Cannabinoids for Medical Purposes in Children: A Living Systematic Review

Area of Science:

• Pediatric pharmacology
• Systematic reviews and meta-analysis
• Cannabinoid therapeutics

Background:

• Cannabinoid-based medicines are increasingly explored for pediatric conditions.
• Comprehensive data on safety and efficacy in children is crucial for clinical practice.
• A continuously updated evidence base is needed due to the evolving research landscape.

Purpose of the Study:

• To establish a living systematic review (LSR) for ongoing assessment of safety and benefit data of medical cannabinoid use in pediatric populations.
• To synthesize evidence from diverse study designs, including interventional, observational, survey, and qualitative research.
• To identify knowledge gaps and inform future research directions in pediatric cannabinoid therapy.

Main Methods:

• Searched major biomedical databases (MEDLINE, Embase, PsycInfo, Cochrane Library) from inception to April 2023.
• Included studies involving participants under 18 years receiving plant-derived or pharmaceutical cannabinoids for medical conditions.
• Extracted and analyzed data on study design, indications, cannabinoid types, dosages, efficacy outcomes, and adverse events.

Main Results:

• Included 276 studies from 37,189 citations, focusing on refractory epilepsy, cancer, and autism spectrum disorder.
• Purified cannabidiol (CBD) was the most common cannabinoid in interventional studies, with documented seizure reduction (30-50%) in randomized controlled trials.
• Common adverse events reported in pediatric studies included somnolence, diarrhea, vomiting, and decreased appetite.

Conclusions:

• The living systematic review provides a continuously updated evidence base on pediatric cannabinoid use.
• Findings highlight the potential of purified cannabidiol (CBD) for specific pediatric conditions like epilepsy.
• Ongoing updates will guide clinical practice and identify critical areas for future research in pediatric cannabinoid therapeutics.