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Table 12 Various conditions

From: Benefits and harms of medical cannabis: a scoping review of systematic reviews

Author, year Search dates; # databases searched Funding source Nstudies Illness/condition Intervention/comparator* Outcomes Conclusions from data AMSTAR-2 rating
Kim, 201797 Inception–apr 2017; 3 Non-profit 24 Dystonia, HD, PD, Tourette syndrome, AD, dementia, ALS, psychosis, schizophrenia, anxiety I: Plant-derived and synthetic cannabinoids
C: Placebo; diazepam; amisulpride
• Weight gain
• Anti-anxiety
• Clinical improvements
• Disturbed behavior
• Sleep outcomes
• Chorea outcomes
• Dyskinesia
• Motor symptoms
• QoL
• Tics
• OCD behavior
• Withdrawal due to adverse effects
Favors intervention for anti-anxiety effects; reported SBS for all other outcomes (vs. diazepam, placebo or amisulpride) M
Goldenberg, 2017 [30] To 2015; 4 No funding 20 Fibromyalgia, HIV, IBD, pain, MS, headache, cramps, cancer-related anorexia, traumatic brain injury I: Plant-based and plant-derived cannabinoids
C: Various combined (non-users, placebo, ibuprofen)
• QoL No statistically significant difference between groups L
Fitzcharles, 2016 [36] To Apr 30, 2015; 2 NR 4 Various conditions (chronic spinal pain, rheumatoid arthritis, osteoarthritis, or fibromyalgia) I: All types of cannabinoids
C: Placebo or amitriptyline
• Pain
• Anxiety
• QoL
• Fatigue
• Depression
• Withdrawal due to AEs
• Total AEs
Favors intervention for pain (vs. placebo); no statistically significant difference between groups for anxiety, QoL, fatigue, and depression; reported SBS for withdrawal due to AEs and total AEs. Only a single study included comparing cannabinoids to amitriptyline. M
Whiting, 2015 [43] Inception to between Apr 2014 and Apr 2015; 8 Government 79 Various conditions: cancer (chemo-induced nausea and vomiting), appetite stimulation for HIV/AIDS, chronic pain, spasticity in MS or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, intraocular pressure in glaucoma, Tourette syndrome I: All types of cannabinoids
C: Placebo
• NP
• Cancer pain
• Nausea and vomiting
• QoL
• Spasticity
• Walking speed
• Activities of daily living
• Spasticity (various measures)
• Sleep outcomes
• Any AEs
• Serious AEs
• Withdrawal due to AEs
Mixed results based on how pain is measured (3 MAs favor intervention for NRS scores, patients CGI-C, and NP Scale and 2 show no statistically significant difference between groups for pain reduction ≥ 30% NRS or VAS and BPI-S); favors intervention for nausea and vomiting, spasticity (NRS or VAS), sleep quality, and CGI-C; no statistically significant difference between groups for QoL, 30% or 50% reduction in spasticity NRS, Ashworth score, ADL, sleep disturbance, any AEs, serious AEs, and withdrawal due to AEs M
Gates, 2014 [46] NR; 8 NR 28 Various (pain, MS, anorexia, cancer, immune deficiency) I: Cannabinoids (not specified)
C: NR; experimental drugs
• Impact on sleep
• Subjective measures of sleep
• Objective measures of sleep
• Effect of dose on sleep
Favors intervention for impact on sleep, insufficient evidence for subjective measure of sleep (vs. experimental drugs), reported SBS for objective measures of sleep, and effect of dose on sleep L
van den Elsen, 2014 [47] To Oct 7, 2013; 4 Government 5 AD, PD, chemotherapy-induced nausea, and vomiting, COPD I: Plant-based and synthetic cannabinoids C: Placebo; Prochlorperazine • Dyskinesia
• Breathlessness
• Chemotherapy-induced nausea and vomiting
• Behavioral problems
• Weight gain
• Triceps skinfold thickness
Reported SBS M
Lynch, 2011 [52] Search run between Sept 7 and Oct 7 2010 and not limited by date; 11 NR 18 Chronic pain, fibromyalgia, HIV, MS, rheumatoid arthritis, brachial plexus avulsion, spinal cord or brachial plexus injury, limb amputation I: All types of cannabinoids
C: Placebo; dihydrocodeine
• Central NP
• Central pain
• NP
• Analgesia
• Spasticity-related pain
• FM pain
• Allodynia
• Hyperalgesia
• Sensory Neuropathy
• Spinal pain
• Sleep
• RA Disease Activity
• Activities of daily living
Favors intervention for all types of pain combined and sleep. Favors control for activities of daily living. Reported SBS for NP (vs. dihydrocodeine) L
Wang, 2008 [61] MEDLINE: Jan 1966 to week 5 of Oct 2007; PsycINFO: Jan 1967 to week 5 of Oct 2007; and EMBASE: Jan 1980 to week 42 of 2007; 3 Government 31 Various (looking at adverse events) I: Plant-derived cannabinoids
C: Placebo; standard care
• Serious adverse events
• Death rate
• Rate of non-serious adverse events
• Average rate of non-serious adverse events
Favors intervention for rate and average rate of non-serious adverse events, except in the case of THC:CBD vs. standard care (no significant difference between groups). No statistically significant difference between groups for serious adverse events and death rate. L
CADTH, 2011 [6] Jan 1 2010 to Sept 18, 2015; 4 NR 5 PTSD, FM, chronic pain, spasticity-related pain, MS, peripheral NP, SCI I: Synthetic cannabinoids
C: Placebo, placebo + gabapentin
• Recurring/distressing dreams—PTSD scale
• General wellbeing questionnaire
• Pain
• Peripheral NP
• Quality of sleep
• Spasticity
Only one study included L
  1. AE adverse effect, AD Alzheimer’s disease, ALS amyotrophic lateral sclerosis, CADTH Canadian Agency for Drugs and Technologies in Health, CGI-C Clinical Global Impression of Change scale, COPD Chronic Obstructive Pulmonary Disease, FIQ fibromyalgia impact questionnaire, FM fibromyalgia, HD Huntington’s disease, IBD inflammatory bowel disease, MS multiple sclerosis, NP neuropathic pain, NR not reported, PD Parkinson’s disease, PTSD posttraumatic stress disorder, RA rheumatoid arthritis, SBS study-by-study, SCI spinal cord injury
  2. *A colon indicates that there were separate analyses for each comparator; a “+” sign indicates placebo was combined with another comparator