Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled Trials

Frontiers in Pharmacology

Yu-Chiang Hung¹  Tsai-Sheng Fu²  Tung-Yi Lin²  Sung Huang Laurent Tsai²  Shih-Chieh Shao³  Chao-Hua Fang⁴  Chun-Ru Lin⁵ 

[1] Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Keelung, Taiwan;Department of Pharmacy, Chang Gung Memorial Hospital, Keelung, Taiwan;Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan;School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan;

关键词: cannabinoids;    spinal cord injury;    trauma;    spine;    pain;    adverse events;   

DOI  :  10.3389/fphar.2022.866235

来源: DOAJ

【 摘 要 】

Background: Spinal cord injury (SCI) often involves multimodal pain control. This study aims to evaluate the efficacy and safety of cannabinoid use for the reduction of pain in SCI patients.Methods and Findings: This study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. We searched PubMed, EMBASE, Scopus, Cochrane, Web of Science, and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) reporting the efficacy (e.g., pain relief) or safety (e.g., adverse events) of cannabinoids in patients with SCI, from inception to 25 December 2021. The study quality and the quality of evidence were evaluated by Cochrane ROB 2.0 and the Grading of Recommendations, Assessment, Development, and Evaluations system (GRADE), respectively. We used the random-effects model to perform the meta-analysis. From a total of 9,500 records, we included five RCTs with 417 SCI patients in the systematic review and meta-analysis. We judged all five of the included RCTs as being at high risk of bias. This meta-analysis indicated no significant difference in pain relief between the cannabinoids and placebo in SCI patients (mean difference of mean differences of pain scores: −5.68; 95% CI: −13.09, 1.73; p = 0.13; quality of evidence: very low), but higher odds of adverse events were found in SCI patients receiving cannabinoids (odds ratio: 3.76; 95% CI: 1.98, 7.13; p < 0.0001; quality of evidence: moderate).Conclusion: The current best evidence suggests that cannabinoids may not be beneficial for pain relief in SCI patients, but they do increase the risks of adverse events, including dizziness, somnolence, and dysgeusia, compared to the placebo. Cannabinoids should not be regularly suggested for pain reduction in SCI patients. Updating the systematic reviews and meta-analyses by integrating future RCTs is necessary to confirm these findings.

【 授权许可】

Unknown