PMID- 32040850
OWN - NLM
STAT- MEDLINE
DCOM- 20210611
LR  - 20210611
IS  - 1179-1934 (Electronic)
IS  - 1172-7047 (Linking)
VI  - 34
IP  - 3
DP  - 2020 Mar
TI  - Adjunctive Cannabidiol in Patients with Dravet Syndrome: A Systematic Review and 
      Meta-Analysis of Efficacy and Safety.
PG  - 229-241
LID - 10.1007/s40263-020-00708-6 [doi]
AB  - BACKGROUND: Dravet syndrome (DS) is one of the most severe forms of 
      drug-resistant epilepsy and available interventions fail to control seizures in 
      most patients. Cannabidiol (CBD) is the first in a new class of antiepileptic 
      drugs with a distinctive chemical structure and mechanism of action. OBJECTIVE: 
      The aim of this systematic review was to evaluate the efficacy and safety of CBD 
      as adjunctive treatment for seizures in patients with DS using meta-analytical 
      techniques. METHODS: We searched for randomized, placebo-controlled, single- or 
      double-blinded trials. Main outcomes included >/= 50% reduction in baseline 
      convulsive seizure frequency and the incidence of treatment withdrawal and 
      adverse events (AEs). Risk ratios (RRs) with 95% confidence intervals (95% CIs) 
      were estimated through the inverse variance method. RESULTS: Three trials were 
      included involving 359 participants, 228 for CBD and 131 for placebo groups. In 
      all trials, the active treatment was a plant-derived pharmaceutical formulation 
      of purified CBD oral solution. The pooled RR for 50% response during the 
      treatment was 1.69 (95% CI 1.21-2.36; p = 0.002). Across the trials, treatment 
      was discontinued in 20 (9.0%) and 3 (2.3%) cases in the add-on CBD and placebo 
      groups, respectively; the RR for CBD withdrawal was 3.12 (95% CI 1.07-9.10; 
      p = 0.037). The RR to develop any AE during add-on CBD treatment was 1.06 (95% CI 
      0.87-1.28; p = 0.561). AEs significantly associated with adjunctive CBD were 
      somnolence, decreased appetite, diarrhea, and increased serum aminotransferases. 
      CONCLUSIONS: Adjunctive CBD resulted in a greater reduction in convulsive seizure 
      frequency than placebo and a higher rate of AEs in patients with DS presenting 
      with seizures uncontrolled by concomitant antiepileptic therapy.
FAU - Lattanzi, Simona
AU  - Lattanzi S
AUID- ORCID: 0000-0001-8748-0083
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Via Conca71, 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 - 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 i. T, Austria.
FAU - Zaccara, Gaetano
AU  - Zaccara G
AD  - Health Agency of Tuscany, Florence, Italy.
FAU - Striano, Pasquale
AU  - Striano P
AD  - Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, 
      Rehabilitation, Ophthalmology Genetics, Maternal and Child Health, "G. Gaslini" 
      Institute, University of Genoa, Genoa, Italy.
FAU - Del Giovane, Cinzia
AU  - Del Giovane C
AD  - Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
FAU - Silvestrini, Mauro
AU  - Silvestrini M
AD  - Neurological Clinic, Department of Experimental and Clinical Medicine, Marche 
      Polytechnic University, Via Conca71, 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  - 19GBJ60SN5 (Cannabidiol)
SB  - IM
MH  - Cannabidiol/*adverse effects/*therapeutic use
MH  - Double-Blind Method
MH  - Drug Therapy, Combination/methods
MH  - Epilepsies, Myoclonic/*drug therapy
MH  - Humans
MH  - Odds Ratio
MH  - Randomized Controlled Trials as Topic
EDAT- 2020/02/11 06:00
MHDA- 2021/06/12 06:00
CRDT- 2020/02/11 06:00
PHST- 2020/02/11 06:00 [pubmed]
PHST- 2021/06/12 06:00 [medline]
PHST- 2020/02/11 06:00 [entrez]
AID - 10.1007/s40263-020-00708-6 [pii]
AID - 10.1007/s40263-020-00708-6 [doi]
PST - ppublish
SO  - CNS Drugs. 2020 Mar;34(3):229-241. doi: 10.1007/s40263-020-00708-6.