Cannabidiol efficacy and clobazam status: A systematic review and meta-analysis.

Lattanzi, Simona; Trinka, Eugen; Striano, Pasquale; Zaccara, Gaetano; Del Giovane, Cinzia; Nardone, Raffaele; Silvestrini, Mauro; Brigo, Francesco (2020). Cannabidiol efficacy and clobazam status: A systematic review and meta-analysis. Epilepsia, 61(6), pp. 1090-1098. Wiley-Blackwell 10.1111/epi.16546

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OBJECTIVE To evaluate the potential impact of concomitant clobazam (CLB) use on the efficacy of cannabidiol (CBD) treatment in patients with Dravet syndrome and Lennox-Gastaut syndrome using meta-analytical techniques. METHODS We searched for randomized, placebo-controlled, single- or double-blinded trials. The proportion of patients who achieved ≥50% reduction from baseline in seizure frequency during the treatment period was assessed according to CLB status. Risk ratios (RRs) with 95% confidence intervals (CIs) were estimated. RESULTS Four trials were included and enrolled 714 participants, 429 for the add-on CBD group and 285 for the add-on placebo group. Among CBD-treated patients, 240 (55.9%) were taking concomitant CLB (CLB-On) and 189 (44.1%) were not taking concomitant CLB (CLB-Off); in placebo-treated patients, 158 (55.4%) were CLB-On and 127 (44.6%) CLB-Off. The percentages of patients who had at least 50% reduction in seizure frequency during the treatment period were 29.1% in the CBD arm and 15.7% in the placebo group among CLB-Off patients (RR = 1.80, 95% CI = 1.12-2.90, P = .015). Among CBL-On patients, the ≥50% reduction in seizure frequency was found in 52.9% and 27.8% in the CBD and placebo groups, respectively (RR = 1.85, 95% CI = 1.40-2.44, P < .001). SIGNIFICANCE CBD was associated with a higher rate of seizure response in comparison to placebo when added to the existing antiepileptic regimen both in patients taking and in those not taking concomitant CLB. The lack of randomization for CLB status and the limited sample size need to be considered in the interpretation of the findings.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Del Giovane, Cinzia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0013-9580

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

05 Jun 2020 12:23

Last Modified:

21 Jun 2020 01:34

Publisher DOI:

10.1111/epi.16546

PubMed ID:

32452532

Uncontrolled Keywords:

Dravet syndrome Lennox-Gastaut syndrome cannabidiol clobazam epilepsy

BORIS DOI:

10.7892/boris.144464

URI:

https://boris.unibe.ch/id/eprint/144464

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