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Benefits and harms of medical cannabis: a scoping review of systematic reviews.
Systematic Reviews ( IF 3.7 ) Pub Date : 2019-12-10 , DOI: 10.1186/s13643-019-1243-x
Misty Pratt 1 , Adrienne Stevens 1, 2 , Micere Thuku 1 , Claire Butler 1, 3 , Becky Skidmore 4 , L Susan Wieland 5 , Mark Clemons 6, 7 , Salmaan Kanji 6, 8, 9 , Brian Hutton 1, 6
Affiliation  

BACKGROUND There has been increased interest in the role of cannabis for treating medical conditions. The availability of different cannabis-based products can make the side effects of exposure unpredictable. We sought to conduct a scoping review of systematic reviews assessing benefits and harms of cannabis-based medicines for any condition. METHODS A protocol was followed throughout the conduct of this scoping review. A protocol-guided scoping review conduct. Searches of bibliographic databases (e.g., MEDLINE®, Embase, PsycINFO, the Cochrane Library) and gray literature were performed. Two people selected and charted data from systematic reviews. Categorizations emerged during data synthesis. The reporting of results from systematic reviews was performed at a high level appropriate for a scoping review. RESULTS After screening 1975 citations, 72 systematic reviews were included. The reviews covered many conditions, the most common being pain management. Several reviews focused on management of pain as a symptom of conditions such as multiple sclerosis (MS), injury, and cancer. After pain, the most common symptoms treated were spasticity in MS, movement disturbances, nausea/vomiting, and mental health symptoms. An assessment of review findings lends to the understanding that, although in a small number of reviews results showed a benefit for reducing pain, the analysis approach and reporting in other reviews was sub-optimal, making it difficult to know how consistent findings are when considering pain in general. Adverse effects were reported in most reviews comparing cannabis with placebo (49/59, 83%) and in 20/24 (83%) of the reviews comparing cannabis to active drugs. Minor adverse effects (e.g., drowsiness, dizziness) were common and reported in over half of the reviews. Serious harms were not as common, but were reported in 21/59 (36%) reviews that reported on adverse effects. Overall, safety data was generally reported study-by-study, with few reviews synthesizing data. Only one review was rated as high quality, while the remaining were rated of moderate (n = 36) or low/critically low (n = 35) quality. CONCLUSIONS Results from the included reviews were mixed, with most reporting an inability to draw conclusions due to inconsistent findings and a lack of rigorous evidence. Mild harms were frequently reported, and it is possible the harms of cannabis-based medicines may outweigh benefits. SYSTEMATIC REVIEW REGISTRATION The protocol for this scoping review was posted in the Open Access (https://ruor.uottawa.ca/handle/10393/37247).

中文翻译:

医用大麻的益处和危害:系统评价的范围审查。

背景 人们越来越关注大麻在治疗疾病方面的作用。不同基于大麻的产品的可用性可以使接触的副作用不可预测。我们试图对系统评价进行范围审查,以评估大麻药物在任何情况下的益处和危害。方法 在整个范围审查的实施过程中遵循了一个协议。协议指导的范围审查行为。对书目数据库(例如 MEDLINE®、Embase、PsycINFO、Cochrane 图书馆)和灰色文献进行了搜索。两个人从系统评价中选择并绘制数据。在数据合成过程中出现了分类。系统评价结果的报告是在适合范围审查的高水平上进行的。结果 在筛选了 1975 次引文后,纳入了 72 篇系统评价。审查涵盖了许多情况,最常见的是疼痛管理。一些评论侧重于将疼痛作为多发性硬化症 (MS)、损伤和癌症等疾病症状的管理。疼痛后,最常见的治疗症状是多发性硬化症的痉挛、运动障碍、恶心/呕吐和心理健康症状。对审查结果的评估有助于理解,尽管在少数审查结果中显示出减轻疼痛的益处,但其他审查中的分析方法和报告不是最佳的,因此在考虑时很难知道结果的一致性一般疼痛。大多数比较大麻与安慰剂的评论(49/59,83%)和 20/24(83%)的比较大麻与活性药物的评论都报告了不良反应。轻微的不良反应(例如,嗜睡、头晕)很常见,并在超过一半的评价中报告。严重危害并不常见,但在 21/59 (36%) 的评论中报告了不良反应。总体而言,安全性数据通常是逐个研究报告的,很少有综述综合数据。只有一篇评​​价被评为高质量,其余评价为中等(n = 36)或低/极低(n = 35)质量。结论 纳入评价的结果好坏参半,大多数报告由于结果不一致和缺乏严格证据而无法得出结论。经常有轻微危害的报道,基于大麻的药物的危害可能超过益处。系统审查注册 此范围审查的协议已发布在开放获取 (https://ruor.uottawa.
更新日期:2019-12-10
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