PMID- 30132269
OWN - NLM
STAT- MEDLINE
DCOM- 20191003
LR  - 20191007
IS  - 1179-1934 (Electronic)
IS  - 1172-7047 (Linking)
VI  - 32
IP  - 10
DP  - 2018 Oct
TI  - Efficacy and Safety of Adjunctive Cannabidiol in Patients with Lennox-Gastaut 
      Syndrome: A Systematic Review and Meta-Analysis.
PG  - 905-916
LID - 10.1007/s40263-018-0558-9 [doi]
AB  - BACKGROUND: Lennox-Gastaut syndrome (LGS) is a severe developmental epileptic 
      encephalopathy, and available interventions fail to control seizures in most 
      patients. Cannabidiol (CBD) is a major chemical of marijuana, which has 
      anti-seizure properties and different mechanisms of action compared with other 
      approved antiepileptic drugs (AEDs). OBJECTIVE: The aim was to evaluate the 
      efficacy and safety of CBD as adjunctive treatment for seizures in patients with 
      LGS using meta-analytical techniques. METHODS: Randomized, placebo-controlled, 
      single- or double-blinded trials were identified. Main outcomes included 
      the >/= 50% reduction in baseline drop and non-drop seizure frequency, and the 
      incidence of treatment withdrawal and adverse events (AEs). Risk ratios (RRs) 
      with 95% confidence intervals (CIs) were estimated through the inverse variance 
      method. RESULTS: Two trials were included involving 396 participants. Patients 
      presenting >/= 50% reduction in drop seizure frequency during the treatment were 
      40.0% with CBD and 19.3% with placebo [RR 2.12 (95% CI 1.48-3.03); p < 0.001]. 
      The rate of non-drop seizure frequency was reduced by 50% or more in 49.4% of 
      patients in the CBD and 30.4% in the placebo arms [RR 1.62 (95% CI 1.09-2.43); 
      p = 0.018]. The RR for CBD withdrawal was 4.93 (95% CI 1.50-16.22; p = 0.009). 
      The RR to develop any AE during CBD treatment was 1.24 (95% CI 1.11-1.38; 
      p < 0.001). AEs significantly associated with CBD were somnolence, decreased 
      appetite, diarrhea and increased serum aminotransferases. CONCLUSIONS: Adjunctive 
      CBD resulted in a greater reduction in seizure frequency and a higher rate of AEs 
      than placebo in patients with LGS presenting seizures uncontrolled by concomitant 
      AEDs.
FAU - Lattanzi, Simona
AU  - Lattanzi S
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Via Conca 71, 60020, Ancona, Italy. 
      alfierelattanzisimona@gmail.com.
FAU - Brigo, Francesco
AU  - Brigo F
AD  - Department of Neuroscience, Biomedicine and Movement Science, University of 
      Verona, Verona, Italy.
AD  - Division of Neurology, "Franz Tappeiner" Hospital, Merano, BZ, Italy.
FAU - Cagnetti, Claudia
AU  - Cagnetti C
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Via Conca 71, 60020, Ancona, Italy.
FAU - Trinka, Eugen
AU  - Trinka E
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria.
AD  - Center for Cognitive Neuroscience, Salzburg, Austria.
AD  - Public Health, Health Services Research and HTA, University for Health Sciences, 
      Medical Informatics and Technology, Hall in Tirol, Austria.
FAU - Silvestrini, Mauro
AU  - Silvestrini M
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Via Conca 71, 60020, Ancona, Italy.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - New Zealand
TA  - CNS Drugs
JT  - CNS drugs
JID - 9431220
RN  - 0 (Anticonvulsants)
RN  - 19GBJ60SN5 (Cannabidiol)
RN  - EC 2.6.1.- (Transaminases)
SB  - IM
MH  - Anticonvulsants/*therapeutic use
MH  - Cannabidiol/*adverse effects/*therapeutic use
MH  - Double-Blind Method
MH  - Humans
MH  - Lennox Gastaut Syndrome/*drug therapy/metabolism
MH  - Odds Ratio
MH  - Randomized Controlled Trials as Topic
MH  - Seizures/drug therapy/metabolism
MH  - Transaminases/metabolism
EDAT- 2018/08/23 06:00
MHDA- 2019/10/08 06:00
CRDT- 2018/08/23 06:00
PHST- 2018/08/23 06:00 [pubmed]
PHST- 2019/10/08 06:00 [medline]
PHST- 2018/08/23 06:00 [entrez]
AID - 10.1007/s40263-018-0558-9 [pii]
AID - 10.1007/s40263-018-0558-9 [doi]
PST - ppublish
SO  - CNS Drugs. 2018 Oct;32(10):905-916. doi: 10.1007/s40263-018-0558-9.