Cannabinoids for spasticity due to multiple sclerosis or paraplegia: A systematic review and meta-analysis of randomized clinical trials

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dc.contributor.authorda Rovare, Victoria P. [UNESP]
dc.contributor.authorMagalhães, Gabriel P.A. [UNESP]
dc.contributor.authorJardini, Guilherme D.A. [UNESP]
dc.contributor.authorBeraldo, Matheus L. [UNESP]
dc.contributor.authorGameiro, Mariel O. [UNESP]
dc.contributor.authorAgarwal, Arnav
dc.contributor.authorLuvizutto, Gustavo José [UNESP]
dc.contributor.authorPaula-Ramos, Lucas [UNESP]
dc.contributor.authorCamargo, Samira Esteves Afonso [UNESP]
dc.contributor.authorde Oliveira, Luciane Dias [UNESP]
dc.contributor.authorBazan, Rodrigo [UNESP]
dc.contributor.authorEl Dib, Regina [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionMcMaster University
dc.contributor.institutionUniversity of Toronto
dc.date.accessioned2018-12-11T17:14:31Z
dc.date.available2018-12-11T17:14:31Z
dc.date.issued2017-10-01
dc.description.abstractObjectives Spasticity remains highly prevalent in patients with spinal cord injury and multiple sclerosis. To summarize the effects of cannabinoids compared with usual care, placebo for spasticity due to multiple sclerosis (MS) or paraplegia. Methods Searches of MEDLINE, EMBASE, CENTRAL and LILACS to March 2017 were performed to identify randomized controlled trials. The primary outcomes were spasticity and spasm frequency. The criteria were any patient with MS and spasticity affecting upper or lower limbs or both, and that had a confirmed diagnosis of MS based on validated criteria, or however defined by the authors of the included studies. Results 16 trials including 2597 patients were eligible. Moderate-certainty evidence suggested a non-statistically significant decrease in spasticity (standardized mean difference (SMD) 0.36 [confidential interval (CI) 95% −0.17 to 0.88; p = 0.18; I2 = 88%]), and spasm frequency (SMD 0.04 [CI 95% −0.15 to 0.22]). There was an increase in adverse events such as dizziness (risk ratio (RR) 3.45 [CI 95% 2.71–4.4; p = 0.20; I2 = 23%]), somnolence (RR 2.9 [CI 95% 1.98–4.23; p = 0.77; I2 = 0%]), and nausea (RR 2.25 [CI 95% 1.62–3.13; p = 0.83; I2 = 0%]). Conclusions There is moderate certainty evidence regarding the impact of cannabinoids in spasticity (average 0.36 more spasticity; 0.17 fewer to 0.88 more) due to multiple sclerosis or paraplegia, and in adverse events such as dizziness (419 more dizziness/1000 over 19 weeks), somnolence (127 more somnolence/1000 over 19 weeks), and nausea (125 more somnolence/1000 over 19 weeks).en
dc.description.affiliationSão Paulo State University (Unesp) Botucatu Medical School
dc.description.affiliationDepartment of Clinical Epidemiology & Biostatistics McMaster University
dc.description.affiliationFaculty of Medicine University of Toronto
dc.description.affiliationSão Paulo State University (Unesp) Department of Neurology Botucatu Medical School
dc.description.affiliationSão Paulo State University (Unesp) Department of Biosciences and Oral Diagnosis Institute of Science and Technology
dc.description.affiliationSão Paulo State University (Unesp) Department of Anesthesiology
dc.description.affiliationMcMaster Institute of Urology McMaster University, St. Joseph's Healthcare
dc.description.affiliationUnespSão Paulo State University (Unesp) Botucatu Medical School
dc.description.affiliationUnespSão Paulo State University (Unesp) Department of Neurology Botucatu Medical School
dc.description.affiliationUnespSão Paulo State University (Unesp) Department of Biosciences and Oral Diagnosis Institute of Science and Technology
dc.description.affiliationUnespSão Paulo State University (Unesp) Department of Anesthesiology
dc.format.extent170-185
dc.identifierhttp://dx.doi.org/10.1016/j.ctim.2017.08.010
dc.identifier.citationComplementary Therapies in Medicine, v. 34, p. 170-185.
dc.identifier.doi10.1016/j.ctim.2017.08.010
dc.identifier.file2-s2.0-85028849626.pdf
dc.identifier.issn1873-6963
dc.identifier.issn0965-2299
dc.identifier.scopus2-s2.0-85028849626
dc.identifier.urihttp://hdl.handle.net/11449/175135
dc.language.isoeng
dc.relation.ispartofComplementary Therapies in Medicine
dc.relation.ispartofsjr0,845
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectCannabinoids
dc.subjectMultiple sclerosis
dc.subjectParaplegia
dc.subjectSpasticity
dc.titleCannabinoids for spasticity due to multiple sclerosis or paraplegia: A systematic review and meta-analysis of randomized clinical trialsen
dc.typeResenha

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