Report of a parent survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant epilepsy.
Porter et al.·Epilepsy & BehaviorImpact 2.4
GemischtGRADESehr niedrig362 Zitate
Stichproben = 19 Pat.
EndpunktAnfallsfrequenz
Verblindungn.a.
DesignEltern-Survey (Beobachtungsstudie)
Cannabinoidvollspektrum
Applikationoral
”Kernaussage
Die Mehrheit der befragten Eltern berichtete eine klinisch relevante Reduktion der Anfallsfrequenz unter CBD-angereichertem Cannabis, jedoch ohne standardisierte Messung oder Kontrollgruppe.
Zusammenfassung
Eltern-Survey n=19 Kinder mit behandlungsresistenter Epilepsie (13 Dravet, 4 Doose, 2 weitere); 84% berichteten Anfallsreduktion unter CBD-angereichertem Cannabis; 11% anfallsfrei, 42% >80% Reduktion, 32% 25–60% Reduktion. Durchschnittlich 12 vorherige AED-Versuche gescheitert. Methodisch: Participation-Bias, kein Kontrollarm.
P
PopulationKinder mit therapierefraktärer Epilepsie (v.a. Dravet-Syndrom, Doose-Syndrom, Lennox-Gastaut-Syndrom), n=19; befragt wurden Eltern
I
InterventionCannabidiol-angereichertes Cannabis (uneinheitliche Präparate, oral; Dosierung nicht standardisiert)
O
Outcome84% der Eltern berichteten Reduktion der Anfallsfrequenz; 11% vollständige Anfallsfreiheit, 42% >80% Reduktion, 32% 25–60% Reduktion; weitere positive Effekte: erhöhte Alertheit, bessere Stimmung, verbesserter Schlaf; Nebenwirkungen: Schläfrigkeit und Müdigkeit
Vertrauen in die Evidenz
Sehr niedrigNiedrigModeratHoch
Sehr niedrig
Niedrigste GRADE-Stufe, die Effektschätzung bleibt unsicher.
Severe childhood epilepsies are characterized by frequent seizures, neurodevelopmental delays, and impaired quality of life. In these treatment-resistant epilepsies, families often seek alternative treatments. This survey explored the use of cannabidiol-enriched cannabis in children with treatment-resistant epilepsy. The survey was presented to parents belonging to a Facebook group dedicated to sharing information about the use of cannabidiol-enriched cannabis to treat their child's seizures. Nineteen responses met the following inclusion criteria for the study: a diagnosis of epilepsy and current use of cannabidiol-enriched cannabis. Thirteen children had Dravet syndrome, four had Doose syndrome, and one each had Lennox-Gastaut syndrome and idiopathic epilepsy. The average number of antiepileptic drugs (AEDs) tried before using cannabidiol-enriched cannabis was 12. Sixteen (84%) of the 19 parents reported a reduction in their child's seizure frequency while taking cannabidiol-enriched cannabis. Of these, two (11%) reported complete seizure freedom, eight (42%) reported a greater than 80% reduction in seizure frequency, and six (32%) reported a 25-60% seizure reduction. Other beneficial effects included increased alertness, better mood, and improved sleep. Side effects included drowsiness and fatigue. Our survey shows that parents are using cannabidiol-enriched cannabis as a treatment for their children with treatment-resistant epilepsy. Because of the increasing number of states that allow access to medical cannabis, its use will likely be a growing concern for the epilepsy community. Safety and tolerability data for cannabidiol-enriched cannabis use among children are not available. Objective measurements of a standardized preparation of pure cannabidiol are needed to determine whether it is safe, well tolerated, and efficacious at controlling seizures in this pediatric population with difficult-to-treat seizures.