Article Figures & Data
Tables
- Table 1.
Clinical Studies of Cannabis and Its Derivatives with SORT Level of Recommendation56
Agent Condition Indicated Form of delivery Nature of Study Patients (n) Outcome Measures Outcome SORT Level of Recommendation Reference Cannabis Gilles de la Tourette Syndrome Smoking Case report 3 Self-reported frequency of motor tics 50% to 70% remission C Sandyk et al57 Cannabis Gilles de la Tourette Syndrome Smoking Case report 1 Self-reported symptoms 100% remission C Hemming et al58 Cannabis Glaucoma Smoking single dose Double-blinded cross-over placebo-controlled RCT 18 Intraocular pressure Significant reduction B Merritt et al59 Cannabis Neuropathic pain in HIV patient Smoking 5 days a week for 2 weeks Prospective placebo-controlled RCT 28 Pain intensity using Descriptor Differential Scale Improvement in pain (P = .016) A Ellis et al49 Cannabis Sensory neuropathic pain in HIV patient Smoking 3 times a day for 5 days Double-blinded cross-over placebo-controlled RCT 50 Chronic pain ratings Reduction of pain by 34% (P = .03) A Abrams et al48 Cannabis Capsaicin-induced pain in volunteers Smoking single dose at various concentrations Double-blinded cross-over placebo-controlled RCT 15 Pain scores and McGill Pain Questionnaire Pain reduction at medium dose within a certain time frame only B Wallace et al60 Cannabis Acute inflammatory pain in volunteers Single oral dose of encapsulate extract Double-blinded cross-over placebo-controlled RCT 18 Threshold to heat and electricity in areas with UV-induced sunburnt No effect on pain thresholds B Kraft et al61 Cannabis Spasticity due to multiple sclerosis Escalating dose of oral encapsulate extract Double-blinded cross-over placebo-controlled RCT 50 Spasms frequency and mobility Improvement in spasms frequency (P = .013) and mobility (P = .01) A Vaney et al62 Cannabis Spasticity caused by multiple sclerosis Titrating oral dose of cannabis extract Double-blinded placebo-controlled RCT 327 Ashworth score and self-reported spasticity Improvement of self-report ratings of pain and spasticity (P = .003) A Zajicek et al63 Δ9-THC Gilles de la Tourette Syndrome Single oral dose Cross-over placebo-controlled RCT 12 TSSL, STSS, YGTSS scores Significant reduction in TSSL score (P = .015), nil for STSS and YGTSS A Müller-Vahl et al64 Δ9-THC Gilles de la Tourette Syndrome Daily oral dose for 6 weeks Placebo-controlled RCT 24 TSSL,TS-CGI, STSS; YGTSS Significant reduction in TSSL score using ANOVA (P = .037), nil for TS-CGI, STSS, YGTSS A Müller-Vahl et al65 Δ9-THC Spasticity caused by multiple sclerosis Escalating dose for 5 days Double-blinded cross-over placebo-controlled RCT 13 Subjective rating and objective measure of spasticity Significant in both scores A Ungerleider et al66 Δ9-THC Spasticity due to multiple sclerosis Titrating oral dose of Δ9-THC Double-blinded placebo-controlled RCT 330 Ashworth score and self-reported spasticity Improvement of self-report ratings of pain and spasticity (P = .003) A Zajicek et al63 Δ9-THC Postoperative pain Single oral dose on postoperative day 2 Double-blinded placebo-controlled RCT 40 Summed pain intensity difference 6 hours after administration No significant difference B Buggy et al67 Δ9-THC Refractory neuropathic pain Titrating oral dose Open label pilot 8 Neuropathic pain score and quality of life No apparent effect C Attal et al68 Δ9-THC Glioblastoma multiforme Daily intracranial tumour injection up to 64 days Phase I cohort pilot study 9 Safety of intracranial route of administration Intracranial route seems to be safe and may slow down tumour growth C Guzman et al69 Dronabinol (synthetic Δ9-THC) Alzheimer’s disease Twice-daily oral dose for 6 weeks Double-blinded cross-over placebo-controlled RCT 15 Body weight, triceps skin fold, disturbed behavior, affect A trend of improvement reported but no significance quoted B Volicer et al70 Dronabinol (synthetic Δ9-THC) Alzheimer’s disease Daily oral dose for 2 weeks Open label pilot 6 Nocturnal motor activity score and Neuropsychiatric Inventory Significant improvement in both (P = .028 and P = 0027) C Walther et al71 Dronabinol (synthetic Δ9-THC) Anorexia and weight loss in AIDS Twice-daily oral dose for 6 weeks Placebo-controlled RCT 139 VAS for appetite, mood, and nausea Significant change in appetite (38%; P = .015); mood (10%; P = .06); and nausea (20%; P = .05) A Beal et al72 Nabilone Spasticity caused by spinal cord injury Twice-daily oral dose for 4 weeks Double-blinded cross-over placebo-controlled RCT 12 Ashworth Scale, Total Ashworth Score Significant reduction, P = .003 and 0.001 respectively A Pooyania et al73 Nabilone Pain caused by fibromyalgia Oral dose for 4 weeks Double-blinded placebo-controlled RCT 40 VAS and Fibromyalgia impact questionnaire Significant reduction in both scores (P < .02) A Skrabek et al74 Sativex (extract of cannabis containing Δ9-THC and cannabidiol) Peripheral neuropathic pain Self-titrating dose of oromucosal spray for 5 weeks Double-blinded placebo-controlled RCT 125 Various pain intensity scores Significant reduction, (P = .001 to P = .04) A Nurmikko et al75 Sativex (extract of cannabis containing Δ9-THC and cannabidiol) Intractable neurogenic symptoms Self-titrating dose of oromucosal spray for 2 weeks Double-blinded cross-over placebo-controlled RCT 20 Self-report symptoms and adverse effects Significant relief in pain with certain domains reaching significance of P < .05 A Wade et al76 Sativex (extract of cannabis containing Δ9-THC and cannabidiol) Central pain in multiple sclerosis Self-titrating dose of oromucosal spray for 4 weeks Double-blinded placebo-controlled RCT 66 11-point scale for pain and sleep disturbance Significant reduction of pain (P = .005) and sleep disturbance (P = .003) A Rog et al77 Sativex (extract of cannabis containing Δ9-THC and cannabidiol) Bladder dysfunction in multiple sclerosis Single daily dose for 8 weeks Open label pilot study 15 Occurrence of urinary incontinence, frequency, nocturia Significant reduction in all 3 domains (P < .05) A Brady et al78 RCT, randomized controlled trial; UV, ultraviolet; TSSL,; STSS,; YGTSS,; TS-CGI, ANOVA, analysis of variance; VAS, Visual Analog Scale; THC, tetrahydrolcannabinol.
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