Adverse events caused by cannabinoids in middle aged and older adults for all indications: a meta-analysis of incidence rate difference.

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Age and ageing Pub Date : 2024-11-01 DOI:10.1093/ageing/afae261
Latha Velayudhan, Sara Pisani, Marta Dugonjic, Katie McGoohan, Sagnik Bhattacharyya
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引用次数: 0

Abstract

Background: Cannabinoid-based medicines (CBMs) are being used widely in older people. However, information on the incidence of adverse events (AEs) is limited.

Objective: To quantify the incidence rate difference (IRD) of AEs in middle aged and older adults of age ≥50 years receiving CBMs and also examine associations with weekly doses.

Design: Systematic review and meta-analysis.

Data sources: MEDLINE, PubMed, EMBASE, CINAHL, PsychInfo, Cochrane Library and ClinicalTrials.gov (1st Jan 1990-12th June 2023).

Methods: We included randomised clinical trials (RCTs) using CBMs with mean participant age ≥50 years for medicinal purposes for all clinical indications. Paired reviewers independently screened studies, extracted data and appraised risk of bias. We estimated pooled effect-sizes IRD under the random-effects model.

Results: Data from 58 RCTs (37 moderate-high quality studies, pooled n = 6611, mean age range 50-87 years, 50% male, n = 3450 receiving CBMs) showed that compared with controls, the incidence of all-cause and treatment-related AEs attributable to delta-9-tetrahydrocannabinol (THC)-containing CBMs were: THC alone [IRD:18.83(95% Confidence Interval [CI], 1.47-55.79) and 16.35(95% CI, 1.25-48.56)] respectively; THC:cannabidiol (CBD) combination [IRD:19.37(95% CI, 4.24-45.47) and 11.36(95% CI, 2.55-26.48)] respectively. IRDs of serious AEs, withdrawals and deaths were not significantly greater for CBMs containing THC with or without CBD. THC dose-dependently increased the incidence of dry mouth, dizziness/lightheadedness, mobility/balance/coordination difficulties, dissociative/thinking/perception problems and somnolence/drowsiness. The interaction of weekly THC:CBD doses played a role in mostly neurological, psychiatric and cardiac side-effects.

Conclusions: Although CBMs in general are safe and acceptable in middle aged and older adults, one needs to be mindful of certain common dose-dependent side-effects of THC-containing CBMs.

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所有适应症的中老年人因大麻素引起的不良事件:发病率差异荟萃分析。
背景:以大麻素为基础的药物(CBMs)正被广泛用于老年人。然而,有关不良事件(AEs)发生率的信息却很有限:量化年龄≥50岁的中老年人接受大麻类药物治疗时的不良反应发生率差异(IRD),并研究其与每周剂量的关系:系统回顾和荟萃分析:数据来源:MEDLINE、PubMed、EMBASE、CINAHL、PsychInfo、Cochrane Library和ClinicalTrials.gov(1990年1月1日-2023年6月12日):我们纳入了使用CBMs的随机临床试验(RCT),参与者平均年龄≥50岁,用于所有临床适应症的药物治疗。配对审稿人独立筛选研究、提取数据并评估偏倚风险。我们在随机效应模型下估算了汇总效应大小 IRD:来自 58 项 RCT(37 项中高级质量研究,合计 n = 6611,平均年龄范围为 50-87 岁,50% 为男性,n = 3450 接受 CBMs 治疗)的数据显示,与对照组相比,含δ-9-四氢大麻酚(THC)的 CBMs 引起的全因和治疗相关 AEs 的发生率分别为:[IRD:18]、[IRD:18]、[IRD:18]和[IRD:18]:单用四氢大麻酚[IRD:分别为18.83(95% 置信区间[CI],1.47-55.79)和16.35(95% CI,1.25-48.56)];四氢大麻酚:大麻二酚(CBD)组合[IRD:分别为19.37(95% CI,4.24-45.47)和11.36(95% CI,2.55-26.48)]。含或不含CBD的CBM在严重AEs、撤药和死亡方面的IRD并无明显增加。四氢大麻酚剂量依赖性地增加了口干、头晕/头昏、行动/平衡/协调困难、分离/思维/感知问题和嗜睡/昏昏欲睡的发生率。每周四氢大麻酚与大麻二酚剂量的相互作用在大部分神经、精神和心脏副作用中都发挥了作用:虽然CBMs在中老年人中一般是安全和可接受的,但需要注意含四氢大麻酚CBMs的某些常见剂量依赖性副作用。
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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