Systematic reviews including this primary study

loading
10 articles (10 References) loading Revert Studify

Systematic review

Unclassified

Medical marijuana for cancer

blocked
Authors Kramer JL
Journal CA: a cancer journal for clinicians
Year 2015
Links Pubmed DOI

This article is included in 3 Broad syntheses 109 Broad syntheses (3 references)

This article includes 111 Primary studies 109 Primary studies (111 references)

Loading references information
Answer questions and earn CME/CNE Marijuana has been used for centuries, and interest in its medicinal properties has been increasing in recent years. Investigations into these medicinal properties has led to the development of cannabinoid pharmaceuticals such as dronabinol, nabilone, and nabiximols. Dronabinol is best studied in the treatment of nausea secondary to cancer chemotherapy and anorexia associated with weight loss in patients with acquired immune deficiency syndrome, and is approved by the US Food and Drug Administration for those indications. Nabilone has been best studied for the treatment of nausea secondary to cancer chemotherapy. There are also limited studies of these drugs for other conditions. Nabiximols is only available in the United States through clinical trials, but is used in Canada and the United Kingdom for the treatment of spasticity secondary to multiple sclerosis and pain. Studies of marijuana have concentrated on nausea, appetite, and pain. This article will review the literature regarding the medical use of marijuana and these cannabinoid pharmaceuticals (with emphasis on indications relevant to oncology), as well as available information regarding adverse effects of marijuana use. CA Cancer J Clin 2015;65: 109-122.

Systematic review

Unclassified

Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy.

blocked
Journal Cochrane Database of Systematic Reviews
Year 2015
Links Pubmed DOI PubMed Central

This article is included in 8 Broad syntheses 23 Broad syntheses (8 references)

This article includes 23 Primary studies 23 Primary studies (23 references)

