Abstract
Introduction
Mistletoe has been used as a medicine since prehistoric times. Modern Western herbal practice continues to use mistletoe. This systematic review aimed to profile mistletoe therapy in research studies and to understand the gaps in the evidence to inform future research.
Methods
We used standard systematic review methodology, searching three databases (Medline, Central and Anthromed) in June 2020.
Results
The search identified 31 relevant trials, and 10 systematic reviews published between 1996 -2020. These trials comprised 14 randomised controlled trials, 15 controlled trials and 2 cohort studies. The most common country of monocentric trials was Germany. Most of the trials declared direct or indirect financial support from companies that produce mistletoe products.
All the included trials involved cancer patients, with breast cancer being the most common condition treated (n=10). Subcutaneous injections were the most common route of administration (27/31).
Quality of life was the most reported outcome. Quality appraisal of the individual trials show that there was a lack of reporting on blinding of participants and blinding of assessors. A third of the trials did not adequately describe how they dealt with
incomplete data. Recent published systematic reviews do not concur on the efficacy of mistletoe and patients’ quality of life; with the risk of bias of these publications being rated as ‘unclear’ overall There were insufficient data to conduct a novel meta-analysis on mistletoe therapy efficacy.
Conclusion
This systematic review identified gaps in mistletoe research for improving the evidence base for mistletoe therapy in supportive cancer care.
Mistletoe has been used as a medicine since prehistoric times. Modern Western herbal practice continues to use mistletoe. This systematic review aimed to profile mistletoe therapy in research studies and to understand the gaps in the evidence to inform future research.
Methods
We used standard systematic review methodology, searching three databases (Medline, Central and Anthromed) in June 2020.
Results
The search identified 31 relevant trials, and 10 systematic reviews published between 1996 -2020. These trials comprised 14 randomised controlled trials, 15 controlled trials and 2 cohort studies. The most common country of monocentric trials was Germany. Most of the trials declared direct or indirect financial support from companies that produce mistletoe products.
All the included trials involved cancer patients, with breast cancer being the most common condition treated (n=10). Subcutaneous injections were the most common route of administration (27/31).
Quality of life was the most reported outcome. Quality appraisal of the individual trials show that there was a lack of reporting on blinding of participants and blinding of assessors. A third of the trials did not adequately describe how they dealt with
incomplete data. Recent published systematic reviews do not concur on the efficacy of mistletoe and patients’ quality of life; with the risk of bias of these publications being rated as ‘unclear’ overall There were insufficient data to conduct a novel meta-analysis on mistletoe therapy efficacy.
Conclusion
This systematic review identified gaps in mistletoe research for improving the evidence base for mistletoe therapy in supportive cancer care.
| Original language | English |
|---|---|
| Article number | 101392 |
| Journal | European Journal of Integrative Medicine |
| Volume | 49 |
| Early online date | 6 Nov 2021 |
| DOIs | |
| Publication status | Published - Jan 2022 |
Bibliographical note
Funding Information:None. This paper is a systematic review, and all the data is in the public domain but any further information on the systematic review process is available on request from the corresponding author (AH).
Publisher Copyright:
© 2021 Elsevier GmbH
Keywords
- systematic review
- Mistletoe
- clinical trials
- Quality of life
