PMID- 32804836
OWN - NLM
STAT- MEDLINE
DCOM- 20210803
LR  - 20230818
IS  - 1872-6623 (Electronic)
IS  - 0304-3959 (Linking)
VI  - 162
IP  - Suppl 1
DP  - 2021 Jul 1
TI  - Cannabinoids, cannabis, and cannabis-based medicine for pain management: a 
      systematic review of randomised controlled trials.
PG  - S45-S66
LID - 10.1097/j.pain.0000000000001929 [doi]
AB  - Cannabinoids, cannabis, and cannabis-based medicines (CBMs) are increasingly used 
      to manage pain, with limited understanding of their efficacy and safety. We 
      summarised efficacy and adverse events (AEs) of these types of drugs for treating 
      pain using randomised controlled trials: in people of any age, with any type of 
      pain, and for any treatment duration. Primary outcomes were 30% and 50% reduction 
      in pain intensity, and AEs. We assessed risk of bias of included studies, and the 
      overall quality of evidence using GRADE. Studies of <7 and >7 days treatment 
      duration were analysed separately. We included 36 studies (7217 participants) 
      delivering cannabinoids (8 studies), cannabis (6 studies), and CBM (22 studies); 
      all had high and/or uncertain risk of bias. Evidence of benefit was found for 
      cannabis <7 days (risk difference 0.33, 95% confidence interval 0.20-0.46; 2 
      trials, 231 patients, very low-quality evidence) and nabiximols >7 days (risk 
      difference 0.06, 95% confidence interval 0.01-0.12; 6 trials, 1484 patients, very 
      low-quality evidence). No other beneficial effects were found for other types of 
      cannabinoids, cannabis, or CBM in our primary analyses; 81% of subgroup analyses 
      were negative. Cannabis, nabiximols, and delta-9-tetrahydrocannabinol had more 
      AEs than control. Studies in this field have unclear or high risk of bias, and 
      outcomes had GRADE rating of low- or very low-quality evidence. We have little 
      confidence in the estimates of effect. The evidence neither supports nor refutes 
      claims of efficacy and safety for cannabinoids, cannabis, or CBM in the 
      management of pain.
CI  - Copyright (c) 2020 International Association for the Study of Pain.
FAU - Fisher, Emma
AU  - Fisher E
AD  - Centre for Pain Research, University of Bath, Bath, United Kingdom.
AD  - Cochrane Pain, Palliative, and Supportive Care Review Groups, Oxford University 
      Hospitals, Oxford, United Kingdom.
FAU - Moore, R Andrew
AU  - Moore RA
AD  - Appledore, Court Road, Newton Ferrers, Plymouth, United Kingdom.
FAU - Fogarty, Alexandra E
AU  - Fogarty AE
AD  - Department of Neurology, Division of Physical Medicine and Rehabilitation, 
      Washington University in St. Louis School of Medicine, St Louis, MO, United 
      States.
FAU - Finn, David P
AU  - Finn DP
AD  - Pharmacology and Therapeutics, School of Medicine, Galway Neuroscience Centre and 
      Centre for Pain Research, Human Biology Building, National University of Ireland 
      Galway, University Road, Galway, Ireland.
FAU - Finnerup, Nanna B
AU  - Finnerup NB
AD  - Department of Clinical Medicine, Danish Pain Research Center, Aarhus University, 
      Aarhus, Denmark.
AD  - Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
FAU - Gilron, Ian
AU  - Gilron I
AD  - Department of Anesthesiology and Perioperative Medicine, Kingston General 
      Hospital, Kingston, ON, Canada.
AD  - Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
AD  - School of Policy Studies, Queen's University, Kingston, ON, Canada.
FAU - Haroutounian, Simon
AU  - Haroutounian S
AD  - Division of Clinical and Translational Research, Department of Anesthesiology, 
      Washington University School of Medicine, Washington University Pain Center, St 
      Louis, MO, United States.
FAU - Krane, Elliot
AU  - Krane E
AD  - Department of Anesthesiology, Perioperative, and Pain Medicine, and Pediatrics, 
      Stanford University School of Medicine, Stanford, CA, United States.
AD  - Palo Alto, Santa Clara, CA, United States.
FAU - Rice, Andrew S C
AU  - Rice ASC
AD  - Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial 
      College London, London, United Kingdom.
FAU - Rowbotham, Michael
AU  - Rowbotham M
AD  - Department of Anesthesia, University of California, San Francisco, CA, United 
      States.
AD  - Sutter Health, CPMC Research Institute, California Pacific Medical Center 
      Research Institute, San Francisco, CA, United States.
FAU - Wallace, Mark
AU  - Wallace M
AD  - Division of Pain Medicine, Department of Anesthesiology, University of 
      California, San Francisco, CA, United States.
FAU - Eccleston, Christopher
AU  - Eccleston C
AD  - Centre for Pain Research, University of Bath, Bath, United Kingdom.
AD  - Cochrane Pain, Palliative, and Supportive Care Review Groups, Oxford University 
      Hospitals, Oxford, United Kingdom.
AD  - Department of Clinical and Health Psychology, Ghent University, Ghent, Belgium.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
PL  - United States
TA  - Pain
JT  - Pain
JID - 7508686
RN  - 0 (Analgesics)
RN  - 0 (Cannabinoids)
SB  - IM
CIN - Pain. 2021 Jul 1;162(Suppl 1):S125-S126. PMID: 32804834
CIN - Pain. 2021 Aug 1;162(8):2309. PMID: 34256383
CIN - Pain. 2021 Aug 1;162(8):2310. PMID: 34256384
MH  - Analgesics/therapeutic use
MH  - *Cannabinoids/therapeutic use
MH  - *Cannabis
MH  - *Chronic Pain
MH  - Humans
EDAT- 2020/08/18 06:00
MHDA- 2021/08/04 06:00
CRDT- 2020/08/18 06:00
PHST- 2020/03/27 00:00 [received]
PHST- 2020/04/28 00:00 [accepted]
PHST- 2020/08/18 06:00 [pubmed]
PHST- 2021/08/04 06:00 [medline]
PHST- 2020/08/18 06:00 [entrez]
AID - 00006396-202107001-00005 [pii]
AID - 10.1097/j.pain.0000000000001929 [doi]
PST - ppublish
SO  - Pain. 2021 Jul 1;162(Suppl 1):S45-S66. doi: 10.1097/j.pain.0000000000001929.