INTRODUCTION: Cachexia and anorexia are among the most frequent symptoms in patients with cancer. Cannabinoids have been used in patients with advanced cancer; however, their role is still controversial.; METHODS: 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 extracted data from the systematic reviews, reanalyzed data of primary studies, and generated a summary of findings table using the GRADE approach.; RESULTS AND CONCLUSIONS: We identified ten systematic reviews including three studies overall, of which two were randomized trials. We concluded it is not clear whether cannabinoids have any positive effect on increasing weight because the certainty of the evidence is very low. They might not have any effect on appetite, and are probably associated to frequent adverse effects.; INTRODUCCIÓN: La caquexia y la anorexia se encuentran dentro de los síntomas más frecuentes en los pacientes oncológicos. Los cannabinoides han sido propuestos para su manejo en los pacientes con cáncer avanzado, sin embargo, su rol es controvertido.; MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud a nivel mundial, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios y preparamos una tabla de resumen de los resultados utilizando el método GRADE.; RESULTADOS Y CONCLUSIONES: Identificamos diez revisiones sistemáticas, que en conjunto incluyen tres estudios, entre ellos dos ensayos aleatorizados. Concluimos que no está claro si los cannabinoides logran o no un aumento de peso en pacientes con anorexia-caquexia porque la certeza de la evidencia es muy baja, podrían no tener tampoco efecto sobre el apetito, y probablemente se asocian a efectos adversos frecuentes.
This document reflects the evidence supporting the use of medicinal cannabis in palliative care patients and the recommendations of the Palliative Care Working Group
BACKGROUND: Several countries use drugs containing cannabinoids for symptom management in patients that need palliative treatment.
MATERIAL AND METHOD: Articles were retrieved through a literature search for randomized controlled studies of cannabinoids used to treat cancer-related symptoms such as pain, nausea and appetite.
RESULTS: Evidence for clinical effect is limited. Some randomized studies have shown a treatment effect of cannabinoids in neuropathic pain. Cannabinoid-containing drugs can have a moderate anti-emetic effect and can stimulate appetite in some subgroups of patients.
INTERPRETATION: Many questions about clinical efficacy and side effects have still not been answered for cannabinoid-containing drugs and there is not sufficient evidence available from relevant randomised controlled trials to base a decision on whether or not to permit such drugs in palliative care in Norway. It is however likely that drugs containing cannabinoids can help to control certain symptoms in some patients.
Cachexia and anorexia are among the most frequent symptoms in patients with cancer. Cannabinoids have been used in patients with advanced cancer; however, their role is still controversial.;
METHODS:
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 extracted data from the systematic reviews, reanalyzed data of primary studies, and generated a summary of findings table using the GRADE approach.;
RESULTS AND CONCLUSIONS:
We identified ten systematic reviews including three studies overall, of which two were randomized trials. We concluded it is not clear whether cannabinoids have any positive effect on increasing weight because the certainty of the evidence is very low. They might not have any effect on appetite, and are probably associated to frequent adverse effects.;
INTRODUCCIÓN:
La caquexia y la anorexia se encuentran dentro de los síntomas más frecuentes en los pacientes oncológicos. Los cannabinoides han sido propuestos para su manejo en los pacientes con cáncer avanzado, sin embargo, su rol es controvertido.;
MÉTODOS:
Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud a nivel mundial, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios y preparamos una tabla de resumen de los resultados utilizando el método GRADE.;
RESULTADOS Y CONCLUSIONES:
Identificamos diez revisiones sistemáticas, que en conjunto incluyen tres estudios, entre ellos dos ensayos aleatorizados. Concluimos que no está claro si los cannabinoides logran o no un aumento de peso en pacientes con anorexia-caquexia porque la certeza de la evidencia es muy baja, podrían no tener tampoco efecto sobre el apetito, y probablemente se asocian a efectos adversos frecuentes.
