Therapeutic use ofCannabis sativaon chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis

Abstract

This paper aims to evaluate the anti-emetic efficacy of cannabinoids in cancer patients receiving chemotherapy using a systematic review of literature searched within electronic databases such as PUBMED, EMBASE, PSYCINFO, LILACS, and 'The Cochrane Collaboration Controlled Trials Register'. Studies chosen were randomized clinical trials comprising all publications of each database until December 2006. From 12 749 initially identified papers, 30 fulfilled the inclusion criteria for this review, with demonstration of superiority of the anti-emetic efficacy of cannabinoids compared with conventional drugs and placebo. The adverse effects were more intense and occurred more often among patients who used cannabinoids. Five meta-analyses were carried out: (1) dronabinol versus placebo [n=185; relative risk (RR)=0.47; confidence interval (CI)=0.19-1.16]; (2) Dronabinol versus neuroleptics [n=325; RR=0.67; CI=0.47-0.96; number needed to treat (NNT)=3.4]; (3) nabilone versus neuroleptics (n=277; RR=0.88; CI=0.72-1.08); (4) levonantradol versus neuroleptics (n=194; RR=0.94; CI=0.75-1.18); and (5) patients' preference for cannabis or other drugs (n=1138; RR=0.33; CI=0.24-0.44; NNT=1.8). The superiority of the anti-emetic efficacy of cannabinoids was demonstrated through meta-analysis.

Legalising medical use of cannabis in South Africa: Is the empirical evidence sufficient to support policy shifts in this direction?

“…[15] Cannabinoids are used for symptom management in cancer, while there is emerging evidence that cannabinoids may have anticancer effects, particularly antitumour effects. [16] However, few human clinical trials have been published in this area, and more trials are required to achieve certainty that cannabis or cannabinoids can be used as anticancer agents. [16] With regard to pain relief in cancer patients, in experimental models of acute pain, inhaled cannabis resulted in dose-dependent pain relief.…”

“…[16] However, few human clinical trials have been published in this area, and more trials are required to achieve certainty that cannabis or cannabinoids can be used as anticancer agents. [16] With regard to pain relief in cancer patients, in experimental models of acute pain, inhaled cannabis resulted in dose-dependent pain relief. In patients with chronic pain, both cannabis and cannabinoids outperformed placebo treatment.…”

“…[17] The evidence is stronger regarding the positive effect of cannabinoids in treating chemotherapy-induced nausea and vomiting in cancer patients. [16,18] Human studies suggest efficacy of cannabinoids in the management of chemically induced nausea and vomiting, but further research aimed at developing new endocannabinoid-based antinausea and antiemetic therapies is still warranted.…”

“…However, few studies have compared cannabis or cannabinoids with conventional medications used to manage pain in cancer. [16] The effects of cannabis or cannabis extracts on AIDS wasting syndrome or weight loss from AIDS have been studied, mainly because cannabis or cannabinoids reportedly stimulate the appetite. A Cochrane review found that the seven studies included in the review suffered from bias and small sample size and lacked longitudinal data, limiting the extent to which conclusions could be drawn.…”

Cannabis som medisin

“…Mange pasienter foretrekker cannabisproduktene, kanskje også på grunn av den stemningshevende effekten (1). Også nyere oversikter bekrefter at cannabinoider er overlegne i behandlingen av cellegiftindusert kvalme (2,3).…”