TY - JOUR
T1 - The use of cannabidiol as adjunctive therapy in adult patients with drug-resistant epilepsy
T2 - a systematic review and meta-analysis
AU - Ong, Marjorie Jia Yi
AU - Abd Rahman, Muhammad Samir Haziq
AU - Lee, Vanessa Lin Lin
AU - Lee, Kong Heng
AU - Chang, Carmen Jia Yinn
AU - Khoo, Ching Soong
AU - Hod, Rozita
AU - Tan, Hui Jan
AU - Trinka, Eugen
N1 - Publisher Copyright:
© The Author(s), 2025.
PY - 2025
Y1 - 2025
N2 - Background: Highly purified cannabidiol (CBD), recently approved for various neurological disorders, is explored as a potential therapeutic avenue for drug-resistant epilepsy (DRE) among adult people with epilepsy (PWE) in this systematic review and meta-analysis. Objectives: To conduct an extensive literature review and meta-analysis of CBD use for DRE in adult PWE. Design: Systematic review and meta-analysis. Data sources and methods: We conducted a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and two electronic resources; we searched Ovid MEDLINE and Scopus using appropriate keywords until August 2023. Data were presented as standardized mean difference (SMD) and odds ratio with confidence interval (CI) via random effect. We appraised the risk of bias of the included studies using the Joanna Briggs Institute critical appraisal tool while their strength of evidence with the Oxford Centre for Evidence-Based Medicine (OCEBM) and Grading of Recommendations Assessment Development and Education (GRADE) Levels of Evidence. Results: We identified 16 studies, 3 of which were randomized controlled trials and 3 prospective cohort studies, while the rest were expanded access programs, deriving a total of 668 participants receiving CBD for seizure control. CBD was used concomitantly with antiseizure medications in all studies. There was a statistically significant seizure reduction in the group receiving CBD therapy compared to the placebo group (SMD: −1.50, 95% CI (−3.47, 0.47), p < 0.01). Conclusion: The evidence on CBD use in adult patients with DRE demonstrates a moderate level of certainty according to GRADE level and OCEBM level 2. Further prospective studies involving multiple centers are encouraged to study both the efficacy and safety of CBD in adult patients with DRE. Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) 2023 CRD42023449955.
AB - Background: Highly purified cannabidiol (CBD), recently approved for various neurological disorders, is explored as a potential therapeutic avenue for drug-resistant epilepsy (DRE) among adult people with epilepsy (PWE) in this systematic review and meta-analysis. Objectives: To conduct an extensive literature review and meta-analysis of CBD use for DRE in adult PWE. Design: Systematic review and meta-analysis. Data sources and methods: We conducted a systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and two electronic resources; we searched Ovid MEDLINE and Scopus using appropriate keywords until August 2023. Data were presented as standardized mean difference (SMD) and odds ratio with confidence interval (CI) via random effect. We appraised the risk of bias of the included studies using the Joanna Briggs Institute critical appraisal tool while their strength of evidence with the Oxford Centre for Evidence-Based Medicine (OCEBM) and Grading of Recommendations Assessment Development and Education (GRADE) Levels of Evidence. Results: We identified 16 studies, 3 of which were randomized controlled trials and 3 prospective cohort studies, while the rest were expanded access programs, deriving a total of 668 participants receiving CBD for seizure control. CBD was used concomitantly with antiseizure medications in all studies. There was a statistically significant seizure reduction in the group receiving CBD therapy compared to the placebo group (SMD: −1.50, 95% CI (−3.47, 0.47), p < 0.01). Conclusion: The evidence on CBD use in adult patients with DRE demonstrates a moderate level of certainty according to GRADE level and OCEBM level 2. Further prospective studies involving multiple centers are encouraged to study both the efficacy and safety of CBD in adult patients with DRE. Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) 2023 CRD42023449955.
KW - cannabidiol
KW - drug-resistant epilepsy
KW - intractable epilepsy
KW - medication-resistant epilepsy
KW - treatment-resistant epilepsy
UR - https://www.scopus.com/pages/publications/85216641381
U2 - 10.1177/17562864251313914
DO - 10.1177/17562864251313914
M3 - Review Article
C2 - 39882324
AN - SCOPUS:85216641381
SN - 1756-2856
VL - 18
SP - 1
EP - 20
JO - Therapeutic Advances in Neurological Disorders
JF - Therapeutic Advances in Neurological Disorders
ER -