Cannabinoids for spasticity in patients with multiple sclerosis: A systematic review and meta-analysis.

IF 2.5 Q2 CLINICAL NEUROLOGY Multiple Sclerosis Journal - Experimental, Translational and Clinical Pub Date : 2024-11-05 eCollection Date: 2024-10-01 DOI:10.1177/20552173241282379
Mohaddeseh Azadvari, Maryam Pourshams, Fatemeh Guitynavard, Seyede Zahra Emami-Razavi, Ensieh Taftian-Banadkouki, Mahsa Ghajarzade, Mohsen Rastkar
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Abstract

Background: One of the most disabling symptoms of patients with multiple sclerosis (MS) is spasticity which affects their quality of life. Nowadays, cannabinoids are used for spasticity control in patients with MS, while the efficacy and safety are not clearly understood. So, we designed this systematic review and meta-analysis to assess the efficacy of cannabinoids for controlling MS-related spasticity.

Methods: PubMed, Scopus, EMBASE, Web of Science, and Google Scholar were systematically searched by two independent researchers on 1 May 2023. They also searched gray literature (references of included studies, as well as conference abstracts).

Results: A literature search revealed 6552 records, 95 full-texts were evaluated, and finally, 31 studies remained for systematic review. Among included studies, six randomized trials were included. Nabiximols was the most commonly used medication for controlling MS-related spasticity. Mean Expanded Disability Status Scale ranged between 4.6 and 7. Most studies (17 studies) were done in Italy, followed by Germany (4 studies). The pooled standardized mean difference (SMD) of NRS (Numeric Rating Scale) (after-before) is estimated as -1.41 (95% confidence interval (CI): -1.65, -1.17) (I2 = 97%, p < 0.001). The pooled standardized mean difference (SMD) of Ashworth (after-before) is estimated as -0.39 (95% CI: -0.72, -0.06) (I2 = 69.9%, p = 0.005).

Conclusion: The results of this systematic review and meta-analysis showed that nabiximols was the most common cannabinoid which was used to control MS-related spasticity, and it was effective in controlling MS-related spasticity (significantly decreased SMD of NRS, and Ashworth after treatment).

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大麻素治疗多发性硬化症患者的痉挛:系统回顾和荟萃分析。
背景:多发性硬化症(MS)患者最严重的致残症状之一是痉挛,这影响了他们的生活质量。如今,大麻素被用于控制多发性硬化症患者的痉挛,但其疗效和安全性尚不明确。因此,我们设计了这一系统综述和荟萃分析,以评估大麻素控制多发性硬化症相关痉挛的疗效:方法:两名独立研究人员于 2023 年 5 月 1 日对 PubMed、Scopus、EMBASE、Web of Science 和 Google Scholar 进行了系统检索。他们还检索了灰色文献(纳入研究的参考文献以及会议摘要):文献检索共发现 6552 条记录,对 95 篇全文进行了评估,最后剩下 31 篇研究进行了系统审查。在纳入的研究中,有 6 项随机试验。纳比昔莫司是控制多发性硬化症相关痉挛最常用的药物。平均残疾状况扩展量表介于 4.6 和 7 之间。大多数研究(17 项)是在意大利进行的,其次是德国(4 项)。NRS(数值评定量表)(治疗后-治疗前)的合并标准化平均差(SMD)估计为-1.41(95% 置信区间(CI):-1.65, -1.17 )(I2 = 97%,P 2 = 69.9%,P = 0.005):本次系统综述和荟萃分析的结果表明,大麻酚是用于控制多发性硬化症相关痉挛的最常见大麻类药物,而且对控制多发性硬化症相关痉挛有效(治疗后 NRS 和 Ashworth 的 SMD 显著降低)。
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来源期刊
CiteScore
4.70
自引率
0.00%
发文量
54
审稿时长
15 weeks
期刊最新文献
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