Evidence map›Paper›PMID 30390221›Full record

SynthesisDrugs2018

Efficacy and Safety of Cannabidiol in Epilepsy: A Systematic Review and Meta-Analysis.

Simona Lattanzi, Francesco Brigo, Eugen Trinka, Gaetano Zaccara, Claudia Cagnetti, Cinzia Del Giovane, Mauro Silvestrini

Registry-linked trialOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Drugs, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06842316 (In Vitro Effects of Phytocannabinoids on Immune Response and Autophagy During Chronic Immune-mediated Inflammatory Diseases), which is not on this map. Cited by 101 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 14 pooled it
19.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06842316 recruitingnot on this mapstarted 2025, after this paper: background citation

In Vitro Effects of Phytocannabinoids on Immune Response and Autophagy During Chronic Immune-mediated Inflammatory Diseases

TypeobservationalSponsorCentre Hospitalier Régional d'OrléansRan2025 to 2027Enrolled100ConditionsInflammatory Disorder of Immune System, Spondylitis, Ankylosing, Arthritis, Rheumatoid, Arthritis, PsoriaticArms1 blood sample, 40 mL (collection during a blood test, part of the standard of care for this disease)
3 · Its place in the literature

Who cites it

101 citing papers in PubMed, 14 syntheses or guidelines pooled it, 220 citations in OpenAlex.

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  15. Exploring cannabidiol effects on inflammatory markers in individuals with cocaine use disorder: a randomized controlled trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2021
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41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 3 countries.

Simona LattanziDepartment of Experimental and Clinical Medicine, Neurological Clinic, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy. alfierelattanzisimona@gmail.com.ORCID http://orcid.org/0000-0001-8748-0083
Francesco BrigoDepartment of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy.
Eugen TrinkaDepartment of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Gaetano ZaccaraHealth Agency of Tuscany, Florence, Italy.
Claudia CagnettiDepartment of Experimental and Clinical Medicine, Neurological Clinic, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy.
Cinzia Del GiovaneInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Mauro SilvestriniDepartment of Experimental and Clinical Medicine, Neurological Clinic, Marche Polytechnic University, Via Conca 71, 60020, Ancona, Italy.
Marche Polytechnic University · ITAgenzia Regionale di Sanità della Toscana · ITUniversity of Bern · CHUniversity of Salzburg · ATUniversity of Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundApproximately one-third of patients with epilepsy presents seizures despite adequate treatment. Hence, there is the need to search for new therapeutic options. Cannabidiol (CBD) is a major chemical component of the resin of Cannabis sativa plant, most commonly known as marijuana. The anti-seizure properties of CBD do not relate to the direct action on cannabinoid receptors, but are mediated by a multitude of mechanisms that include the agonist and antagonist effects on ionic channels, neurotransmitter transporters, and multiple 7-transmembrane receptors. In contrast to tetra-hydrocannabinol, CBD lacks psychoactive properties, does not produce euphoric or intrusive side effects, and is largely devoid of abuse liability.

objectiveThe aim of the study was to estimate the efficacy and safety of CBD as adjunctive treatment in patients with epilepsy using meta-analytical techniques.

methodsRandomized, placebo-controlled, single- or double-blinded add-on trials of oral CBD in patients with uncontrolled epilepsy were identified. Main outcomes included the percentage change and the proportion of patients with ≥ 50% reduction in monthly seizure frequency during the treatment period and the incidence of treatment withdrawal and adverse events (AEs).

resultsFour trials involving 550 patients with Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) were included. The pooled average difference in change in seizure frequency during the treatment period resulted 19.5 [95% confidence interval (CI) 8.1-31.0; p = 0.001] percentage points between the CBD 10 mg and placebo groups and 19.9 (95% CI 11.8-28.1; p < 0.001) percentage points between the CBD 20 mg and placebo arms, in favor of CBD. The reduction in all-types seizure frequency by at least 50% occurred in 37.2% of the patients in the CBD 20 mg group and 21.2% of the placebo-treated participants [risk ratio (RR) 1.76, 95% CI 1.07-2.88; p = 0.025]. Across the trials, drug withdrawal for any reason occurred in 11.1% and 2.6% of participants receiving CBD and placebo, respectively (RR 3.54, 95% CI 1.55-8.12; p = 0.003) [Chi squared = 2.53, degrees of freedom (df) = 3, p = 0.506; I

conclusionsAdjunctive CBD in patients with LGS or DS experiencing seizures uncontrolled by concomitant anti-epileptic treatment regimens is associated with a greater reduction in seizure frequency and a higher rate of AEs than placebo.

Indexed as

AnticonvulsantsCannabidiolAdolescentAdultChildChild, PreschoolDrug Therapy, CombinationEpilepsies, MyoclonicEpilepsyFemaleHumansLennox Gastaut SyndromeMaleMiddle AgedRandomized Controlled Trials as TopicSeizuresAnticonvulsantsCannabidiol

Identifiers

PMID30390221
OpenAlexW2898642751

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.