Cannabinoids for Medical Use: A Systematic Review and Meta-analysis.
Penny Whiting,Penny Whiting,Robert Wolff,Sohan Deshpande,Marcello Di Nisio,Steven Duffy,Adrian V. Hernandez,Adrian V. Hernandez,J. Christiaan Keurentjes,Shona H. Lang,Kate Misso,Steve Ryder,Simone Schmidlkofer,Marie Westwood,Jos Kleijnen +14 more
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TLDR
There was moderate- quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity and low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome.Abstract:
Importance Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear. Objective To conduct a systematic review of the benefits and adverse events (AEs) of cannabinoids. Data Sources Twenty-eight databases from inception to April 2015. Study Selection Randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome. Data Extraction and Synthesis Study quality was assessed using the Cochrane risk of bias tool. All review stages were conducted independently by 2 reviewers. Where possible, data were pooled using random-effects meta-analysis. Main Outcomes and Measures Patient-relevant/disease-specific outcomes, activities of daily living, quality of life, global impression of change, and AEs. Results A total of 79 trials (6462 participants) were included; 4 were judged at low risk of bias. Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials. Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete nausea and vomiting response (47% vs 20%; odds ratio [OR], 3.82 [95% CI, 1.55-9.42]; 3 trials), reduction in pain (37% vs 31%; OR, 1.41 [95% CI, 0.99-2.00]; 8 trials), a greater average reduction in numerical rating scale pain assessment (on a 0-10-point scale; weighted mean difference [WMD], −0.46 [95% CI, −0.80 to −0.11]; 6 trials), and average reduction in the Ashworth spasticity scale (WMD, −0.12 [95% CI, −0.24 to 0.01]; 5 trials). There was an increased risk of short-term AEs with cannabinoids, including serious AEs. Common AEs included dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination. Conclusions and Relevance There was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity. There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome. Cannabinoids were associated with an increased risk of short-term AEs.read more
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Self-Reported Cannabis Use and Markers of Inflammation in Men Who Have Sex With Men With and Without HIV
Martin Krsak,Nikolas Wada,Michael Plankey,Gregory L. Kinney,Marta Epeldegui,Chukwuemeka N. Okafor,Mackey R. Friedman,Frank J. Palella,Kristine M. Erlandson +8 more
TL;DR: In this paper, the authors evaluated participants in the Multicenter AIDS Cohort Study (MACS) beginning in 2004 with available data on cannabis use and inflammatory biomarkers and found that daily users had 30% higher levels of Factor 2 biomarkers than nonusers.
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Therapeutic Attributes of Endocannabinoid System against Neuro-Inflammatory Autoimmune Disorders
Ishtiaq Ahmed,Ishtiaq Ahmed,Saif ur Rehman,Shiva Shahmohamadnejad,Muhammad Anjum Zia,Muhammad Ahmad,Muhammad Saeed,Zain Akram,Hafiz M.N. Iqbal,Qingyou Liu +9 more
TL;DR: In this article, the functional relationship between the endocannabinoid system (ECS) and anti-tumor characteristics of cannabinoids in various cancers has been discussed, and the therapeutic potential of cannabinoids for cancer-both in vivo and in vitro clinical trials-has also been highlighted and reported to be effective in mice models in arthritis for the inflammation reduction, neuropathic pain, positive effect in multiple sclerosis and type-1 diabetes mellitus.
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Management of Cannabinoid Hyperemesis Syndrome: Focus on Capsaicin.
TL;DR: This review summarizes the epidemiology, clinical presentation, diagnosis, pathophysiology, and management of cannabinoid hyperemesis syndrome, focusing on treatment with topical capsaicin.
Journal ArticleDOI
Cannabis as Secondary Drug Is Not Associated With a Greater Risk of Death in Patients With Opiate, Cocaine, or Alcohol Dependence.
Daniel Fuster,Arantza Sanvisens,Ferran Bolao,Paola Zuluaga,Inmaculada Rivas,Magí Farré,Jordi Tor,Robert Muga +7 more
TL;DR: Positive urinary cannabis did not confer an increased risk of death in patients with severe opiate, cocaine or alcohol dependence and there was no association between cannabis detection and overall mortality in the adjusted regression models.
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Clinical Pharmacokinetics of Cannabinoids and Potential Drug-Drug Interactions.
TL;DR: In this paper, the authors summarized the current knowledge on the pharmacokinetics and metabolic fate of cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) in humans and discussed relevant drug-drug interactions.
References
More filters
Journal ArticleDOI
Meta-Analysis in Clinical Trials*
TL;DR: This paper examines eight published reviews each reporting results from several related trials in order to evaluate the efficacy of a certain treatment for a specified medical condition and suggests a simple noniterative procedure for characterizing the distribution of treatment effects in a series of studies.
Journal ArticleDOI
Quantifying heterogeneity in a meta‐analysis
TL;DR: It is concluded that H and I2, which can usually be calculated for published meta-analyses, are particularly useful summaries of the impact of heterogeneity, and one or both should be presented in publishedMeta-an analyses in preference to the test for heterogeneity.
Journal ArticleDOI
The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials
Julian P T Higgins,Douglas G. Altman,Peter C Gøtzsche,Peter Jüni,David Moher,Andrew D Oxman,Jelena Savović,Kenneth F. Schulz,Laura Weeks,Jonathan A C Sterne +9 more
TL;DR: The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate.
Book
Cochrane Handbook for Systematic Reviews of Interventions
Julian P T Higgins,Sally Green +1 more
TL;DR: The Cochrane Handbook for Systematic Reviews of Interventions is the official document that describes in detail the process of preparing and maintaining Cochrane systematic reviews on the effects of healthcare interventions.