 different CAMs. Overall, there was limited evidence on the effectiveness of CAM in adult asthma as most CAMs were assessed in a single trial only. CAMs with multiple trials provided null or inconsistent results. Many of the trials were rated as having high risk of bias. The existing evidence is insufficient to recommend any of the oral and topical CAMs in the management of asthma in adults.