Graham Myfanwy, Renaud Elianne, Lucas Catherine J, Schneider Jennifer, Martin Jennifer H
Australian Centre for Cannabinoid Clinical and Research Excellence, University of Newcastle, New South Wales, Australia; Centre for Drug Repurposing and Medicines Research, University of Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New South Wales, Australia.
Australian Centre for Cannabinoid Clinical and Research Excellence, University of Newcastle, New South Wales, Australia; Centre for Drug Repurposing and Medicines Research, University of Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New South Wales, Australia.
Clin Ther. 2023 Jun;45(6):527-534. doi: 10.1016/j.clinthera.2023.03.007.
Interest in the use of cannabis as a medicine has markedly increased during the last decade, with an unprecedented number of patients now seeking advice or prescriptions for medicinal cannabis. Unlike other medicines prescribed by physicians, many medicinal cannabis products have not undergone standard clinical trial development required by regulatory authorities. Different formulations with varying strengths and ratios of tetrahydrocannabinol and cannabidiol are available, and this diversity of medicinal cannabis products available for a myriad of therapeutic indications adds to the complexity. Physicians face challenges and barriers in their clinical decision making with medicinal cannabis because of current evidence limitations. Research efforts to address evidence limitations are ongoing; in the interim, educational resources and clinical guidance are being developed to address the gap in clinical information and support the needs of health professionals.
This article provides an overview of various resources that health professionals may use when seeking information about medicinal cannabis in the absence of high-quality evidence and clinical guidelines. It also identifies examples of international evidence-based resources that support clinical decision making with medicinal cannabis.
Similarities and differences between international examples of guidance and guideline documents are identified and summarized.
Guidance can help guide physicians in the individualized choice and dose of medicinal cannabis. Before quality clinical trials and regulator-approved products with risk management programs, safety data require clinical and academic collaborative pharmacovigilance.
在过去十年中，将大麻用作药物的关注度显著增加，如今寻求医用大麻建议或处方的患者数量空前。与医生开具的其他药物不同，许多医用大麻产品尚未经过监管机构要求的标准临床试验开发。有不同配方的产品，其四氢大麻酚和大麻二酚的强度和比例各不相同，而可用于众多治疗适应症的这种医用大麻产品多样性增加了复杂性。由于目前证据有限，医生在医用大麻的临床决策上面临挑战和障碍。解决证据限制的研究工作正在进行；在此期间，正在开发教育资源和临床指南，以弥补临床信息差距并满足卫生专业人员的需求。
本文概述了在缺乏高质量证据和临床指南的情况下，卫生专业人员在寻求有关医用大麻信息时可能使用的各种资源。它还列举了支持医用大麻临床决策的国际循证资源示例。
识别并总结了国际指导示例和指南文件之间的异同。
指导可帮助医生对医用大麻进行个性化选择和确定剂量。在进行高质量临床试验以及监管机构批准带有风险管理计划的产品之前，安全数据需要临床和学术方面的协作药物警戒。