Loading references information
BACKGROUND: Cannabis has a long history of medicinal use. Cannabis-based medications (cannabinoids) are based on its active element, delta-9-tetrahydrocannabinol (THC), and have been approved for medical purposes. Cannabinoids may be a useful therapeutic option for people with chemotherapy-induced nausea and vomiting that respond poorly to commonly used anti-emetic agents (anti-sickness drugs). However, unpleasant adverse effects may limit their widespread use. OBJECTIVES: To evaluate the effectiveness and tolerability of cannabis-based medications for chemotherapy-induced nausea and vomiting in adults with cancer. SEARCH METHODS: We identified studies by searching the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and LILACS from inception to January 2015. We also searched reference lists of reviews and included studies. We did not restrict the search by language of publication. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that compared a cannabis-based medication with either placebo or with a conventional anti-emetic in adults receiving chemotherapy. DATA COLLECTION AND ANALYSIS: At least two review authors independently conducted eligibility and risk of bias assessment, and extracted data. We grouped studies based on control groups for meta-analyses conducted using random effects. We expressed efficacy and tolerability outcomes as risk ratio (RR) with 95% confidence intervals (CI). MAIN RESULTS: We included 23 RCTs. Most were of cross-over design, on adults undergoing a variety of chemotherapeutic regimens ranging from moderate to high emetic potential for a variety of cancers. The majority of the studies were at risk of bias due to either lack of allocation concealment or attrition. Trials were conducted between 1975 and 1991. No trials involved comparison with newer anti-emetic drugs such as ondansetron. Comparison with placebo People had more chance of reporting complete absence of vomiting (3 trials; 168 participants; RR 5.7; 95% CI 2.6 to 12.6; low quality evidence) and complete absence of nausea and vomiting (3 trials; 288 participants; RR 2.9; 95% CI 1.8 to 4.7; moderate quality evidence) when they received cannabinoids compared with placebo. The percentage of variability in effect estimates that was due to heterogeneity rather than chance was not important (I(2) = 0% in both analyses).People had more chance of withdrawing due to an adverse event (2 trials; 276 participants; RR 6.9; 95% CI 1.96 to 24; I(2) = 0%; very low quality evidence) and less chance of withdrawing due to lack of efficacy when they received cannabinoids, compared with placebo (1 trial; 228 participants; RR 0.05; 95% CI 0.0 to 0.89; low quality evidence). In addition, people had more chance of 'feeling high' when they received cannabinoids compared with placebo (3 trials; 137 participants; RR 31; 95% CI 6.4 to 152; I(2) = 0%).People reported a preference for cannabinoids rather than placebo (2 trials; 256 participants; RR 4.8; 95% CI 1.7 to 13; low quality evidence). Comparison with other anti-emetics There was no evidence of a difference between cannabinoids and prochlorperazine in the proportion of participants reporting no nausea (5 trials; 258 participants; RR 1.5; 95% CI 0.67 to 3.2; I(2) = 63%; low quality evidence), no vomiting (4 trials; 209 participants; RR 1.11; 95% CI 0.86 to 1.44; I(2) = 0%; moderate quality evidence), or complete absence of nausea and vomiting (4 trials; 414 participants; RR 2.0; 95% CI 0.74 to 5.4; I(2) = 60%; low quality evidence). Sensitivity analysis where the two parallel group trials were pooled after removal of the five cross-over trials showed no difference (RR 1.1; 95% CI 0.70 to 1.7) with no heterogeneity (I(2) = 0%).People had more chance of withdrawing due to an adverse event (5 trials; 664 participants; RR 3.9; 95% CI 1.3 to 12; I(2) = 17%; low quality evidence), due to lack of efficacy (1 trial; 42 participants; RR 3.5; 95% CI 1.4 to 8.9; very low quality evidence) and for any reason (1 trial; 42 participants; RR 3.5; 95% CI 1.4 to 8.9; low quality evidence) when they received cannabinoids compared with prochlorperazine.People had more chance of reporting dizziness (7 trials; 675 participants; RR 2.4; 95% CI 1.8 to 3.1; I(2) = 12%), dysphoria (3 trials; 192 participants; RR 7.2; 95% CI 1.3 to 39; I(2) = 0%), euphoria (2 trials; 280 participants; RR 18; 95% CI 2.4 to 133; I(2) = 0%), 'feeling high' (4 trials; 389 participants; RR 6.2; 95% CI 3.5 to 11; I(2) = 0%) and sedation (8 trials; 947 participants; RR 1.4; 95% CI 1.2 to 1.8; I(2) = 31%), with significantly more participants reporting the incidence of these adverse events with cannabinoids compared with prochlorperazine.People reported a preference for cannabinoids rather than prochlorperazine (7 trials; 695 participants; RR 3.3; 95% CI 2.2 to 4.8; I(2) = 51%; low quality evidence).In comparisons with metoclopramide, domperidone and chlorpromazine, there was weaker evidence, based on fewer trials and participants, for higher incidence of dizziness with cannabinoids.Two trials with 141 participants compared an anti-emetic drug alone with a cannabinoid added to the anti-emetic drug. There was no evidence of differences between groups; however, the majority of the analyses were based on one small trial with few events. Quality of the evidence The trials were generally at low to moderate risk of bias in terms of how they were designed and do not reflect current chemotherapy and anti-emetic treatment regimens. Furthermore, the quality of evidence arising from meta-analyses was graded as low for the majority of the outcomes analysed, indicating that we are not very confident in our ability to say how well the medications worked. Further research is likely to have an important impact on the results. AUTHORS' CONCLUSIONS: Cannabis-based medications may be useful for treating refractory chemotherapy-induced nausea and vomiting. However, methodological limitations of the trials limit our conclusions and further research reflecting current chemotherapy regimens and newer anti-emetic drugs is likely to modify these conclusions.

Systematic review

Unclassified

Cannabinoids for medical use: A systematic review and meta-analysis.

Journal JAMA
Year 2015
Links Pubmed DOI

This article is included in 23 Broad syntheses 81 Broad syntheses (23 references) 1 Structured summary of systematic reviews 81 Structured summaries of systematic reviews (1 reference)

This article includes 148 Primary studies 81 Primary studies (148 references)

Loading references information
Importance: Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear. OBJECTIVE: To conduct a systematic review of the benefits and adverse events (AEs) of cannabinoids. Data sources: Twenty-eight databases from inception to April 2015. Study selection: Randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome. Data extraction and systemsis: Study quality was assessed using the Cochrane risk of bias tool. All review stages were conducted independently by 2 reviewers. Where possible, data were pooled using random-effects meta-analysis. Main outcomes and measures: Patient-relevant/disease-specific outcomes, activities of daily living, quality of life, global impression of change, and AEs. RESULTS: A total of 79 trials (6462 participants) were included; 4 were judged at low risk of bias. Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials. Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete nausea and vomiting response (47%vs 20%; odds ratio [OR], 3.82 [95%CI, 1.55-9.42]; 3 trials), reduction in pain (37%vs 31%; OR, 1.41 [95%CI, 0.99-2.00]; 8 trials), a greater average reduction in numerical rating scale pain assessment (on a 0-10-point scale; weighted mean difference [WMD], −0.46 [95%CI, −0.80 to −0.11]; 6 trials), and average reduction in the Ashworth spasticity scale (WMD, −0.36 [95%CI, −0.69 to −0.05]; 7 trials). There was an increased risk of short-term AEs with cannabinoids, including serious AEs. Common AEs included dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination. Conclusions and relevance: There was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity. There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome. Cannabinoids were associated with an increased risk of short-term AEs. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Systematic review

