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耐药性癫痫中大麻二酚的最新情况

Update on Cannabidiol in Drug-Resistant Epilepsy.

作者信息

Singh Akanksha, Madaan Priyanka, Bansal Dipika

机构信息

Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, SAS Nagar, Punjab, India.

Department of Pediatric Neurology, Amrita School of Medicine, Amrita Vishwavidyapeetham, Faridabad, India.

出版信息

Indian J Pediatr. 2025 Jan;92(1):61-69. doi: 10.1007/s12098-024-05337-1. Epub 2024 Nov 25.

Abstract

Cannabidiol (CBD) has arisen as a promising therapeutic option for children with drug-resistant epilepsy (DRE). CBD has received regulatory nod from different regulatory authorities in the United States, Europe, and India for children with DRE particularly, Dravet syndrome (DS), Lennox Gastaut syndrome (LGS), and Tuberous sclerosis complex (TSC). Recent clinical trials and observational studies highlight the potential of CBD to lower seizure frequency and provide better quality of life in children affected by these disorders. The safety profile is generally favorable with minor common adverse events such as somnolence, diarrhea, and gastrointestinal issues. Furthermore, the expense associated with CBD remains a notable concern, especially in low- and middle-income countries such as India, where access to this promising treatment may be constrained. This draws attention to the cost-effective perspective of CBD. This review aims to explore the pharmacological properties of CBD, its mechanisms of action, and the clinical evidence supporting its use in various pediatric epilepsies, including LGS, DS, and TSC. Additionally, this review sheds light on the current regulatory landscape in India where CBD use is still in its nascent stages, and discusses the challenges and opportunities for integrating CBD into clinical practice.

摘要

大麻二酚(CBD)已成为治疗耐药性癫痫(DRE)儿童的一种有前景的治疗选择。CBD已获得美国、欧洲和印度不同监管机构的批准,专门用于患有DRE的儿童,特别是德雷韦特综合征(DS)、伦诺克斯-加斯东综合征(LGS)和结节性硬化症(TSC)。最近的临床试验和观察性研究突出了CBD降低癫痫发作频率以及改善受这些疾病影响儿童生活质量的潜力。其安全性总体良好,常见的轻微不良事件包括嗜睡、腹泻和胃肠道问题。此外,与CBD相关的费用仍然是一个显著问题,尤其是在印度等低收入和中等收入国家,在这些国家,获得这种有前景的治疗方法可能受到限制。这就凸显了CBD的成本效益问题。本综述旨在探讨CBD的药理特性、作用机制以及支持其用于包括LGS、DS和TSC在内的各种儿童癫痫的临床证据。此外,本综述还阐明了印度目前CBD使用仍处于初期阶段的监管情况,并讨论了将CBD纳入临床实践的挑战和机遇。

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