Cannabidiol efficacy and clobazam coadministration: Where do we stand now?

@article{Lattanzi2020CannabidiolEA,
  title={Cannabidiol efficacy and clobazam coadministration: Where do we stand now?},
  author={Simona Lattanzi and Francesco Brigo and Eugen Trinka},
  journal={Epilepsia},
  year={2020},
  volume={61}
}
To the Editor In this issue of Epilepsia, two articles deal with the debated relationship between cannabidiol (CBD) efficacy and concomitant clobazam (CLB) use.1,2 The differences and similarities of these studies deserve some comments to adequately appreciate their strengths and limits. The first review1 is a critical appraisal of publicly available analyses of seizure outcomes on CBD treatment as presented by the applicant and provided by the European Medicines Agency (EMA) Assessment Report… 

Results From an Italian Expanded Access Program on Cannabidiol Treatment in Highly Refractory Dravet Syndrome and Lennox–Gastaut Syndrome

CBD is associated with improved seizure control also in a considerable proportion of highly refractory patients with DS and LGS independently from clobazam use, and overall, CBD safety and effectiveness are not dose-related in this cohort.

Practical use of pharmaceutically purified oral cannabidiol in Dravet syndrome and Lennox-Gastaut syndrome

This review will critically review the pharmacokinetic properties of CBD, the interactions with antiseizur and non-antiseizure medications, and the main tolerability and safety issues to provide guidance for its use in everyday practice.

References

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Does cannabidiol have antiseizure activity independent of its interactions with clobazam? An appraisal of the evidence from randomized controlled trials

The best clinical evidence to date is provided that CBD exerts therapeutic effects in patients with epilepsy that are independent of its interaction with CLB, and greater antiseizure effects, and a greater burden of adverse effects, are observed when CBD is combined withCLB.

Adjunctive Cannabidiol in Patients with Dravet Syndrome: A Systematic Review and Meta-Analysis of Efficacy and Safety

Adjunctive CBD resulted in a greater reduction in convulsive seizure frequency than placebo and a higher rate of AEs in patients with DS presenting with seizures uncontrolled by concomitant antiepileptic therapy.

Efficacy and Safety of Adjunctive Cannabidiol in Patients with Lennox–Gastaut Syndrome: A Systematic Review and Meta-Analysis

Adjunctive CBD resulted in a greater reduction in seizure frequency and a higher rate of AEs than placebo in patients with LGS presenting seizures uncontrolled by concomitant AEDs.

Cannabidiol efficacy and clobazam status: A systematic review and meta‐analysis

To evaluate the potential impact of concomitant clobazam (CLB) use on the efficacy of cannabidiol (CBD) treatment in patients with Dravet syndrome and Lennox‐Gastaut syndrome using meta‐analytical

Assessment Report : Epidiolex . International non - proprietary name : Cannabidiol

  • Guideline on Clinical Investigation of Medicinal Products in the Treatment of Epileptic Disorders