Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled Trials
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-Analys...
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Frontiers Media S.A.
2022-04-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2022.866235/full |
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| author | Sung Huang Laurent Tsai Chun-Ru Lin Shih-Chieh Shao Chao-Hua Fang Tsai-Sheng Fu Tung-Yi Lin Yu-Chiang Hung |
| author_facet | Sung Huang Laurent Tsai Chun-Ru Lin Shih-Chieh Shao Chao-Hua Fang Tsai-Sheng Fu Tung-Yi Lin Yu-Chiang Hung |
| author_sort | Sung Huang Laurent Tsai |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-10T12:13:15Z |
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| id | doaj.art-c6fcda7e8a7d4ea5aceed942cd41ca2d |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-10T12:13:15Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-c6fcda7e8a7d4ea5aceed942cd41ca2d2022-12-22T01:49:17ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122022-04-011310.3389/fphar.2022.866235866235Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled TrialsSung Huang Laurent Tsai0Chun-Ru Lin1Shih-Chieh Shao2Chao-Hua Fang3Tsai-Sheng Fu4Tung-Yi Lin5Yu-Chiang Hung6Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Keelung, TaiwanSchool of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, TaiwanDepartment of Pharmacy, Chang Gung Memorial Hospital, Keelung, TaiwanDepartment of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung, TaiwanDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Keelung, TaiwanDepartment of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Keelung, TaiwanDepartment of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanBackground: 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.https://www.frontiersin.org/articles/10.3389/fphar.2022.866235/fullcannabinoidsspinal cord injurytraumaspinepainadverse events |
| spellingShingle | Sung Huang Laurent Tsai Chun-Ru Lin Shih-Chieh Shao Chao-Hua Fang Tsai-Sheng Fu Tung-Yi Lin Yu-Chiang Hung Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled Trials Frontiers in Pharmacology cannabinoids spinal cord injury trauma spine pain adverse events |
| title | Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled Trials |
| title_full | Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled Trials |
| title_short | Cannabinoid Use for Pain Reduction in Spinal Cord Injuries: A Meta-Analysis of Randomized Controlled Trials |
| title_sort | cannabinoid use for pain reduction in spinal cord injuries a meta analysis of randomized controlled trials |
| topic | cannabinoids spinal cord injury trauma spine pain adverse events |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2022.866235/full |
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