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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Experimental Therapeutics
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1243597

Comparison of various doses of oral cannabidiol for treating refractory epilepsy indications: a network meta-analysis

Provisionally accepted
Xin Wang Xin Wang 1Haiyan Zhu Haiyan Zhu 1*Tao Liu Tao Liu 2Zhi Guo Zhi Guo 1*Chenyang Zhao Chenyang Zhao 1*Zhiyi He Zhiyi He 1*Wenxu Zheng Wenxu Zheng 3*
  • 1 The First Affiliated Hospital of China Medical University, Shenyang, China
  • 2 Tianjin Medical University General Hospital, Tianjin, China
  • 3 Dalian Friendship Hospita, Dalian, China

The final, formatted version of the article will be published soon.

    Aim: To evaluate the comparative efficacy and safety of various doses of oral cannabidiol (CBD) in treating refractory epilepsy indications, thus providing more informative evidence for clinical decision-making. Methods: A literature search of PubMed, Embase, the Cochrane library, and Web of Science (WoS) was performed to retrieve relevant randomized controlled trials (RCTs) that compared different doses of oral CBD with placebo or each other in refractory epilepsy indications. The search was limited from the inception of each database to January 3, 2023. Relative risk [RR] with a 95% confidence interval [CI] was used to express results. STATA/SE 14 was employed for network meta-analysis. Results: Six RCTs involving 972 patients were included in the final data analysis. Network meta-analysis showed that, , CBD10 (10 mg/kg/day) (RR: 1.77, 95%CI: 1.28 to 2.44), CBD20 (20 mg/kg/day) (RR: 1.91, 95%CI: 1.49 to 2.46), CBD25 (25 mg/kg/day) (RR: 1.61, 95%CI: 0.96 to 2.70), and CBD50 (50 mg/kg/day) (RR: 1.78, 95%CI: 1.07 to 2.94) were associated with higher antiseizure efficacy although the pooled result for CBD25 was only close to significant. In addition, in terms of the risk of treatment-emergent adverse events (TEAEs), the difference between different doses is not significant. However, CBD20 ranked first in terms of antiseizure efficacy, followed by CBD50, CBD10, and CBD25. For TEAEs, CBD25 ranked first, followed by CBD10, CBD50, CBD5, and CBD20. Conclusions: For refractory indications, CBD20 may be optimal option for antiseizure efficacy; however, CBD25 may be best for TEAEs. Therefore, an appropriate dose of oral CBD should be selected based on the actual situation. Due to the limitations of eligible studies and the limited sample size, more studies are needed in the future to validate our findings.

    Keywords: seizure, refractory epilepsy, Antiseizure drugs, Cannabidiol, Network meta-analysis

    Received: 21 Jun 2023; Accepted: 20 May 2024.

    Copyright: © 2024 Wang, Zhu, Liu, Guo, Zhao, He and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Haiyan Zhu, The First Affiliated Hospital of China Medical University, Shenyang, China
    Zhi Guo, The First Affiliated Hospital of China Medical University, Shenyang, China
    Chenyang Zhao, The First Affiliated Hospital of China Medical University, Shenyang, China
    Zhiyi He, The First Affiliated Hospital of China Medical University, Shenyang, China
    Wenxu Zheng, Dalian Friendship Hospita, Dalian, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.