The long-term efficacy of cannabidiol in the treatment of refractory epilepsy.
Adolescent
Anticonvulsants
/ therapeutic use
Cannabidiol
/ administration & dosage
Child
Child, Preschool
Clobazam
/ therapeutic use
Dose-Response Relationship, Drug
Drug Resistant Epilepsy
/ drug therapy
Drug Therapy, Combination
Female
Humans
Kaplan-Meier Estimate
Male
Retrospective Studies
Seizures
/ drug therapy
Treatment Outcome
Tuberous Sclerosis
/ drug therapy
Young Adult
antiepileptic drugs
refractory epilepsy
seizures
tolerability
tuberous sclerosis complex
Journal
Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
07
05
2021
received:
15
01
2021
accepted:
07
05
2021
pubmed:
30
5
2021
medline:
16
10
2021
entrez:
29
5
2021
Statut:
ppublish
Résumé
Cannabidiol (CBD) has been shown to reduce seizures among patients with refractory epilepsies of various etiologies in recent clinical trials and an expanded access program (EAP). Most studies report efficacy over short time periods (<1 year), with little published on longer term efficacy. Here, we investigate the efficacy of CBD for a treatment period of up to 60 months (median = 45.5 months). We conducted a retrospective review of patient-reported seizure logs and medical records for 54 subjects with refractory epilepsy who enrolled in the Massachusetts General Hospital's open-label EAP for CBD as a new treatment for epilepsy. We analyzed the effect of CBD on seizure frequencies and concomitant antiepileptic drug (AED) use at 1 year after starting treatment and the most recent study visit. Our results indicate that CBD maintains its efficacy for controlling seizures from Year 1 to the most recent study visit. The percentage of seizure responders remained similar at these time points (41.7%-42.6%), and the seizure response rate was also maintained (p = .12). Efficacy was also seen over a broad dose range, and up to 50 mg/kg/day. CBD was particularly effective for controlling seizures in the setting of tuberous sclerosis complex and for reducing epileptic spasms and absence seizures. Although CBD use did not lead to an overall decrease in concomitant AEDs, most subjects reduced the dose of at least one concomitant AED compared to baseline. CBD was generally well tolerated, with drowsiness and diarrhea as the primary adverse reactions. This study demonstrates CBD does not lose its efficacy in controlling seizures over a treatment period of up to 60 months. Taken alongside other results on the efficacy and tolerability of CBD in the treatment of refractory epilepsies, our results provide evidence that CBD is an effective, safe, and well-tolerated AED for long-term use.
Substances chimiques
Anticonvulsants
0
Cannabidiol
19GBJ60SN5
Clobazam
2MRO291B4U
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1594-1603Informations de copyright
© 2021 International League Against Epilepsy.
Références
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