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Study register · detail Systematic Review · Epilepsy · 2024

Exploring the efficacy and safety of cannabidiol in individuals with epilepsy: an umbrella review of meta-analyses and systematic reviews.

Abbasi et al. ·Inflammopharmacology Impact 4.4
Mixed GRADE High 1 citations
Samplek = 13 Studien
Durationuntil May 2024
ControlControls
EndpointSeizure frequency / seizure…
Blindingunklar
DesignSystematic Review
Cannabinoidcbd
Key finding

CBD led to 10,87% seizure freedom and a 73% increased likelihood of ≥50% seizure reduction, but also to increased treatment discontinuation at higher dosing (20 mg/kg/d).

Summary

Umbrella review of k=13 meta-analyses and systematic reviews on CBD in epilepsy. 10,87% of patients became seizure-free (RD: 10,87%, 95%CI: 2,39%–19,34%; I²=80%). Compared to controls, 73% increase in ≥50% seizure reduction (RR: 1,73, 95%CI: 1,47–2,03; I²=0%). At 20 mg/kg/d CBD, increased treatment discontinuation rate (RR: 4,39, 95%CI: 2,46–7,83; I²=0%).

P
PopulationEpilepsy patients (various forms), pooled data from 13 meta-analyses/systematic reviews
I
InterventionCannabidiol (CBD), among others 20 mg/kg/Tag
C
ControlControls (placebo or standard therapy)
O
Outcome10,87% became seizure-free (RD: 10,87%, 95%-CI: 2,39%–19,34%; I²=80%); 73% more patients with ≥50% seizure reduction (RR: 1,73, 95%-CI: 1,47–2,03; I²=0%); increased risk of treatment discontinuation at 20 mg/kg/Tag (RR: 4,39, 95%-CI: 2,46–7,83; I²=0%)
Confidence in the evidence
High

The highest of four GRADE levels, the effect estimate is very reliable.

Quality profile
Sample size ★★★★★
Blinding —
Effect size Mixed
Citations / year ★★★★★
Authors
Abbasi H, Abbasi MM, Pasand M, Mohtadi M, Bakhshimoghaddam F, Eslamian G
DOI 10.1007/s10787-024-01523-x↗
Design: Systematic Review
Share
Abstract
Background: Epilepsy ranks among the most prevalent neurological conditions worldwide. Cannabidiol (CBD) has received authorization for epilepsy treatment, yet utilizing CBD is linked to a variety of adverse events (AEs). This umbrella review aims to explore risk and frequency of AEs in epilepsy patients undergoing treatment with Cbd. Methods: International electronic databases comprising Scopus, PubMed, and Web of Science were extensively searched from the most ancient data accessible until May 2024. In line with fundamental principle of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA), this umbrella review was executed. RStudio software version 2023.03.1 along with R software 4.3.2 was used for our statistical analyses. Results: Thirteen meta-analyses and systematic reviews were included. CBD use in epileptic patients compared to controls can be meaningfully linked with 10.87% becoming seizure-free (RD: 10.87%, 95%CI: 2.39%, 19.34%; I(2) = 80%). Compared to controls, a meaningful 73% increase in 50% or greater reduction in seizure frequency was observed (RR: 1.73, 95%CI: 1.47, 2.03; I(2) = 0%). In epileptic individuals who using CBD with the dosage of 20 mg/kg/d, a higher incidence of treatment withdrawal was detected (RR: 4.39, 95%CI: 2.46, 7.83; I(2) = 0%). Conclusion: In this umbrella review of meta-analyses and systematic reviews, CBD use in epileptic patients was linked to an increased risk of ample AEs. Further research, specifically targeting various epilepsy categories, is essential to fully understand the effectiveness and potential side effects of CBD across different epilepsy forms.
Indication
Further studies on Epilepsy
All studies →
S Devinsky et al. · 2018 · The New England journal of medicine
973 citations
Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome.
Clear benefit RCT

Multizentrische Phase-III-RCT bei Lennox-Gastaut-Syndrom (n=225, Alter 2-55 Jahre, 30 Zentren), Cannabidiol 20 mg/kg vs. 10 mg/kg vs. Placebo (14 Wochen). Baseline: median 85 Drop-Seizures/28 Tage. Mediane Reduktion der Drop-Seizure-Frequenz: 41,9% (20 mg/kg, p=0,005 vs. Placebo), 37,2% (10 mg/kg, p=0,002 vs. Placebo), 17,2% (Placebo). Häufigste Nebenwirkungen: Somnolenz, verminderter Appetit, Diarrhö (dosisabhängig); 6 Patienten (20 mg/kg-Gruppe) und 1 Patient (10 mg/kg-Gruppe) brachen wegen Nebenwirkungen ab.

10.1056/nejmoa1714631 View study →
S Devinsky et al. · 2017 · New England Journal of Medicine
1652 citations
Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome
Clear benefit RCT

n=120 Dravet-Syndrom (therapierefraktär), CBD 20mg/kg/d vs. Placebo über 14 Wochen; median konvulsive Anfallsreduktion 38,9% (CBD) vs. 13,3% (Placebo), adjustierte Differenz -22,8 Prozentpunkte (95%-CI -41,1 bis -5,4; p=0,01); 5% anfallsfrei (CBD) vs. 0% (Placebo).

10.1056/nejmoa1611618 View study →
S Thiele et al. · 2018 · The Lancet
881 citations
Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial
Clear benefit RCT

Phase-III-RCT (GWPCARE4) bei Lennox-Gastaut-Syndrom, n=171 (2–55 Jahre), randomisiert zu CBD 20 mg/kg/d vs. Placebo über 14 Wochen. Primärer Endpunkt: prozentuale Reduktion der monatlichen Drop-Seizure-Frequenz. Multizentrisch (24 Zentren USA, Niederlande, Polen). 14 Patienten in CBD-Gruppe, 1 in Placebo-Gruppe brachen ab. [Numerische Outcomes im Abstract abgeschnitten; Volltext zeigt signifikante Drop-Seizure-Reduktion vs. Placebo].

10.1016/s0140-6736(18)30136-3 View study →

The impediment to action advances action. — Marcus Aurelius