CBD Use-Related Adverse Events Twice As Common in Patients with Epilepsy


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CBD Use-Related Adverse Events Twice As Common in Patients With Epilepsy

According to a systematic review and meta-analysis published in JAMA Network Open, Cannabidiol (CBD) use among patients with epilepsy is linked to an elevated risk of adverse events (AEs), including somnolence, decreased appetite, and pyrexia. Epilepsy is one of the most commonly occurring neurologic conditions globally, and in approximately one-third of patients with the disease, seizures persist even with the use of existing treatments. Therefore, the need exists for new alternative epilepsy treatment options.

CBD is among a number of naturally occurring compounds produced by the cannabis plant known as cannabinoids. The US Food and Drug Administration and the European Medicines Agency have approved CBD as an additional treatment for severe types of epilepsy, including Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS).

Study Methodology

The researchers searched databases, including PubMed, Scopus, Web of Science, and Google Scholar, for articles that reported at least 1 AE after CBD use among patients with epilepsy. They identified a total of nine articles that fulfilled the eligibility criteria. The trials were published between 2017 and 2022 and evaluated patients with LGS, DS, or tuberous sclerosis-associated epilepsy.

The researchers assessed the frequency of and risk for AEs related to CBD use among individuals with epilepsy. They conducted a quality evaluation of the included studies to examine any potential bias due to outcome measurements. Overall, three of the trials exhibited a low risk for bias, three were associated with some concerns, and three had a high risk for bias.

Study Results

The researchers found that AEs of any grade were more frequent in the CBD group, with the overall percentage of AEs of any grade at 9.7%, compared to 4.0% in the control group. The proportions of mild AEs, moderate AEs, and severe AEs were 11.1%, 3.1%, and 1.2%, respectively, in the CBD group, compared with 6.4%, 1.3%, and 0.7%, respectively, in the control group. The risk ratios for any grade AEs and severe grade AEs in the CBD group were 1.12 and 3.39, respectively.

The incidence of the following AEs was significantly higher in the CBD arm compared with the control arm: diarrhea, somnolence, decreased appetite, and elevation in alanine aminotransferase or aspartate aminotransferase levels. The overall RR for the incidence of serious AEs was 2.67 in the CBD arm compared with the control arm. The incidence of AEs associated with treatment discontinuation was significantly higher in the CBD group compared with the control group, as was the incidence of AEs leading to dose reduction.

This study concluded that CBD use among patients with epilepsy is associated with an elevated risk for AEs, with such impacts found to be significantly higher in the intervention group than in the control group.

Conclusion

Considering the findings of the study, this research highlights the importance of continued investigation into the therapeutic effects of CBD and AEs and achieving a safe and effective dose for treatment-resistant patients with epilepsy.

Reference

Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the author’s disclosures.

This article originally appeared on Neurology Advisor


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