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Study register · detail Systematische Review + Meta-Analyse · Chronic Pain · 2022

Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications

Bilbao et al. ·BMC Medicine Impact 6.8
Mixed GRADE High 163 citations
Samplek = 152 Studien
n = 12.123 Pat.
Durationunclear
ControlPlacebo
EndpointDisease-specific outcomes
Blindingn.a.
DesignSystematische Review + Meta-Analyse
Key finding

Medical cannabinoids show variable therapeutic effects depending on substance and indication: CBD effective for epilepsy (high evidence) and parkinsonism (moderate evidence); dronabinol and nabiximols effective for chronic pain, spasticity and other indications (moderate evidence); many other effects with low or very low evidence.

Summary

Pharmacology-based SR of k=152 RCTs (n=12.123) on medical cannabinoids; for chronic pain moderate evidence for dronabinol (SMD -0.31, 95% CI [-0.46, -0.15]) and nabiximols (SMD -0.25, 95% CI [-0.37, -0.14]). Nabiximols additionally showed significant effects on sleep (SMD -0.24, 95% CI [-0.35, -0.14]) and spasticity (SMD -0.36, 95% CI [-0.54, -0.19]).

P
PopulationAdults with various indications (chronic pain, spasticity, nausea/vomiting, epilepsy, Parkinson's, Tourette, SUDs among others), pooled n=12.123
I
InterventionMedical cannabinoids (dronabinol, nabilone, cannabidiol, nabiximols)
C
ControlPlacebo
O
OutcomeCBD: significant effect in epilepsy (SMD -0,50 [CI -0,62; -0,38], high) and parkinsonism (-0,41 [CI -0,75; -0,08], moderate); dronabinol: moderate for pain, appetite, Tourette; nabiximols: moderate for pain, spasticity, sleep, SUDs; all further effects with low or very low evidence
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
Bilbao A, Spanagel R
DOI 10.1186/s12916-022-02459-1↗
Design: Systematische Review + Meta-Analyse
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Indication
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