Cannabinoids in Pain Management and Palliative Medicine: An Overview of Systematic Reviews and Prospective Observational Studies.
Background: There are conflicting interpretations of the evidence regarding the efficacy, tolerability, and safety of cannabinoids in pain management and palliative medicine. Methods: We conducted a systematic review (SR) of systematic reviews of randomized controlled trials (RCT) and prospective lo...
| Published in: | Deutsches Ärzteblatt International Vol. 114; no. 38; pp. 627 - 643 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Published: |
Deutscher Aerzte-Verlag GmbH
9/22/2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125736877&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125736877 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18660452 5F0N jtl: Deutsches Ärzteblatt International issn: 18660452 maglogo: N pubinfo: dt: 9/22/2017 vid: 114 iid: 38 pid: 25312 pub: Deutscher Aerzte-Verlag GmbH artinfo: ui: 125736877 10.3238/arztebl.2017.0627 125736877 ppf: 627 ppct: 16 formats: fmt: @attributes: type: P tig: atl: Cannabinoids in Pain Management and Palliative Medicine: An Overview of Systematic Reviews and Prospective Observational Studies. aug: au: Häuser, Winfried Fitzcharles, Mary-Ann Radbruch, Lukas Petzke, Frank affil: Department of Internal Medicine I, Klinikum Saarbrücken, Germany sug: ab: Background: There are conflicting interpretations of the evidence regarding the efficacy, tolerability, and safety of cannabinoids in pain management and palliative medicine. Methods: We conducted a systematic review (SR) of systematic reviews of randomized controlled trials (RCT) and prospective long-term observational studies of the use of cannabinoids in pain management and palliative medicine. Pertinent publications from January 2009 to January 2017 were retrieved by a selective search in the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, and Medline. The methodological quality of the SRs was assessed with the AMSTAR instrument, and the clinical relevance of quantitative data syntheses was assessed according to the standards of the Cochrane Collaboration. Results: Of the 750 publications identified, 11 SRs met the inclusion criteria; 3 of them were of high and 8 of moderate methodological quality. 2 prospective long-term observational studies with medical cannabis and 1 with tetrahydrocannabinol/ cannabidiol spray (THC/CBD spray) were also analyzed. There is limited evidence for a benefit of THC/CBD spray in the treatment of neuropathic pain. There is inadequate evidence for any benefit of cannabinoids (dronabinol, nabilone, medical cannabis, or THC/CBD spray) to treat cancer pain, pain of rheumatic or gastrointestinal origin, or anorexia in cancer or AIDS. Treatment with cannabis-based medicines is associated with central nervous and psychiatric side effects. Conclusion: The public perception of the efficacy, tolerability, and safety of cannabis-based medicines in pain management and palliative medicine conflicts with the findings of systematic reviews and prospective observational studies conducted according to the standards of evidence-based medicine. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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