|
Studies
<br />nrmuiu. c Ph ---.l (2015110293-3Dt
<br />1 1 n. J;7
<br />I I a 5 t 111 i_,k,Op6
<br />Nvnvb rc VMW
<br />RECENT META-ANALYSES SUPPORT
<br />-- UR OF CANN,4R1nin.,.. _
<br />THE USE
<br />1"'% FOR CHR
<br />OPAT81C NO ONIC
<br />NE
<br />CAN
<br />generally short smallN ER PAIND
<br />, d e s t effect with mo , BUT '>
<br />Annals of Internal Medicine
<br />IReseareh es.ect sizcQ
<br />"annabinoids for the Treatment of Chn
<br />len Updated Systematic Review of Rand
<br />it. E. LyncW • Mark A. Ware=
<br />teedvnt 29 hmay 1015!Accepted_ 3 b(erdh 2015 rPublisbodoolim 22 Ntardh 2n 15
<br />� 8pno8tt Scieom.Busuu55 xicdia Neer Yod[ 2Dli
<br />A6saact An updadd.systerarde review afrandmnized can.
<br />trolled trials examining camabinoids in the treatment of
<br />chronic noncancer pain was wnducted acmding to PRIS
<br />MA guidelines for systematic reviews reporting on healthcare
<br />outcomes. Eleven Dials published since our List su
<br />t review et
<br />inclusion .,heels. The quality o1"the trials wu excellent. Sev-
<br />en of the vials demonstrated a significant analgesic eBect.
<br />Several tri.L, also demonstared irip—trnem in secondary
<br />outcomes (e.g, sleep, musele stiffness and spasticiry). Ad-
<br />verse etreevi most frcquenty reponed such as ratigue and
<br />dizziness were mild to moderate in.seeerity and generally well
<br />tole aced. This review adds further support that c—Ily
<br />available cannabinoids are safe, modestly effective analgesics
<br />that provide a reasonable therapeutic option in the manage-
<br />ment f,b,-. nn
<br />ocancer pain.
<br />Keywords Camabinoids Chmrticnorn-wnce,pain
<br />Nemnpadue pain - Systematic revim - Marijuana
<br />DCPonmaus ofAantieicb& Pain M&L j -ant Peripp—Wry
<br />Circ P,3ehimy and P eingy V.Ih ie L'luverpy,
<br />Nalilit, Nova Scans, Canada
<br />DePmrmcrosaf ansth.is and Family Makcioe. M0001 LNivesip,
<br />Intredm
<br />Chronic I
<br />approxin
<br />crease to
<br />ei aL 20(
<br />prevaleo
<br />popit
<br />prove sv
<br />eases th,
<br />Lily, but
<br />pain coo
<br />(eg. antid
<br />and nmhn
<br />2010) are
<br />with limi,
<br />dation wi
<br />constipate
<br />diovascu
<br />There N;
<br />In Wier
<br />turning u
<br />et al. 20(
<br />sates wif
<br />people w:
<br />(tharijuan
<br />grams (e
<br />Stares) n
<br />for the in,
<br />ical profe
<br />both pole
<br />The Effects of Cannabis Among Adults With Chronic Pain and aR ;V PWEW M
<br />Efficacy and adverse effects of n �VeryiewofGeneralHarms �rna''Oyestf
<br />A Systematic Review �a/)n 8a%r,
<br />marijuana for chronic noncancer shamianM,Nugent,Php; ( abl�7
<br />Rarlf Rundo,(:amine Elvena MDJ. Maraud, PhD; ya E. O'Neil, PhD; S}ig °ids f
<br />Systematic review of randomized controlled triols Devon Kanzagara Ml)MCR 8ernadene Zak a MBBa; Makala valdkhela Freeman, MPH; ARlwnlow
<br />P Mmu apuaka, aA; Robin Pa mer, Pen YF f. Q
<br />Amo! Oeshpande aro utu Angela Mollis -Gagnon Ms rn rxvc Nivan loheiry �ckgroumt: Canna6s - r t n Whi - ��a`ie • to°r ��d'Cal
<br />roan[ of chronic pain, yet ,` ncreasagfy a ailade fa i* treat
<br />Abstract ru�l [maim once a n.
