The authors also mentioned that none of the alternative therapies for asthma, including cupping, was efficacious. Previous research has shown little benefit of CAM compared with sham or placebo interventions. However, evidence of overall effectiveness, including the nonspecific effects of CAM compared with no treatment that might be important in a patient’s perspective, was lacking and was noted as a subject of future research in the Cochrane review.4 Because culture-specific interventions have shown promising results for patients with asthma compared with usual care regimens,5 it would be plausible to use evidence of CAM from pragmatic studies in those interventions for cultural minorities or for those with a preference to CAM. Given the definition of evidence-based medicine as “the integration of best research evidence with clinical expertise and patient values” by Sackett et al,6 the evidence for CAM, including cupping therapies for patients with severe asthma, should not be judged solely on placebo-controlled studies. Rather, decisions about CAM should also incorporate evidence from pragmatic trials that reflect patients’ values and preferences and culture-specific contexts in a real-world clinical practice. Last, but not least, evidence of cupping for asthma regardless of the comparison type was evaluated neither by the authors of this study1 nor in any existing systematic review that we are aware of, implying a huge gap between the evidence of the success of cupping and its widespread use.