FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4229005706> ?p ?o ?g. }

• W4229005706 abstract "Spasticity and chronic neuropathic pain are common and serious symptoms in people with multiple sclerosis (MS). These symptoms increase with disease progression and lead to worsening disability, impaired activities of daily living and quality of life. Anti-spasticity medications and analgesics are of limited benefit or poorly tolerated. Cannabinoids may reduce spasticity and pain in people with MS. Demand for symptomatic treatment with cannabinoids is high. A thorough understanding of the current body of evidence regarding benefits and harms of these drugs is required.To assess benefit and harms of cannabinoids, including synthetic, or herbal and plant-derived cannabinoids, for reducing symptoms for adults with MS.We searched the following databases from inception to December 2021: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Library), CINAHL (EBSCO host), LILACS, the Physiotherapy Evidence Database (PEDro), the World Health Organisation International Clinical Trials Registry Platform, the US National Institutes of Health clinical trial register, the European Union Clinical Trials Register, the International Association for Cannabinoid Medicines databank. We hand searched citation lists of included studies and relevant reviews.We included randomised parallel or cross-over trials (RCTs) evaluating any cannabinoid (including herbal Cannabis, Cannabis flowers, plant-based cannabinoids, or synthetic cannabinoids) irrespective of dose, route, frequency, or duration of use for adults with MS.We followed standard Cochrane methodology. To assess bias in included studies, we used the Cochrane Risk of bias 2 tool for parallel RCTs and crossover trials. We rated the certainty of evidence using the GRADE approach for the following outcomes: reduction of 30% in the spasticity Numeric Rating Scale, pain relief of 50% or greater in the Numeric Rating Scale-Pain Intensity, much or very much improvement in the Patient Global Impression of Change (PGIC), Health-Related Quality of Life (HRQoL), withdrawals due to adverse events (AEs) (tolerability), serious adverse events (SAEs), nervous system disorders, psychiatric disorders, physical dependence.We included 25 RCTs with 3763 participants of whom 2290 received cannabinoids. Age ranged from 18 to 60 years, and between 50% and 88% participants across the studies were female. The included studies were 3 to 48 weeks long and compared nabiximols, an oromucosal spray with a plant derived equal (1:1) combination of tetrahydrocannabinol (THC) and cannabidiol (CBD) (13 studies), synthetic cannabinoids mimicking THC (7 studies), an oral THC extract of Cannabis sativa (2 studies), inhaled herbal Cannabis (1 study) against placebo. One study compared dronabinol, THC extract of Cannabis sativa and placebo, one compared inhaled herbal Cannabis, dronabinol and placebo. We identified eight ongoing studies. Critical outcomes • Spasticity: nabiximols probably increases the number of people who report an important reduction of perceived severity of spasticity compared with placebo (odds ratio (OR) 2.51, 95% confidence interval (CI) 1.56 to 4.04; 5 RCTs, 1143 participants; I2 = 67%; moderate-certainty evidence). The absolute effect was 216 more people (95% CI 99 more to 332 more) per 1000 reporting benefit with cannabinoids than with placebo. • Chronic neuropathic pain: we found only one small trial that measured the number of participants reporting substantial pain relief with a synthetic cannabinoid compared with placebo (OR 4.23, 95% CI 1.11 to 16.17; 1 study, 48 participants; very low-certainty evidence). We are uncertain whether cannabinoids reduce chronic neuropathic pain intensity. • Treatment discontinuation due to AEs: cannabinoids may increase slightly the number of participants who discontinue treatment compared with placebo (OR 2.41, 95% CI 1.51 to 3.84; 21 studies, 3110 participants; I² = 17%; low-certainty evidence); the absolute effect is 39 more people (95% CI 15 more to 76 more) per 1000 people. Important outcomes • PGIC: cannabinoids probably increase the number of people who report 'very much' or 'much' improvement in health status compared with placebo (OR 1.80, 95% CI 1.37 to 2.36; 8 studies, 1215 participants; I² = 0%; moderate-certainty evidence). The absolute effect is 113 more people (95% CI 57 more to 175 more) per 1000 people reporting improvement. • HRQoL: cannabinoids may have little to no effect on HRQoL (SMD -0.08, 95% CI -0.17 to 0.02; 8 studies, 1942 participants; I2 = 0%; low-certainty evidence); • SAEs: cannabinoids may result in little to no difference in the number of participants who have SAEs compared with placebo (OR 1.38, 95% CI 0.96 to 1.99; 20 studies, 3124 participants; I² = 0%; low-certainty evidence); • AEs of the nervous system: cannabinoids may increase nervous system disorders compared with placebo (OR 2.61, 95% CI 1.53 to 4.44; 7 studies, 1154 participants; I² = 63%; low-certainty evidence); • Psychiatric disorders: cannabinoids may increase psychiatric disorders compared with placebo (OR 1.94, 95% CI 1.31 to 2.88; 6 studies, 1122 participants; I² = 0%; low-certainty evidence); • Drug tolerance: the evidence is very uncertain about the effect of cannabinoids on drug tolerance (OR 3.07, 95% CI 0.12 to 75.95; 2 studies, 458 participants; very low-certainty evidence).Compared with placebo, nabiximols probably reduces the severity of spasticity in the short-term in people with MS. We are uncertain about the effect on chronic neurological pain and health-related quality of life. Cannabinoids may increase slightly treatment discontinuation due to AEs, nervous system and psychiatric disorders compared with placebo. We are uncertain about the effect on drug tolerance. The overall certainty of evidence is limited by short-term duration of the included studies." @default.
