Study register · detailSystematic Review · Multiple Sclerosis · 2018
The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews.
Nielsen et al.·Current neurology and neuroscience reportsImpact 5.3
MixedGRADEHigh146 citations
Samplek = 11 Studien
Durationunclear
ControlPlacebo
EndpointPain / spasticity
Blindingdoppelblind
DesignSystematic Review
”Key finding
Cannabinoids may show modest effects on pain and/or spasticity in MS, while evidence for other symptoms is limited.
Summary
Umbrella review of k=11 systematic reviews on cannabinoids for MS symptoms (data from 32 studies, including 10 moderate to high-quality RCTs). Five reviews concluded sufficient evidence for efficacy for pain and/or spasticity. Conclusion: cannabinoids may have moderate effects on MS-associated pain or spasticity; evidence for other symptoms (disability progression, tremor/ataxia, bladder function, quality of life) insufficient.
P
PopulationAdults with multiple sclerosis (MS), various symptoms
I
InterventionPharmaceutical and herbal cannabinoids (nabiximols, nabilone, dronabinol, plant-based cannabinoids)
C
ControlPlacebo (in included RCTs)
O
Outcome5 of 11 reviews: sufficient evidence for efficacy for pain and/or spasticity; low evidence for other symptoms (bladder function, tremor/ataxia, quality of life)
Confidence in the evidence
Very lowLowModerateHigh
High
The highest of four GRADE levels, the effect estimate is very reliable.
Quality profile
Sample size★★★★★
BlindingDouble-blind
Effect sizeMixed
Citations / year★★★★★
Authors
Nielsen S, Germanos R, Weier M, Pollard J, Degenhardt L, Hall W, Buckley N, Farrell M
Purpose Of Review: Pharmaceutical cannabinoids such as nabiximols, nabilone and dronabinol, and plant-based cannabinoids have been investigated for their therapeutic potential in treating multiple sclerosis (MS) symptoms. This review of reviews aimed to synthesise findings from high quality systematic reviews that examined the safety and effectiveness of cannabinoids in multiple sclerosis. We examined the outcomes of disability and disability progression, pain, spasticity, bladder function, tremor/ataxia, quality of life and adverse effects.
Recent Findings: We identified 11 eligible systematic reviews providing data from 32 studies, including 10 moderate to high quality RCTs. Five reviews concluded that there was sufficient evidence that cannabinoids may be effective for symptoms of pain and/or spasticity in MS. Few reviews reported conclusions for other symptoms. Recent high quality reviews find cannabinoids may have modest effects in MS for pain or spasticity. Future research should include studies with non-cannabinoid comparators; this is an important gap in the evidence.