←Parkinson Disease
Study register · detail Meta-Analyse · Parkinson Disease · 2017

Are cannabinoids effective for Parkinson’s disease?

Bravo-Soto et al. ·Medwave Impact 0.3
No benefit demonstrated GRADE High 3 citations
Samplek = 6 Studien
Durationunclear
ControlPlacebo
EndpointParkinson's symptoms /…
Blindingunklar
DesignMeta-Analyse
Key finding

Cannabinoids probably do not reduce the symptoms of Parkinson's disease or dyskinesia and are probably associated with common adverse effects.

Summary

Umbrella review across k=6 systematic reviews (8 studies in total, of which 4 RCTs) on cannabinoids in Parkinson's disease. Meta-analysis according to GRADE: cannabinoids probably do NOT reduce Parkinson's symptoms or dyskinesias and are probably associated with common adverse effects.

P
PopulationAdults with Parkinson's disease (pooled from 4 RCTs)
I
InterventionCannabinoids (various)
C
ControlPlacebo
O
OutcomeCannabinoids probably do not reduce symptoms in Parkinson's disease or dyskinesia; common adverse effects probably associated
Confidence in the evidence
High

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

Quality profile
Sample size ★★★★★
Blinding —
Effect size No benefit
Citations / year ★★★★★
Authors
Bravo-Soto GA, Juri C
DOI 10.5867/medwave.2017.6974↗
Design: Meta-Analyse
Share
Abstract
It is postulated cannabinoids may have benefits in Parkinson's disease. However, its actual clinical effectiveness is still discussed. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We identified six systematic reviews including eight studies overall, of which four were randomized trials relevant for the question of interest. We extracted data from the systematic reviews, reanalyzed data of primary studies included in these reviews, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded cannabinoids probably do not decrease symptoms in Parkinson’s disease or dyskinesia, and probably are associated to frequent adverse effects in patients with Parkinson’s disease.
Indication
Further studies on Parkinson Disease
All studies →
A Figura et al. · 2022 · Neurologia i neurochirurgia polska
19 citations
Cannabis in Parkinson's Disease - the patient's perspective versus clinical trials: a systematic literature review.
No benefit demonstrated Systematic Review

Systematische Review zu Cannabis bei Parkinson; k=7 randomisierte Studien identifiziert. Ergebnisse unterstützen KEINE Wirksamkeit von Cannabinoiden bei motorischen Symptomen der Parkinson-Krankheit. Schlussfolgerung: derzeit unzureichende Datenlage für Cannabinoid-Einsatz bei PD-Patienten.

10.5603/pjnns.a2022.0004 View study →
A Liu et al. · 2024 · Movement disorders
19 citations
Short-Term Cannabidiol with Delta-9-Tetrahydrocannabinol in Parkinson's Disease: A Randomized Trial.
No benefit demonstrated RCT

RCT n=61 (CBD/THC n=31, Placebo n=30), 2 Wochen Titration auf finale Dosis 191,8±48,9 mg CBD + 6,4±1,6 mg THC täglich. Primärer Endpunkt motor MDS-UPDRS: Reduktion -4,57 (95% CI -8,11 bis -1,03; p=0,013) in CBD/THC-Gruppe vs. -2,77 (-4,92 bis -0,61; p=0,014) in Placebo; Gruppen-Differenz nicht signifikant: -1,80 (-5,88 bis 2,27; p=0,379). Kein Benefit, möglicherweise verschlechterte Kognition und Schlaf; starker Placebo-Effekt. Nebenwirkungen mild, häufiger in CBD/THC-Gruppe.

10.1002/mds.29768 View study →
A Peball et al. · 2020 · Annals of neurology
118 citations
Non-Motor Symptoms in Parkinson's Disease are Reduced by Nabilone.
Mixed RCT

Phase-II-RCT, n=47 Parkinson-Patienten mit stabiler Motorik aber störenden Non-Motor-Symptoms (NMS, MDS-UPDRS-I ≥4). Open-label Nabilone-Titration (0,25–1 mg 2×/d), dann Randomisierung Responder zu Nabilone vs. Placebo (n=19). Primärer Endpunkt MDS-UPDRS-I nach 4 Wochen: Placebo-Gruppe verschlechterte sich um 2,63 Punkte (95% CI 1,53–3,74, p=0,002), Nabilone-Gruppe nur um 1,00 Punkte (95% CI −0,16–2,16, p=0,280); Differenz 1,63 Punkte (95% CI 0,09–3,18, p=0,030, Effektgröße 0,66). Positive Effekte v.a. auf Angst und nächtliche Schlafprobleme. 77% AEs in Titrationsphase (meist transient), keine schwerwiegenden AEs.

10.1002/ana.25864 View study →

The impediment to action advances action. — Marcus Aurelius