• W4229005706 created "2022-05-08" @default.
• W4229005706 creator A5002541055 @default.
• W4229005706 creator A5025190469 @default.
• W4229005706 creator A5026458697 @default.
• W4229005706 creator A5032242852 @default.
• W4229005706 creator A5050689894 @default.
• W4229005706 date "2022-05-05" @default.
• W4229005706 modified "2023-10-03" @default.
• W4229005706 title "Cannabis and cannabinoids for symptomatic treatment for people with multiple sclerosis" @default.
• W4229005706 cites W1181448258 @default.
• W4229005706 cites W1247968195 @default.
• W4229005706 cites W1509273375 @default.
• W4229005706 cites W1512895399 @default.
• W4229005706 cites W1596910530 @default.
• W4229005706 cites W1743704663 @default.
• W4229005706 cites W1790460690 @default.
• W4229005706 cites W1801725150 @default.
• W4229005706 cites W1845447069 @default.
• W4229005706 cites W1864159196 @default.
• W4229005706 cites W1968718735 @default.
• W4229005706 cites W1973788448 @default.
• W4229005706 cites W1973987251 @default.
• W4229005706 cites W1976224300 @default.
• W4229005706 cites W1976848876 @default.
• W4229005706 cites W1979747755 @default.
• W4229005706 cites W1980502203 @default.
• W4229005706 cites W1987613482 @default.
• W4229005706 cites W1993030207 @default.
• W4229005706 cites W1993981100 @default.
• W4229005706 cites W1996712837 @default.
• W4229005706 cites W1997513305 @default.
• W4229005706 cites W1998609863 @default.
• W4229005706 cites W1999118767 @default.
• W4229005706 cites W1999684902 @default.
• W4229005706 cites W2002288054 @default.
• W4229005706 cites W2010214078 @default.
• W4229005706 cites W2010535402 @default.
• W4229005706 cites W2014323073 @default.
• W4229005706 cites W2031114852 @default.
• W4229005706 cites W2035426541 @default.
• W4229005706 cites W2035726759 @default.
• W4229005706 cites W2036272035 @default.
• W4229005706 cites W2037377025 @default.
• W4229005706 cites W2039898366 @default.
• W4229005706 cites W2040490389 @default.
• W4229005706 cites W2043053000 @default.
• W4229005706 cites W2049064046 @default.
• W4229005706 cites W2053360860 @default.
• W4229005706 cites W2056588555 @default.
• W4229005706 cites W2060715958 @default.
• W4229005706 cites W2061668392 @default.
• W4229005706 cites W2067343268 @default.
• W4229005706 cites W2075298115 @default.
• W4229005706 cites W2077468788 @default.
• W4229005706 cites W2080185710 @default.
• W4229005706 cites W2085917280 @default.
• W4229005706 cites W2095413919 @default.
• W4229005706 cites W2097717578 @default.
• W4229005706 cites W2098046832 @default.
• W4229005706 cites W2101233587 @default.
• W4229005706 cites W2103513615 @default.
• W4229005706 cites W2105490558 @default.
• W4229005706 cites W2105601238 @default.
• W4229005706 cites W2107328434 @default.
• W4229005706 cites W2110094427 @default.
• W4229005706 cites W2110690684 @default.
• W4229005706 cites W2112303081 @default.
• W4229005706 cites W2114826780 @default.
• W4229005706 cites W2114866171 @default.
• W4229005706 cites W2120142285 @default.
• W4229005706 cites W2120227293 @default.
• W4229005706 cites W2122545833 @default.
• W4229005706 cites W2127438675 @default.
• W4229005706 cites W2130355701 @default.
• W4229005706 cites W2133895281 @default.
• W4229005706 cites W2140180096 @default.
• W4229005706 cites W2142081611 @default.
• W4229005706 cites W2142577589 @default.
• W4229005706 cites W2143370526 @default.
• W4229005706 cites W2148726807 @default.
• W4229005706 cites W2149576547 @default.
• W4229005706 cites W2153372855 @default.
• W4229005706 cites W2156098321 @default.
• W4229005706 cites W2158699108 @default.
• W4229005706 cites W2161344815 @default.
• W4229005706 cites W2166281097 @default.
• W4229005706 cites W2167149788 @default.
• W4229005706 cites W2168718800 @default.
• W4229005706 cites W2170172398 @default.
• W4229005706 cites W2272347031 @default.
• W4229005706 cites W2288418329 @default.
• W4229005706 cites W2325472161 @default.
• W4229005706 cites W2325549248 @default.
• W4229005706 cites W2329777850 @default.
• W4229005706 cites W2336815228 @default.
• W4229005706 cites W2346015640 @default.
• W4229005706 cites W2413658068 @default.
• W4229005706 cites W246286872 @default.
• W4229005706 cites W2473786944 @default.

• next