Unclassified

Systematic review of cannabis for medical use

blocked
Report Kleijnen Systematic Reviews Ltd
Year 2014

This article is included in 10 Broad syntheses 120 Broad syntheses (10 references)

This article includes 184 Primary studies 120 Primary studies (184 references)

Loading references information

Systematic review

Unclassified

Efficacy of Crude Marijuana and Synthetic Delta-9-Tetrahydrocannabinol as Treatment for Chemotherapy-Induced Nausea and Vomiting: A Systematic Literature Review.

blocked
Authors Cotter J
Journal Oncology nursing forum
Year 2009
Links Pubmed DOI

This article is included in 4 Broad syntheses 10 Broad syntheses (4 references)

This article includes 10 Primary studies 10 Primary studies (10 references)

Loading references information
PURPOSE/OBJECTIVES: To synthesize the research to determine whether oral delta-9-tetrahydrocannabinol (THC) and smoked marijuana are effective treatments for chemotherapy-induced nausea and vomiting (CINV) and to evaluate side effects and patient preference of these treatments.DATA SOURCES: Original research, review articles, and other published articles in CINAHL(R), MEDLINE(R), and Cochrane Library databases.DATA SYNTHESIS: Cannabinoids are effective in controlling CINV, and oral THC and smoked marijuana have similar efficacy. However, smoked marijuana may not be accessible or safe for all patients with cancer. Also, these drugs have a unique side-effect profile that may include alterations in motor control, dizziness, dysphoria, and decreased concentration.CONCLUSIONS: This synthesis shows that cannabinoids are more effective than placebo and comparable to antiemetics such as prochlorperazine and ondansetron for CINV.Implications for Nursing: Nurses should feel supported by the literature to recommend oral synthetic THC as a treatment for CINV to their patients and physician colleagues. Nurses should be cognizant of the side-effect profile for this medication and provide appropriate patient education.

Systematic review / Broad synthesis

Unclassified

Oral nabilone capsules in the treatment of chemotherapy-induced nausea and vomiting and pain

Authors Davis MP
Journal Expert opinion on investigational drugs
Year 2008
Links Pubmed DOI

This article is included in 1 Broad synthesis 24 Broad syntheses (1 reference)

This article includes 23 Primary studies 24 Primary studies (23 references)

Loading references information
Background: Nabilone has been approved to treat chemotherapy-induced nausea and vomiting. Recent studies have explored cannabinoids in pain management. Objectives: To review the evidence for the use of cannabinolds in general and nabilone in particular; i)in managing chemotherapy-induced nausea and vomiting; and ii) in treating pain. Method: A systematic review of published English literature used the terms: cancer, cannabinoid, nabilone, nausea, pain, tetrahydrocannabinol and vomiting as search terms. Reviews, meta-analyses and treatment trials were reviewed. Results/conclusions: Nabilone is superior to placebo, domperidone and prochlorperazine but not metoclopramide or chlorpromazine. Cannabinoids do not add to benefits of 5-HT3 receptor antagonists. Side effects are greater for nabilone than for prochlorperazine, in most studies patients prefered nabilone over prochlorperazine. Nabilone is ineffective in acute pain but benefits' in neuropathic pain and central hypersensitization. Recent guidelines place nabilone as a second to fourth line drug for neuropathic pain. © 2008 Informa UK Ltd.

Systematic review

Unclassified

Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: Systematic review and meta-analysis

Journal European journal of cancer care
Year 2008
Links Pubmed DOI

This article is included in 1 Structured summary of systematic reviews 30 Structured summaries of systematic reviews (1 reference) 6 Broad syntheses 30 Broad syntheses (6 references)

This article includes 30 Primary studies 30 Primary studies (30 references)

