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Síntesis amplia / Revisión panorámica de revisiones sistemáticas

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Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms.

Revista Canadian Family Physician
Año 2018
Enlaces Pubmed PubMed Central

Este artículo incluye 26 Revisiones sistemáticas Revisiones sistemáticas (26 referencias)

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OBJECTIVE: To determine the effects of medical cannabinoids on pain, spasticity, and nausea and vomiting, and to identify adverse events. DATA SOURCES: MEDLINE, the Cochrane Database, and the references of included studies were searched. STUDY SELECTION: Systematic reviews with 2 or more randomized controlled trials (RCTs) that focused on medical cannabinoids for pain, spasticity, or nausea and vomiting were included. For adverse events, any meta-analysis for the conditions listed or of adverse events of cannabinoids was included. SYNTHESIS: From 1085 articles, 31 relevant systematic reviews were identified including 23 for pain, 5 for spasticity, 6 for nausea and vomiting, and 12 for adverse events. Meta-analysis of 15 RCTs found more patients taking cannabinoids attained at least a 30% pain reduction: risk ratio (RR) of 1.37 (95% CI 1.14 to 1.64), number needed to treat (NNT) of 11. Sensitivity analysis found study size and duration affected findings (subgroup differences, CONCLUSION: There is reasonable evidence that cannabinoids improve nausea and vomiting after chemotherapy. They might improve spasticity (primarily in multiple sclerosis). There is some uncertainty about whether cannabinoids improve pain, but if they do, it is neuropathic pain and the benefit is likely small. Adverse effects are very common, meaning benefits would need to be considerable to warrant trials of therapy.

Síntesis amplia / Revisión panorámica de revisiones sistemáticas

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Cannabinoids for nausea and vomiting related to chemotherapy: Overview of systematic reviews.

Revista Phytotherapy research : PTR
Año 2018
Enlaces Pubmed DOI

Este artículo incluye 5 Revisiones sistemáticas Revisiones sistemáticas (5 referencias)

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Nausea and vomiting are common and distressing adverse events of chemotherapy. This review focuses on the findings and quality of systematic reviews (SRs) of cannabinoids for chemotherapy-induced nausea and vomiting (CINV). Review of SRs, a systematic literature search, was conducted in several electronic databases and included SRs evaluating cannabinoids for CINV in cancer patients. Methodological quality and quality of reporting were evaluated by AMSTAR and PRISMA, respectively. Initial search retrieved 2,206 records, and 5 SRs were included. On the basis of findings of the sole SR judged as high methodological quality, cannabinoids seem to be more effective than placebo, equal to prochlorperazine for reducing CINV, and to be preferred by patients. The response to different combinations of antiemetic agents seems to be equal to 1 antiemetic alone. The average of AMSTAR score was 5, and the average of PRISMA score was 13.2. Cannabinoids represent a valuable option for treating CINV, despite the adverse events related to treatment, such as drowsiness and cognitive impairment. There is no good quality evidence to recommend or not the use of cannabinoids for CINV. More studies are still needed to evaluate the effectiveness of cannabinoids when compared with modern antiemetics.

Síntesis amplia / Guía

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Guidance for the use of medicinal cannabis for the prevention or management of nausea and vomiting in Australia

Revista Therapeutic Goods Administration (TGA)
Año 2017
Enlaces tga.gov.au

Este artículo incluye 14 Revisiones sistemáticas Revisiones sistemáticas (14 referencias) 20 Estudios primarios Estudios primarios (20 referencias)

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This document reflects the evidence supporting the use of medicinal cannabis in nausea and vomiting and the recommendations of the Nausea and Vomiting Working Group

Síntesis amplia / Living FRISBEE

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¿Son efectivos los cannabinoides para el manejo de náuseas y vómitos inducidos por quimioterapia?

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Autores Morales M , Corsi O , Peña J
Revista Medwave
Año 2017
Enlaces Pubmed DOI

Este artículo incluye 16 Revisiones sistemáticas Revisiones sistemáticas (16 referencias) 61 Estudios primarios Estudios primarios (61 referencias)

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INTRODUCCIÓN: El tratamiento de las náuseas y vómitos inducidos por quimioterapia podría mejorar la calidad de vida de los pacientes oncológicos; para lograrlo se ha propuesto la adición de cannabinoides a los esquemas de antieméticos habituales. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, 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, realizamos un metanálisis y preparamos tablas de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos 16 revisiones sistemáticas que en conjunto incluyen 61 estudios primarios, de los cuales cuatro son ensayos aleatorizados que responden a la pregunta de interés. Concluimos que no hay claridad respecto a si los cannabinoides otorgan un beneficio al añadirlos a esquemas antieméticos habituales para el control de náuseas y vómitos inducidos por quimioterapia, porque la certeza de la evidencia es muy baja. Probablemente aumentan los efectos adversos de manera sustantiva.