UK Medical Cannabis Registry: A Clinical Outcomes Analysis for Epilepsy

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.