Use of cannabidiol in the treatment of epilepsy: Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorSILVINATO, Antonio
dc.contributor.authorFLORIANO, Idevaldo
dc.contributor.authorBERNARDO, Wanderley Marques
dc.date.accessioned2023-02-23T15:09:06Z
dc.date.available2023-02-23T15:09:06Z
dc.date.issued2022
dc.description.abstractOBJECTIVE: 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.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.description.indexScielo
dc.description.sponsorshipUnimed Regional da Baixa Mogiana
dc.identifier.citationREVISTA DA ASSOCIACAO MEDICA BRASILEIRA, v.68, n.10, p.1345-1357, 2022
dc.identifier.doi10.1590/1806-9282.2022D689
dc.identifier.eissn1806-9282
dc.identifier.issn0104-4230
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/51829
dc.language.isoeng
dc.publisherASSOC MEDICA BRASILEIRAeng
dc.relation.ispartofRevista da Associacao Medica Brasileira
dc.rightsopenAccesseng
dc.rights.holderCopyright ASSOC MEDICA BRASILEIRAeng
dc.subjectDravet syndromeeng
dc.subjectLennox Gastaut syndromeeng
dc.subjectTuberous sclerosis complexeng
dc.subjectCannabidioleng
dc.subjectSeizureseng
dc.subjectSeizures refractoryeng
dc.subject.otherseizureseng
dc.subject.othertrialeng
dc.subject.wosMedicine, General & Internaleng
dc.titleUse of cannabidiol in the treatment of epilepsy: Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complexeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalSILVINATO, Antonio:Assoc Med Brasileira, Med Baseada Evidencias, Sao Paulo, SP, Brazil
hcfmusp.author.externalFLORIANO, Idevaldo:Assoc Med Brasileira, Med Baseada Evidencias, Sao Paulo, SP, Brazil
hcfmusp.citation.scopus4
hcfmusp.contributor.author-fmusphcWANDERLEY MARQUES BERNARDO
hcfmusp.description.beginpage1345
hcfmusp.description.endpage1357
hcfmusp.description.issue10
hcfmusp.description.volume68
hcfmusp.origemWOS
hcfmusp.origem.pubmed36417631
hcfmusp.origem.scieloSCIELO:S0104-42302022001001345
hcfmusp.origem.scopus2-s2.0-85142873403
hcfmusp.origem.wosWOS:000913824800003
hcfmusp.publisher.citySAO PAULOeng
hcfmusp.publisher.countryBRAZILeng
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