Cowley Isaac, Erridge Simon, Aggarwal Arushika, Evans Lilia, Varadpande Madhur, Clarke Evonne, McLachlan Katy, Coomber Ross, Iqbal Augustin, Rucker James J, Weatherall Mark W, Sodergren Mikael H
Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.
Curaleaf Clinic, London, UK.
Brain Behav. 2025 Apr;15(4):e70490. doi: 10.1002/brb3.70490.
A third of epilepsy patients fail to enter seizure remission despite optimal therapeutic management. Cannabis-based medicinal products (CBMPs) have shown promise as a potential therapy. However, a paucity of high-quality literature regarding CBMPs' efficacy and safety profile means further investigation is needed. The study aimed to examine changes in epilepsy-specific and general health-related quality of life (HRQoL) patient-reported outcome measures (PROMs) in individuals with treatment-resistant epilepsy.
A case series of patients with epilepsy from the UK Medical Cannabis Registry analyzed changes in Quality of Life in Epilpesy-31 (QOILE-31), Single-Item Sleep Quality Score (SQS), EQ-5D-5L, Generalized Anxiety Disorder-7 (GAD-7) and Patient Global Impression of Change (PGIC) between baseline, one, three, and six months. Adverse events (AEs) were collected and classified by severity. p < 0.050 was considered statistically significant.
There were 134 patients included. Improvements were recorded from baseline to one, three, and six months in QOILE-31 and all HRQoL PROMs (p < 0.050). Forty patients (29.85%) reported a minimal clinically important difference in Quality of Life in Epilepsy-31 (QOLIE-31) at six months. There were 18 (13.43%) AEs reported by 5 (3.73%) patients, mainly mild and moderate.
The proportion of patients achieving a clinically significant change is similar to existing CBMPs in epilepsy literature. AE incidence was lower than similar studies although this may be due to the large proportion (67.16%) of individuals who were not cannabis naïve.
Initiation of CBMPs was associated with an improvement across all PROMs. CBMPs were well tolerated across the cohort. However, randomized controlled trials are needed to help determine causality.
尽管进行了最佳治疗管理,仍有三分之一的癫痫患者未能实现癫痫发作缓解。基于大麻的药用产品(CBMPs)已显示出作为一种潜在疗法的前景。然而,关于CBMPs疗效和安全性的高质量文献匮乏,这意味着需要进一步研究。该研究旨在检查难治性癫痫患者中癫痫特异性和一般健康相关生活质量(HRQoL)患者报告结局指标(PROMs)的变化。
对英国医用大麻登记处的一系列癫痫患者病例进行分析,比较基线、1个月、3个月和6个月时癫痫生活质量-31(QOILE-31)、单项睡眠质量评分(SQS)、EQ-5D-5L、广泛性焦虑障碍-7(GAD-7)和患者总体变化印象(PGIC)的变化。收集不良事件(AE)并按严重程度分类。p<0.050被认为具有统计学意义。
共纳入134例患者。从基线到1个月、3个月和6个月,QOILE-31和所有HRQoL PROMs均有改善(p<0.050)。40例患者(29.85%)在6个月时报告癫痫生活质量-31(QOLIE-31)有最小临床重要差异。5例患者(3.73%)报告了18例(13.43%)AE,主要为轻度和中度。
实现临床显著变化的患者比例与癫痫文献中现有的CBMPs相似。AE发生率低于类似研究,尽管这可能是由于很大比例(67.16%)的个体并非初次使用大麻。
启动CBMPs与所有PROMs的改善相关。CBMPs在整个队列中耐受性良好。然而,需要随机对照试验来帮助确定因果关系。