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Study register · detail Systematic Review · Epilepsy · 2017

Medical Cannabinoids in Children and Adolescents: A Systematic Review

Wong et al. ·Pediatrics Impact 4.3
Mixed GRADE High 153 citations
Samplek = 22 Studien
n = 795 Pat.
Durationunclear
Controlvariable
EndpointTreatment effect per…
Blindingn.a.
DesignSystematic Review
Key finding

Strong evidence for chemotherapy-induced nausea/vomiting and increasing evidence for epilepsy; insufficient evidence for spasticity, neuropathic pain, PTSD and Tourette syndrome.

Summary

Systematic review on medical cannabinoids in children/adolescents; k=22 studies (5 RCTs, 5 retrospective chart reviews, 5 case reports, 4 open-label studies, 2 parent surveys, 1 case series), n=795 participants. Strongest evidence for chemotherapy-induced nausea/vomiting, increasing evidence for epilepsy. Insufficient evidence for spasticity, neuropathic pain, PTSD and Tourette syndrome. Methodological heterogeneity (cannabinoid composition, dosing), small sample sizes, lack of long-term follow-ups.

P
PopulationChildren and adolescents (pediatric patients), pooled n=795
I
InterventionMedical cannabinoids (various substances/applications)
C
Controlvariable (5 RCTs with control, remaining without control group)
O
OutcomeStrongest evidence for chemotherapy-induced nausea/vomiting and increasing evidence for epilepsy; insufficient evidence for spasticity, neuropathic pain, PTSD and Tourette syndrome
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
Wong SS, Wilens TE
DOI 10.1542/peds.2017-1818↗
Design: Systematic Review
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Indication
Further studies on Epilepsy
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Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome.
Clear benefit RCT

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S Devinsky et al. · 2017 · New England Journal of Medicine
1652 citations
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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].

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