Kelly Lauren E, Rieder Michael J, Finkelstein Yaron
Canadian Paediatric Society, Drug Therapy Committee, Ottawa, Ontario, Canada.
Paediatr Child Health. 2024 Apr 5;29(2):104-121. doi: 10.1093/pch/pxad078. eCollection 2024 May.
Interest in using cannabis products for a medical purpose in children under the age of 18 years is increasing. There are many medical cannabis products available that can include cannabidiol (CBD) or delta-9-tetrahydrocannabinol (THC), or both. Despite many therapeutic claims, there are few rigorous studies to inform the dosing, safety, and efficacy of medical cannabis in paediatric clinical practice. This statement reviews the current evidence and provides recommendations for using medical cannabis in children. Longer-term (2-year) reports support the sustained tolerability and efficacy of cannabidiol therapy for patients with Lennox-Gastaut and Dravet syndromes. CBD-enriched cannabis extracts containing small amounts of THC have been evaluated in a small number of paediatric patients, and further research is needed to inform clinical practice guidelines. Given the widespread use of medical cannabis in Canada, paediatricians should be prepared to engage in open, ongoing discussions with families about its potential benefits and risks, and develop individualized plans that monitor efficacy, reduce harms, and mitigate drug-drug interactions.
18岁以下儿童出于医疗目的使用大麻产品的情况日益增多。市面上有许多医用大麻产品，其中可能含有大麻二酚（CBD）或9-四氢大麻酚（THC），或两者皆有。尽管有许多治疗功效宣称，但在儿科临床实践中，关于医用大麻的剂量、安全性和疗效的严格研究却很少。本声明回顾了当前证据，并为儿童使用医用大麻提供建议。长期（2年）报告支持大麻二酚疗法对伦诺克斯-加斯东综合征和德雷维特综合征患者的持续耐受性和疗效。含少量THC的富含CBD的大麻提取物已在少数儿科患者中进行了评估，还需要进一步研究以指导临床实践指南。鉴于医用大麻在加拿大广泛使用，儿科医生应准备好与家庭就其潜在益处和风险展开公开、持续的讨论，并制定个性化计划，以监测疗效、减少危害并减轻药物相互作用。
