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Cannabinoids for treating neurogenic lower urinary tract dysfunction in patients with multiple sclerosis: a systematic review and meta-analysis


Abo Youssef, Nadim; Schneider, Marc P; Mordasini, Livio; Ineichen, Benjamin V; Bachmann, Lucas M; Chartier-Kastler, Emmanuel; Panicker, Jalesh N; Kessler, Thomas M (2017). Cannabinoids for treating neurogenic lower urinary tract dysfunction in patients with multiple sclerosis: a systematic review and meta-analysis. BJU International, 119(4):515-521.

Abstract

OBJECTIVES To systematically review all available evidence on efficacy and safety of cannabinoids for treating neurogenic lower urinary tract dysfunction (NLUTD) in patients with multiple sclerosis (MS).
PATIENTS AND METHODS The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by electronic search of Cochrane register, Embase, Medline, Scopus (last search on 11 November 2016).
RESULTS After screening 8469 articles, two randomized controlled trials and one open label study enrolling a total of 426 patients, were included. Cannabinoids relevantly decreased incontinence episodes in all three studies. Pooling data showed mean difference in incontinence episodes per 24 hours to be -0.35 (95% confidence interval -0.46 to -0.24). Mild adverse events were frequent (38-100%), but only two patients (0.7%) reported a serious adverse event.
CONCLUSIONS Preliminary data imply, that cannabinoids might be an effective and safe treatment option for NULTD in patients with MS. However, evidence base is poor and more high-quality, well-designed, adequately powered and sampled studies are urgently needed to reach definitive conclusions.

Abstract

OBJECTIVES To systematically review all available evidence on efficacy and safety of cannabinoids for treating neurogenic lower urinary tract dysfunction (NLUTD) in patients with multiple sclerosis (MS).
PATIENTS AND METHODS The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by electronic search of Cochrane register, Embase, Medline, Scopus (last search on 11 November 2016).
RESULTS After screening 8469 articles, two randomized controlled trials and one open label study enrolling a total of 426 patients, were included. Cannabinoids relevantly decreased incontinence episodes in all three studies. Pooling data showed mean difference in incontinence episodes per 24 hours to be -0.35 (95% confidence interval -0.46 to -0.24). Mild adverse events were frequent (38-100%), but only two patients (0.7%) reported a serious adverse event.
CONCLUSIONS Preliminary data imply, that cannabinoids might be an effective and safe treatment option for NULTD in patients with MS. However, evidence base is poor and more high-quality, well-designed, adequately powered and sampled studies are urgently needed to reach definitive conclusions.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
04 Faculty of Medicine > Brain Research Institute
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:6 January 2017
Deposited On:17 Jan 2017 14:17
Last Modified:21 Mar 2017 02:02
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1464-4096
Publisher DOI:https://doi.org/10.1111/bju.13759
PubMed ID:28058780

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Embargo till: 2017-12-23