University of Manitoba, Faculty of Pharmacy, 750 McDermot Avenue, Winnipeg, Manitoba, R3E 0T5 Canada.
Expert Opin Pharmacother. 2010 Jan;11(1):17-31. doi: 10.1517/14656560903413534.
In recent times, our knowledge of cannabinoids and the endocannabinoid system has greatly advanced. With expanding knowledge, synthetic cannabinoids - including nabilone, dronabinol and a combination of synthetic Delta9-THC and cannabidiol - have been developed and tested for benefit in a variety of therapeutic indications.
The aim of this article is to provide a summative review of the vast amount of clinical trial data now available on these agents.
To locate clinical trials for review, a literature search was performed using PubMed between the dates of 25 May and 30 June 2009. Search parameters were set to isolate only human randomized controlled trials (RCTs) published between 1990 and 2009. Keywords consistently used for each search include: cannabinoids, marijuana, THC, nabilone and dronabinol. Preferential selection was given to the best-designed trials, focusing on placebo-controlled, double-blind RCTs with the largest patient populations, if available.
As efficacy and tolerability of these agents remain questionable, it is important that cannabinoids not be considered 'first-line' therapies for conditions for which there are more supported and better-tolerated agents. Instead, these agents could be considered in a situation of treatment failure with standard therapies or as adjunctive agents where appropriate.
在最近的时间里，我们对大麻素和内源性大麻素系统的认识有了很大的提高。随着知识的不断扩展，合成大麻素 - 包括纳布隆、大麻隆和合成 Delta9-THC 和大麻二酚的组合 - 已经被开发出来，并在各种治疗适应症中进行了测试，以证明其益处。
本文综述了这些药物的大量临床试验数据。
为了找到用于综述的临床试验，我们在 2009 年 5 月 25 日至 6 月 30 日期间在 PubMed 上进行了文献检索。搜索参数设置为仅隔离 1990 年至 2009 年期间发表的人类随机对照试验 (RCT)。每个搜索中始终使用的关键词包括：大麻素、大麻、THC、纳布隆和大麻隆。如果有可用的，最好选择设计最好的试验，重点关注安慰剂对照、双盲 RCT，患者人数最多。
由于这些药物的疗效和耐受性仍然存在疑问，因此大麻素不应被视为治疗某些疾病的“一线”药物，而这些疾病有更支持和更耐受的药物。相反，这些药物可以在标准治疗失败的情况下或在适当的情况下作为辅助药物考虑。
