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Broad synthesis / Overview of systematic reviews

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The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: a Systematic Review of Reviews.

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Journal Current neurology and neuroscience reports
Year 2018
Links Pubmed DOI

This article includes 11 Systematic reviews Systematic reviews (11 references)

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PURPOSE OF REVIEW: Pharmaceutical cannabinoids such as nabiximols, nabilone and dronabinol, and plant-based cannabinoids have been investigated for their therapeutic potential in treating multiple sclerosis (MS) symptoms. This review of reviews aimed to synthesise findings from high quality systematic reviews that examined the safety and effectiveness of cannabinoids in multiple sclerosis. We examined the outcomes of disability and disability progression, pain, spasticity, bladder function, tremor/ataxia, quality of life and adverse effects. RECENT FINDINGS: We identified 11 eligible systematic reviews providing data from 32 studies, including 10 moderate to high quality RCTs. Five reviews concluded that there was sufficient evidence that cannabinoids may be effective for symptoms of pain and/or spasticity in MS. Few reviews reported conclusions for other symptoms. Recent high quality reviews find cannabinoids may have modest effects in MS for pain or spasticity. Future research should include studies with non-cannabinoid comparators; this is an important gap in the evidence.

Broad synthesis / Living FRISBEE

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Are cannabinoids an effective treatment for chronic non-cancer pain?

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Authors Allende-Salazar RF , Rada G
Journal Medwave
Year 2017
Links Pubmed DOI

This article includes 38 Systematic reviews Systematic reviews (38 references) 84 Primary studies Primary studies (84 references)

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The use of cannabinoids has been proposed as an analgesic for different painful conditions, especially for chronic pain refractory to usual treatment. However, its real efficacy and safety remains controversial. We sought to determine whether cannabinoids are an effective treatment for chronic non-cancer pain. 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 37 systematic reviews including 41 studies overall, of which 32 were randomized trials relevant for the question of interest. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded it is not clear whether cannabinoids decrease pain in patients with chronic non-cancer pain because the certainty of available evidence is very low. On the other hand, they are associated with significant adverse effects.

Broad synthesis / Living FRISBEE

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Are cannabinoids effective in multiple sclerosis?

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Authors Meza R , Peña J , García K , Corsi O , Rada G
Journal Medwave
Year 2017
Links Pubmed DOI

This article includes 26 Systematic reviews Systematic reviews (26 references) 59 Primary studies Primary studies (59 references)

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Multiple beneficial effects have been proposed lately for cannabinoids in different clinical situations. Among them, it has been postulated they would control symptoms of multiple sclerosis. However, there is no consensus about their real clinical role. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple databases. We identified 25 systematic reviews including 35 studies overall, of which 26 were randomized trials. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded cannabinoids in multiple sclerosis do not reduce spasticity or pain, and are probably associated to frequent adverse effects.

Broad synthesis / Guideline

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Guidance for the use of medicinal cannabis in the treatment of multiple sclerosis in Australia

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Journal Therapeutic Goods Administration (TGA)
Year 2017
Links tga

This article includes 11 Systematic reviews Systematic reviews (11 references) 19 Primary studies Primary studies (19 references)

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This document reflects the evidence supporting the use of medicinal cannabis in treating symptoms of MS

Broad synthesis / Living FRISBEE

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Are cannabinoids effective for Parkinson's disease?

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Authors Bravo-Soto GA , Juri C
Journal Medwave
Year 2017
Links Pubmed DOI

This article includes 6 Systematic reviews Systematic reviews (6 references) 8 Primary studies Primary studies (8 references)

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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.

Broad synthesis / Guideline

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The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

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Journal Washington, DC: The National Academies Press
Year 2017
Links DOI

This article includes 77 Primary studies Primary studies (77 references) 22 Systematic reviews Systematic reviews (22 references)

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Broad synthesis / Guideline

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Guidance for the use of medicinal cannabis in the treatment of chronic non-cancer pain in Australia

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Journal Therapeutic Goods Administration (TGA)
Year 2017
Links tga

This article includes 4 Systematic reviews Systematic reviews (4 references) 55 Primary studies Primary studies (55 references)

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This document reflects the evidence supporting the use of medicinal cannabis in treating chronic pain and the recommendations of the Chronic Pain Working Group

Broad synthesis

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Cannabinoid derivatives and the pharmacological management of pain

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Journal Revista Dor
Year 2016
Links DOI LILACS

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

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ABSTRACT BACKGROUND AND OBJECTIVES: Medical properties of Cannabis sativa have been reported for centuries for the treatment of diff ent disorders and, more recently, to manage pain. Th study aimed at reviewing major pharmacological advances of the endocannabinoid system and the potential therapeutic use of some cannabinoid compounds to manage diff ent types of pain. CONTENTS: A search was carried out in Pubmed, Scielo and Lilacs databases to identify studies and literature reviews on the pharmacology and therapeutic use of cannabinoids for pain. The following keywords were used: Cannabis sativa, tetra-hydrocannabinol, cannabidiol, sativex®, cannador®, cannabinoids, endocannabinoid, pain and neuropathic pain. Synthetic cannabinoids and Cannabis sativa extracts have shown analgesic effects in several clinical trials, suggesting their potential role for pain management, especially neuropathic pain. Synthetic cannabinoids and CS extracts have also induced anxiolytic effects when used as adjuvants to treat cancer pain, rheumatoid arthritis and multiple sclerosis. However, significant adverse effects, such as euphoria, depression and sedation limit the clinical use of such cannabinoids. CONCLUSION: Further understanding of endocannabinoid system pharmacology, together with study results involving pain management with cannabinoid substances may be very useful for the development of drugs allowing a significant advance in the treatment of patients with painful syndromes, especially difficult to control. However, further studies are needed to confirm such findings and to determine the safety of such compounds.

Broad synthesis / Living FRISBEE

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Do cannabinoids have a role to play in Tourette's syndrome?

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Authors García K , Rada G
Journal Medwave
Year 2016
Links Pubmed DOI

This article includes 7 Systematic reviews Systematic reviews (7 references) 4 Primary studies Primary studies (4 references)

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It has been suggested that the use of cannabinoids might play a role in the treatment of Tourette’s syndrome, but there is no consensus. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified seven systematic reviews including two randomized trials addressing the question of this article. We extracted data, combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded it is not clear whether cannabinoids reduce tics in Tourette’s syndrome, and they are probably associated to frequent adverse effects.

Broad synthesis

Unclassified

Cannabis: The Evidence for Medical Use

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Authors Barnes, MP , Barnes, JC
Report Group for Drug Policy Reform
Year 2016

This article includes 124 Primary studies Primary studies (124 references) 25 Systematic reviews Systematic reviews (25 references)

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