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An August 2023 study entitled "Cannabinoids for Symptom Management in Children with Cancer: A Systematic Review and Meta-analysis" that was published in the journal Cancer "systematically appraised the existing published literature for the use of cannabis products in children with cancer."
Cannabinoids for Children with Cancer Study
Cannabinoids for Children with Cancer. The design of the study was that of a literature review that searched the following databases: MEDLINE, Embase, PsycINFO, and the Cochrane Library. The scientists collected data regarding cannabis products, doses, formulations, frequencies, consumption avenues, indications, and other clinical and demographic details.
"This study examined data from more than 1,900 children ranging from six months to 18 years of age."
The scientific investigation identified 34,611 studies, of which 19 were included. These considered data from more than 1,900 children. Median age of study participants ranged from six months to 18 years. The studies reviewed employed "a wide variety of cannabinoids," including nabilone, delta-9 THC, dronabinol, delta-8 THC, and levonantradol, among others (such as CBD).
Cannabinoids for Children with Cancer Study Results
Cannabinoids for Children with Cancer. Chemotherapy-induced nausea and vomiting (CINV) was the most common reason for the use of cannabinoids in the prior research investigations, with 58 percent of participants seeking relief for this condition. General cancer symptoms was another major area for which researchers were seeking relief for the children with cancer, with 42 percent of participants seeking relief for this.
The study's authors reported that cannabinoids were "superior in controlling nausea and vomiting in comparison with active control groups." Of the side effects suffered by participants, drowsiness was front and center, followed by dizziness, headache, and euphoria. Other studies reviewed revealed that participants experienced somnolence (sleepiness), appetite increase, dizziness, and dry mouth.
Cannabinoids for Children with Cancer Study Conclusions
Cannabinoids for Children with Cancer. The scientists observed that cannabinoids are "increasingly being used for symptom management in children with cancer—with or without authorization (or medical advice) from pediatricians or health care professionals."
Concluded the study's authors:
"The management of CINV was the most studied indication for cannabinoids in both the observational studies and the interventional studies, and this leaves a knowledge gap concerning the impact of medical cannabis and cannabinoids with respect to pain, mood, sleep, anxiety, and health-related quality of life.
"The majority of the studies did not adequately describe the types of cannabinoids, dosing, frequencies, and routes of administration of cannabis products."
"The studies included in this review also used cannabis for the management of epilepsy in children with brain tumors. Although CBD has been shown to be effective for the management of drug-resistant epilepsies, there is a strong need to generate evidence on the safety and efficacy of CBD for seizure management in children with cancer, particularly with respect to how cannabinoids may act with other medications. RCTs evaluating responses to pain, mood, sleep, and health-related quality of life are also urgently needed to evaluate different combinations of cannabinoids, dosing schedules, and safety outcomes.
"The majority of the included observational studies did not adequately describe the types of cannabinoids, dosing, frequencies, and routes of administration of cannabis products; this hinders reproducibility and meta-analysis. The outcomes of the observational studies were heterogeneous; there was no uniformity in reporting outcomes.
"On the other hand, there is a lot of heterogeneity in the products currently being used in children with cancer. However, the majority of our included trials were from the late 1990s and there was large variation in the reporting of efficacy outcomes. We were not able to pool the efficacy outcomes because of these variations. There is a strong need for interventional studies comparing the safety and efficacy of cannabinoids and available treatment options in children with cancer.
"There is also a need for cannabinoid researchers to work together on standards for reporting cannabis exposures and cannabis-related AEs to ensure that future research is optimally useful. Evidence is urgently required on the safety of cannabinoids with respect to different cannabis products, tolerability, and doses of cannabinoids in the vulnerable pediatric population diagnosed with cancer.
"There is a strong need for interventional studies comparing the safety and efficacy of cannabinoids and available treatment options in children with cancer."
"Pediatric oncologists express concerns about unknown cannabinoid dosing and product selection; this was highlighted in our findings by the lack of detailed cannabis exposures reported, particularly in observational study designs. Because of the lack of a core set of outcome tools for cannabis, there is scope for developing a core set of outcomes for cannabinoid clinical trials in pediatric oncology. Additionally, there is scope for pediatricians to collaborate internationally to generate long-term safety and efficacy data for cannabinoids in children with cancer.
"Most of the children receiving medical cannabis in the included studies were diagnosed with central nervous system tumors and blood-related cancers. A recent systematic review of the safety and efficacy of medical cannabinoids in the child and adult populations with seizures reported safety concerns with adverse mental events and decreases in appetite. However, the safety data for cannabinoids are limited to CBD use in epilepsy, for which RCTs have been conducted.
"Cannabinoids may be beneficial for the management of pain, nausea, and vomiting in children with cancer."
"Cannabinoids may be beneficial for the management of pain, nausea, and vomiting in children with cancer, especially when there is a failure to respond to available therapeutics. In this systematic review, we pooled safety evidence from interventional studies and identified higher study withdrawal due to cannabinoid-related AEs in comparison with the control groups.
"Cannabinoids possess a risk of developing AEs such as somnolence, increases in appetite, altered mood and perception, and dizziness.
"There are certain limitations of this systematic review. First, few studies were included in the review and methodological limitations of reporting resulted in limited recommendations for practice. Second, we included retrospective medical record reviews and primarily nonrandomized studies.
"As the overall quality of evidence was low, there was no uniformity in the outcomes in the included studies."
"As the overall quality of evidence was low, there was no uniformity in the outcomes in the included studies. However, the included clinical trials were published in the late 1990s and the study findings were interpreted in light of this factor. Furthermore, because of the high variability in the reporting of outcome data, we were not able to perform a quantitative synthesis of outcome data.
"There were no case-control studies or cohort studies. Cannabinoids have a strong potential to interact with other drugs metabolized by the same pathway and increase the risk of AEs. There was very little reporting on what other medications study participants were taking at the time they were receiving cannabinoids; this limited our ability to provide guidance on safety precautions for drug–drug interactions."
View the original study.
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