PMID- 36417631
OWN - NLM
STAT- MEDLINE
DCOM- 20230403
LR  - 20230403
IS  - 1806-9282 (Electronic)
IS  - 0104-4230 (Print)
IS  - 0104-4230 (Linking)
VI  - 68
IP  - 10
DP  - 2022
TI  - Use of cannabidiol in the treatment of epilepsy: Lennox-Gastaut syndrome, Dravet 
      syndrome, and tuberous sclerosis complex.
PG  - 1345-1357
LID - S0104-42302022001001345 [pii]
LID - 10.1590/1806-9282.2022D689 [doi]
AB  - OBJECTIVE: The objective of this systematic review with meta-analysis was to 
      evaluate the efficacy, safety, and short- and long-term tolerability of 
      cannabidiol (CBD), as an adjunct treatment, in children and adults with Dravet 
      syndrome (SD), Lennox-Gataut syndrome (LGS), or tuberous sclerosis complex (TSC), 
      with inadequate control of seizures. METHODS: This systematic review was 
      conducted through a search for scientific evidence in the Mediline/PubMed, 
      Central Cochrane, and ClinicalTrials.gov databases until April 2022. Selected 
      randomized clinical trials (RCTs) that presented the outcomes: reduction in the 
      frequency of seizures and total seizures (all types), number of patients with a 
      response greater than or equal to 50%, change in caregiver global impression of 
      change (CGIC) (improvement >/=1 category on the initial scale), adverse events 
      (AEs), and tolerability to treatment. This review followed Preferred Reporting 
      Items for Systematic reviews and Meta-Analyses. RESULTS: Notably, six RCTs were 
      included, with a total of 1,034 patients with SD, LGS, and TSC, of which 3 were 
      open-label extension RCTs. The meta-analysis of the studies showed that the use 
      of CBD as compared with placebo, in patients with convulsive seizures refractory 
      to the use of medications, reduces the frequency of seizures by 33%; increases 
      the number of patients with a reduction >/=50% in the frequency of seizures by 20%; 
      increases the number of patients with absence of seizures by 3%; improves the 
      clinical impression evaluated by the caregiver or patient (S/CGIC) in 21%; 
      increases total AEs by 12%; increases serious AE by 16%; increases the risk of 
      treatment abandonment by 12%; and increases the number of patients with 
      transaminase elevation (>/=3 times the referral) by 15%. CONCLUSIONS: This 
      systematic review, with meta-analysis, supports the use of CBD in the treatment 
      of patients with seizures, originated in DS, LGS, and TSC, who are resistant to 
      the common medications, presenting satisfactory benefits in reducing seizures and 
      tolerable toxicity.
FAU - Silvinato, Antonio
AU  - Silvinato A
AUID- ORCID: 0000-0003-3718-1442
AD  - Associacao Medica Brasileira, Medicina Baseada em Evidencias - Sao Paulo (SP) 
      Brasil.
FAU - Floriano, Idevaldo
AU  - Floriano I
AUID- ORCID: 0000-0002-3753-2866
AD  - Associacao Medica Brasileira, Medicina Baseada em Evidencias - Sao Paulo (SP) 
      Brasil.
FAU - Bernardo, Wanderley Marques
AU  - Bernardo WM
AUID- ORCID: 0000-0002-8597-5207
AD  - Associacao Medica Brasileira, Medicina Baseada em Evidencias - Sao Paulo (SP) 
      Brasil.
AD  - Universidade de Sao Paulo, Faculdade de Medicina - Sao Paulo (SP) Brasil.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20221121
PL  - Brazil
TA  - Rev Assoc Med Bras (1992)
JT  - Revista da Associacao Medica Brasileira (1992)
JID - 9308586
RN  - 0 (Anticonvulsants)
RN  - 19GBJ60SN5 (Cannabidiol)
RN  - CDKL5 deficiency disorder
SB  - IM
MH  - Adult
MH  - Child
MH  - Humans
MH  - Anticonvulsants/therapeutic use/adverse effects
MH  - *Cannabidiol/therapeutic use/adverse effects
MH  - *Epilepsies, Myoclonic/drug therapy/chemically induced
MH  - *Epilepsy
MH  - *Lennox Gastaut Syndrome/drug therapy
MH  - Seizures/etiology/chemically induced
MH  - *Tuberous Sclerosis/complications/drug therapy/chemically induced
PMC - PMC9683917
COIS- Conflicts of interest: the authors declare there is no conflicts of interest.
EDAT- 2022/11/24 06:00
MHDA- 2022/11/26 06:00
PMCR- 2022/11/21
CRDT- 2022/11/23 15:23
PHST- 2022/07/07 00:00 [received]
PHST- 2022/07/07 00:00 [accepted]
PHST- 2022/11/23 15:23 [entrez]
PHST- 2022/11/24 06:00 [pubmed]
PHST- 2022/11/26 06:00 [medline]
PHST- 2022/11/21 00:00 [pmc-release]
AID - S0104-42302022001001345 [pii]
AID - 1806-9282.2022D689 [pii]
AID - 10.1590/1806-9282.2022D689 [doi]
PST - epublish
SO  - Rev Assoc Med Bras (1992). 2022 Nov 21;68(10):1345-1357. doi: 
      10.1590/1806-9282.2022D689. eCollection 2022.