<br />Ohjecilve To determine if medical marijuana provides pain relief for at arao'aru (^rro� eeb Wt of plan -busy � yes p
<br />and m de[emdnr the therapeutic dose, adverse effects, and specific indica[ nabis use in duorvc c pain b adults and the harm of �n
<br />Pan and general aduh popdadons
<br />Dai. sotvices In April 2014, ME DUNE and EMBASE worth- were rot „b -a-R°1p n Cochrane Wlahase
<br />par., smoked momrsino or mnrwbiraUds, pf.aeho and pom reliry or side of Maser pal several °der sou'— from database n c m
<br />Snrdy selection An anide was selected for inclusion if it evaluated the
<br />Inensynthetiq for CNCP; it was designed as a conunted study inWvi:
<br />or historically; and it was published in English in a par -review joumal
<br />adverse effects were colleted, if avaitable. Alt articles thin were only aw
<br />Synthesis A total of 6 randomized controlled trials (N=226 patiem
<br />assessed the use of medical marijuana in neuropathic pain as an
<br />adiunct to other concomitant analgesics including apioids and
<br />anticonvulsants. The 6 trials were considered to be of high quality; 1
<br />however, all of them had diallengits with masking. Data could rot s
<br />be pooled owing to heterogeneity in dclta4-temahydracannabinol
<br />potency by dried weight, differing frequency and duration of
<br />treatment, and vanaWty in assessing outcomes All cWtimmial
<br />sessions in the studies were of short duration (maximum of
<br />Saketl°m 1--1 trials and
<br />°bseneriorhal statics,
<br />use of medicinal cannabis has be
<br />roma irlaeas
<br />States and ylobahy (1,
<br />f columbiaegal-
<br />• I urposes, and 28 states
<br />IQ( alized 0 for nted_
<br />1 and BO% of Persons
<br />so for pain manage.
<br />are prescribed long_
<br />to 39% are also use
<br />creasingly need to arts
<br />ons with their patients
<br />harms d ❑nnabis use.
<br />( nd oidralYy appraised
<br />^ and harms of us-
<br />"t
<br />of a larger report commissioned
<br />Heath Admi 'It, n (8). A protocol
<br />��nvNg V1eyv.a vSe
<br />ulationsWdies include inoeasedrak for mr �M �MD�f-War rJ�j
<br />Psycho symptoms, andel c k�S��.k!>�chrasrlaMa�r �nt)esl '""Ie a -a
<br />though adverse pukrbn vaur�r a,`� h
<br />PoPhaaBooni evidence on most other leer r kOi S. M e^9es, ,k • Mme. ' rC?Iy!
<br />nb19 term ZZ users,a Thr W PhPsh 'Telloa
<br />uAli—
<br />LI,Ran •Get ate'`sand en" °j'a Jos tan& 20,30: R PlaD.
<br />ft-tiom Few medhodabgi�ly rig p�E-[bait Gh 'ytENheR,ylo EMi
<br />Woducts: snd,ed may rot re8er _'•vF effXat. habenal
<br />lau^n and pat n Ewho puseawlnnah � T�CO�OcrasyytYferi<k� d� �Wi-e u� PhD
<br />Agrsn ematicrev' ishotc In heat
<br />itltt�, r._. �ofttko.� ✓sere drseaseo
<br />n
<br />MS 000 r2�CllnJCa! �rncePtion ro (a
<br />11*4 sci dlerrlak hral5 °tea d 1018
<br />o�T Wye »�r0 p.4� Mrrtsii 1, rn
<br />W �Nesis u� �� ahrierya �S Dro
<br />ori•
<br />[and 40 6;s F
<br />brn.eryu[reb'in0'�Wasar._P dis
<br />S(, -•c. quality li". Ones ppa�t ., �arysli ''aNC
<br />Y2reyreZll
<br />k't
<br />'Most �al4lofch
<br />trial,�haf" '..,'ort�lepant/d� Posse of
<br />cah�bi 00% w� 01PnW (6462A, �Mopa It Onge. �frc oaI
<br />Odea swerpa �uatistirrry'Pt lwereMclud actit-igof
<br />3 alsl. aotl ppmrt>� ted Wi o to oris as �' 4 very
<br />p ,p�onin Rte (g3�ygaereatpr ncceNaf!pU/sratedwith fjogeda()o
<br />nrJ'A'eren mnurner3 ps31 [?2046., e1a8'da e%rlt Conwat(�y r"'a4401ds wru,Yof
<br />e �krorths ihrMpZ _�qS ratir>bu .t471fgs�p(OR g�tiegft5ho ebR4t these
<br />rksee^adi-,kshorr. P M (IMM 6 -tz a�smeQ. n�(p�Opl.B%g 1ss9 2trp(ete
<br />w?hr-_��21g59st 0,,,e aO.rQ Zal.agr 1
<br />_D _ trials). a.., •p`otht y.,. meter
<br />
|