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Article: Analgesic Effects of Cannabinoids for Chronic Non-cancer Pain: a Systematic Review and Meta-Analysis with Meta-Regression

TitleAnalgesic Effects of Cannabinoids for Chronic Non-cancer Pain: a Systematic Review and Meta-Analysis with Meta-Regression
Authors
KeywordsCannabinoids
Chronic non-cancer pain
Meta-analysis
Meta-regression
Neuropathic pain
Issue Date2020
PublisherSpringer New York LLC.
Citation
Journal of Neuroimmune Pharmacology, 2020, Epub 2020-03-14 How to Cite?
AbstractThere is growing interest in using cannabinoids for chronic pain. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the analgesic efficacy and adverse effects of cannabinoids for chronic non-cancer pain. PubMed, EMBASE, Web of Science, Cochrane CENTRAL and clinicaltrials.gov were searched up to December 2018. Information on the type, dosage, route of administration, pain conditions, pain scores, and adverse events were extracted for qualitative analysis. Meta-analysis of analgesic efficacy was performed. Meta-regression was performed to compare the analgesic efficacy for different pain conditions (neuropathic versus non-neuropathic pain). Risk of bias was assessed by The Cochrane Risk of Bias tool, and the strength of the evidence was assessed using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Forty-three randomized controlled trials were included. Meta-analysis was performed for 33 studies that compared cannabinoids to placebo, and showed a mean pain score (scale 0–10) reduction of −0.70 (p < 0.001, random effect). Meta-regression showed that analgesic efficacy was similar for neuropathic and non-neuropathic pain (Difference = −0.14, p = 0.262). Inhaled, oral, and oromucosal administration all provided statistically significant, but small reduction in mean pain score (−0.97, −0.85, −0.45, all p < 0.001). Incidence of serious adverse events was rare, and non-serious adverse events were usually mild to moderate. Heterogeneity was moderate. The GRADE level of evidence was low to moderate. Pain intensity of chronic non-cancer patients was reduced by cannabinoids consumption, but effect sizes were small. Efficacy for neuropathic and non-neuropathic pain was similar.
Persistent Identifierhttp://hdl.handle.net/10722/281693
ISSN
2019 Impact Factor: 4.113
2015 SCImago Journal Rankings: 1.662
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, SSC-
dc.contributor.authorChan, WS-
dc.contributor.authorCheung, CW-
dc.date.accessioned2020-03-22T04:18:24Z-
dc.date.available2020-03-22T04:18:24Z-
dc.date.issued2020-
dc.identifier.citationJournal of Neuroimmune Pharmacology, 2020, Epub 2020-03-14-
dc.identifier.issn1557-1890-
dc.identifier.urihttp://hdl.handle.net/10722/281693-
dc.description.abstractThere is growing interest in using cannabinoids for chronic pain. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the analgesic efficacy and adverse effects of cannabinoids for chronic non-cancer pain. PubMed, EMBASE, Web of Science, Cochrane CENTRAL and clinicaltrials.gov were searched up to December 2018. Information on the type, dosage, route of administration, pain conditions, pain scores, and adverse events were extracted for qualitative analysis. Meta-analysis of analgesic efficacy was performed. Meta-regression was performed to compare the analgesic efficacy for different pain conditions (neuropathic versus non-neuropathic pain). Risk of bias was assessed by The Cochrane Risk of Bias tool, and the strength of the evidence was assessed using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Forty-three randomized controlled trials were included. Meta-analysis was performed for 33 studies that compared cannabinoids to placebo, and showed a mean pain score (scale 0–10) reduction of −0.70 (p < 0.001, random effect). Meta-regression showed that analgesic efficacy was similar for neuropathic and non-neuropathic pain (Difference = −0.14, p = 0.262). Inhaled, oral, and oromucosal administration all provided statistically significant, but small reduction in mean pain score (−0.97, −0.85, −0.45, all p < 0.001). Incidence of serious adverse events was rare, and non-serious adverse events were usually mild to moderate. Heterogeneity was moderate. The GRADE level of evidence was low to moderate. Pain intensity of chronic non-cancer patients was reduced by cannabinoids consumption, but effect sizes were small. Efficacy for neuropathic and non-neuropathic pain was similar.-
dc.languageeng-
dc.publisherSpringer New York LLC.-
dc.relation.ispartofJournal of Neuroimmune Pharmacology-
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: http://dx.doi.org/[insert DOI]-
dc.subjectCannabinoids-
dc.subjectChronic non-cancer pain-
dc.subjectMeta-analysis-
dc.subjectMeta-regression-
dc.subjectNeuropathic pain-
dc.titleAnalgesic Effects of Cannabinoids for Chronic Non-cancer Pain: a Systematic Review and Meta-Analysis with Meta-Regression-
dc.typeArticle-
dc.identifier.emailWong, SSC: wongstan@hku.hk-
dc.identifier.emailChan, WS: wshing@hku.hk-
dc.identifier.emailCheung, CW: cheucw@hku.hk-
dc.identifier.authorityWong, SSC=rp01789-
dc.identifier.authorityCheung, CW=rp00244-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s11481-020-09905-y-
dc.identifier.pmid32172501-
dc.identifier.scopuseid_2-s2.0-85082681636-
dc.identifier.hkuros309479-
dc.identifier.volumeEpub 2020-03-14-
dc.identifier.isiWOS:000565192900001-
dc.publisher.placeUnited States-
dc.identifier.issnl1557-1890-

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