Loading references information
This paper aims to evaluate the anti-emetic efficacy of cannabinoids in cancer patients receiving chemotherapy using a systematic review of literature searched within electronic databases such as PUBMED, EMBASE, PSYCINFO, LILACS, and 'The Cochrane Collaboration Controlled Trials Register'. Studies chosen were randomized clinical trials comprising all publications of each database until December 2006. From 12 749 initially identified papers, 30 fulfilled the inclusion criteria for this review, with demonstration of superiority of the anti-emetic efficacy of cannabinoids compared with conventional drugs and placebo. The adverse effects were more intense and occurred more often among patients who used cannabinoids. Five meta-analyses were carried out: (1) dronabinol versus placebo [n = 185; relative risk (RR) = 0.47; confidence interval (CI) = 0.19-1.16]; (2) Dronabinol versus neuroleptics [n = 325; RR = 0.67; CI = 0.47-0.96; number needed to treat (NNT) = 3.4]; (3) nabilone versus neuroleptics (n = 277; RR = 0.88; CI = 0.72-1.08); (4) levonantradol versus neuroleptics (n = 194; RR = 0.94; CI = 0.75-1.18); and (5) patients' preference for cannabis or other drugs (n = 1138; RR = 0.33; CI = 0.24-0.44; NNT = 1.8). The superiority of the anti-emetic efficacy of cannabinoids was demonstrated through meta-analysis. © 2008 The Authors.

Systematic review

Unclassified

Cannabinoids in medicine: A review of their therapeutic potential.

Authors Ben Amar M
Journal Journal of ethnopharmacology
Year 2006
Links Pubmed DOI

This article is included in 12 Broad syntheses 71 Broad syntheses (12 references)

This article includes 72 Primary studies 71 Primary studies (72 references)

Loading references information
In order to assess the current knowledge on the therapeutic potential of cannabinoids, a meta-analysis was performed through Medline and PubMed up to July 1, 2005. The key words used were cannabis, marijuana, marihuana, hashish, hashich, haschich, cannabinoids, tetrahydrocannabinol, THC, dronabinol, nabilone, levonantradol, randomised, randomized, double-blind, simple blind, placebo-controlled, and human. The research also included the reports and reviews published in English, French and Spanish. For the final selection, only properly controlled clinical trials were retained, thus open-label studies were excluded. Seventy-two controlled studies evaluating the therapeutic effects of cannabinoids were identified. For each clinical trial, the country where the project was held, the number of patients assessed, the type of study and comparisons done, the products and the dosages used, their efficacy and their adverse effects are described. Cannabinoids present an interesting therapeutic potential as antiemetics, appetite stimulants in debilitating diseases (cancer and AIDS), analgesics, and in the treatment of multiple sclerosis, spinal cord injuries, Tourette's syndrome, epilepsy and glaucoma.

Systematic review

Unclassified

Medical efficacy of cannabinoids and marijuana: a comprehensive review of the literature.

blocked
Authors Bagshaw SM , Hagen NA
Journal Journal of palliative care
Year 2002
Links Pubmed

This article is included in 7 Broad syntheses 80 Broad syntheses (7 references)

This article includes 80 Primary studies 80 Primary studies (80 references)

Loading references information

Systematic review

Unclassified

Cannabinoids for control of chemotherapy induced nausea and vomiting: Quantitative systematic review.

Journal BMJ (Clinical research ed.)
Year 2001
Links Pubmed DOI PubMed Central

This article is included in 2 Structured summaries of systematic reviews 30 Structured summaries of systematic reviews (2 references) 8 Broad syntheses 30 Broad syntheses (8 references)

This article includes 30 Primary studies 30 Primary studies (30 references)

Loading references information
Examined the antiemetic efficacy and adverse effects of cannabis used for sickness induced by chemotherapy. 30 randomised comparison studies of cannabis with placebo or antiemetics from which dichotomous data on efficacy and harm were available (1,366 patients) were used. Oral nabilone, oral dronabinol (tetrahydrocannabinol), and intramuscular levonantradol were tested. Results show that cannabinoids were more effective antiemetics than prochlorperazine, metoclopramide, chlorpromazine, thiethylperazine, haloperidol, domperidone, or alizapride. Cannabinoids were not more effective in patients receiving very low or very high emetogenic chemotherapy. In crossover trials, patients preferred cannabinoids for future chemotherapy cycles. Some potentially beneficial side effects that occurred more often with cannabinoids included a "high", sedation or drowsiness, and euphoria. Harmful side effects also occurred more often with cannabinoids, including dizziness, dysphoria or depression, hallucinations, paranoia, and arterial hypotension. Patients given cannabinoids were more likely to withdraw due to side effects. In selected patients, the cannabinoids tested in these trials may be useful as mood enhancing adjuvants for controlling chemotherapy related sickness. (PsycInfo Database Record (c) 2021 APA, all rights reserved)