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一项关于大麻二酚减少智障儿童和青少年严重行为问题的随机安慰剂对照试验。

A pilot randomised placebo-controlled trial of cannabidiol to reduce severe behavioural problems in children and adolescents with intellectual disability.

机构信息

Murdoch Children's Research Institute, Parkville, Victoria, Australia.

Royal Children's Hospital, Parkville, Victoria, Australia.

出版信息

Br J Clin Pharmacol. 2021 Feb;87(2):436-446. doi: 10.1111/bcp.14399. Epub 2020 Jul 1.

Abstract

AIMS

Severe behavioural problems (SBP) are a major contributor to morbidity in children with intellectual disability (ID). Medications used to treat SBP in ID are associated with a high risk of side effects. Cannabidiol has potential therapeutic effects in SBP. This pilot study aimed to investigate the feasibility of conducting a randomised placebo-controlled trial of cannabidiol to reduce SBP in children with ID.

METHODS

This is a double-blind, placebo-controlled, two-armed, parallel-design, randomised controlled trial of cannabidiol in children aged 8-16 years with ID and SBP. Participants were randomised 1:1 to receive either 98% cannabidiol in oil (Tilray, Canada) or placebo orally for 8 weeks. The dose was up-titrated over 9 days to 20 mg/kg/day in two divided doses, with a maximum dose of 500 mg twice/day. The feasibility and acceptability of all study components were assessed.

RESULTS

Eight children were randomised, and all completed the full study protocol. There were no serious adverse events or drop-outs. Protocol adherence for key study components was excellent: study visits 100%, medication adherence 100%, blood tests 92% and questionnaire completion 88%. Parents reported a high degree of acceptability with the study design. All parents reported they would recommend the study to other families with children with similar problems. There was an efficacy signal in favour of active drug.

CONCLUSIONS

The findings suggest that the study protocol is feasible and acceptable to patients with ID and SBP and their families.

摘要

目的

严重行为问题(SBP)是导致智力障碍(ID)儿童发病和致残的主要因素。用于治疗 ID 中 SBP 的药物存在副作用风险高的问题。大麻二酚在 SBP 中有潜在的治疗作用。本研究旨在探讨大麻二酚治疗 ID 儿童 SBP 的随机安慰剂对照试验的可行性。

方法

这是一项双盲、安慰剂对照、两臂、平行设计、随机对照试验,纳入 8-16 岁 ID 合并 SBP 的儿童,随机 1:1 接受大麻二酚或安慰剂治疗,疗程 8 周。起始剂量为 98%大麻二酚油(加拿大 Tilray 公司)或安慰剂,口服,9 天内滴定至 20 mg/kg/天,分两次服用,最大剂量为 500 mg,每日两次。评估所有研究组成部分的可行性和可接受性。

结果

8 例儿童被随机分组,均完成了完整的研究方案。无严重不良事件或脱落。主要研究环节的方案依从性极佳:访视 100%、用药依从性 100%、血药浓度检测 92%、问卷完成率 88%。家长对研究设计的接受度很高,均表示愿意将该研究推荐给其他有类似问题儿童的家庭。有研究药物有效的信号。

结论

研究方案对 ID 合并 SBP 儿童及其家属是可行且可接受的。

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