Cannabinoids for adult cancer-related pain: systematic review and meta-analysis

Boland, Elaine G; Bennett, Michael I.; Allgar, Victoria; Boland, Jason W.

Abstract

Objectives
There is increased interest in cannabinoids for cancer pain management and legislative changes are in progress in many countries. This study aims to determine the beneficial and adverse effects of cannabis/cannabinoids compared with placebo/other active agents for the treatment of cancer-related pain in adults.

Methods
Systematic review and meta-analysis to identify randomised controlled trials of cannabinoids compared with placebo/other active agents for the treatment of cancer-related pain in adults to determine the effect on pain intensity (primary outcome) and adverse effects, including dropouts. Searches included Embase, MEDLINE, PsycINFO, Web of Science, ClinicalTrials.gov, Cochrane and grey literature. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.

Results
We identified 2805 unique records, of which six randomised controlled trials were included in this systematic review (n=1460 participants). Five studies were included in the meta-analysis (1442 participants). All had a low risk of bias. There was no difference between cannabinoids and placebo for the difference in the change in average Numeric Rating Scale pain scores (mean difference −0.21 (−0.48 to 0.07, p=0.14)); this remained when only phase III studies were meta-analysed: mean difference −0.02 (−0.21 to 0.16, p=0.80). Cannabinoids had a higher risk of adverse events when compared with placebo, especially somnolence (OR 2.69 (1.54 to 4.71), p

Citation

Boland, E. G., Bennett, M. I., Allgar, V., & Boland, J. W. (2020). Cannabinoids for adult cancer-related pain: systematic review and meta-analysis. BMJ supportive & palliative care, 10(1), 14-24. https://doi.org/10.1136/bmjspcare-2019-002032

• Journal Article Type: Review
• Acceptance Date: Nov 14, 2019
• Online Publication Date: Jan 20, 2020
• Publication Date: Mar 1, 2020
• Deposit Date: Jan 31, 2020
• Publicly Available Date: Feb 3, 2020
• Journal: BMJ Supportive and Palliative Care
• Print ISSN: 2045-435X
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 10
• Issue: 1
• Pages: 14-24
• DOI: https://doi.org/10.1136/bmjspcare-2019-002032
• Public URL: https://hull-repository.worktribe.com/output/3382853
• Publisher URL: https://spcare.bmj.com/content/10/1/14