Table.
e-7. Effect sizes and relative differences of randomized control studies of the effects of cannabinoids among adults with chronic SCI.
| Outcome | Author, Year |
Outcome
Measure |
Group | Dose | Follow-up Times | Treatment | Control | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| n | Mean* | n | Mean* | Effect size (d)** [CI] | |Hedges| (Δ) | ||||||||||||||||
| Pain | Karst et al., 2003 [56] |
VRS pain | CT-3 – placebo sequence AM PM |
CT-3 10.0mg-80.0mg | 3hrs 8hrs |
10 10 |
-0.36 (0.47) -0.57 (0.95) |
10 10 |
-0.11 (0.40) -0.25 (0.55) |
-0.57 (0.44) [-1.44-0.34] -0.41 (0.06) [-1.28-0.49] |
0.55 (↓) 0.39 (↓) |
||||||||||
| Placebo – CT-3 sequence AM PM |
3hrs 8hrs |
11 11 |
-0.61 (1.01) -0.62 (0.74) |
11 11 |
-0.19 (0.55) -0.29 (0.38) |
-0.52 (0.81) [-1.35-0.35] -0.56 (0.59) [-1.39-0.31] |
0.50 (↓) 0.54 (↓) |
||||||||||||||
| VAS pain, 100-mm scale | CT-3 – placebo sequence AM PM |
3hrs 8hrs |
10 10 |
-13.07 (13.76) -15.56 (23.38) |
10 10 |
-1.52 (12.98) -5.91 (14.82) |
-0.86 (13.38) [-1.74-0.09] -0.49 (19.57) [-1.36-0.42] |
0.82 (↓) 0.47 (↓) |
|||||||||||||
| Placebo – CT-3 sequence AM PM |
3hrs 8hrs |
11 11 |
-13.00 (22.14) -12.39 (14.48) |
11 11 |
-3.14 (13.11) -8.26 (29.15) |
-0.54 (18.19) [-1.37-0.33] -0.18 (23.00) [-1.01-0.66] |
0.52 (↓) 0.17 (↓) |
||||||||||||||
| Wade et al., 2003 [58] |
VAS pain, 100-mm scale (0=worst, 100=best possible) |
CBD THC CBD:THC |
2.5mg-120.0mg/d | Daily | 20 20 20 |
54.8 (22.6) 54.6 (27.4) 51.3 (27.0) |
20 | 44.5 (22.7) | 0.46 (22.6) [-0.18-0.43] 0.40 (25.1) [-0.37-2.02] 0.27(24.9) [-0.36-0.89] |
0.45 (↓) 0.39 (↓) 0.27 (↓) |
|||||||||||
| VAS pain, 11-point scale | CBD THC CBD:THC |
2wks | 20 20 20 |
3.8 (2.9) 3.5 (2.8) 3.9 (2.9) |
20 | 4.4 (3.2) | -0.20 (3.05) [-0.81-0.43] -0.90 (1.70) [-0.37-2.02] -0.16 (3.05) [-0.78-0.46] |
0.19 (↓) 0.82 (↓) 0.16 (↓) |
|||||||||||||
| Wilsey et al., 2008 [59] |
VAS pain intensity, 11-point scale | 3.5% THC 7% THC |
9 puffs | 1, 2, 3, 4, 5, 6 hrs | 36 34 |
NR NR |
33 | NR | Insufficient data | Insufficient data | |||||||||||
| Rintala et al., 2010 [57] |
Brief Pain Inventory, 11-point scale | Dronabinol | 5.0-20.0mg/d | 4wks | 7 | -0.27 (0.84) | 5 | -1.80 (2.49) | 0.90 (1.70) [-0.37-2.02] | 0.83 | |||||||||||
| Wilsey et al., 2016 [60] |
VAS pain, 100-mm scale (0=worst, 100=best possible) |
2.9% THC 6.7% THC |
4-8 puffs | 1, 2, 3, 4, 5, 6 hrs | 42 42 |
NR NR |
42 | NR | Insufficient data | Insufficient data | |||||||||||
| Spasticity | Wade et al., 2003 [58] |
NRS spasms, 100-mm scale (0=worst, 100=best possible) |
CBD THC CBD:THC |
2.5mg-120.0mg/d | Daily | 20 20 20 |
54.6 (19.1) 58.4 (22.3) 55.8 (24.4) |
20 | 47.3 (22.6) | 0.35 (20.9) [-0.28-0.97] 0.49 (22.4) [-0.14-1.11] 0.36 (23.5) [-0.27-0.98] |
0.34 (↓) 0.48 (↓) 0.35 (↓) |
||||||||||
| NRS spasticity, 100-mm scale (0=worst, 100=best possible) |
CBD THC CBD:THC |
20 20 20 |
47.8 (18.5) 57.3 (22.2) 43.8 (15.6) |
20 | 42.3 (18.1) | 0.30 (18.3) [-0.33-0.92] 0.74 (20.3) [0.09-1.37] 0.09 (16.9) [0.71-0.08] |
0.29 (↓) 0.75 (↓) 0.09 (↓) |
||||||||||||||
| Spasticity severity, 11-point scale | CBD THC CBD:THC |
2wk | 20 20 20 |
3.8 (2.0) 3.8 (2.0) 4.1 (1.8) |
20 | 5.4 (2.3) | -0.74 (2.15) [-1.37-(-0.09)] -0.74 (2.15) [-1.37-(-0.09)] -0.63 (2.07) [-1.25-(-0.57)] |
0.73 (↓) 0.73 (↓) 0.62 (↓) |
|||||||||||||
| Outcome | Author, Year | Outcome Measure | Group | Dose | Follow-up Times | Treatment | Control | ||||||||||||||
| n | Mean* | n | Mean* | Effect size (d)** [CI] | |Hedges| (Δ) | ||||||||||||||||
| - | Spasticity frequency, per day |
CBD THC CBD:THC |
20 20 20 |
4.6 (2.2) 3.4 (1.8) 3.6 (1.6) |
20 | 4.9 (2.5) | -0.36 (2.25) [-0.97-0.28] -0.97 (2.07) [-1.60-(-0.30)] -0.91 (1.98) [-1.54-(-0.24)] |
0.35 (↓) 0.95 (↓) 0.89 (↓) |
|||||||||||||
| AS | CBD THC CBD:THC |
20 20 20 |
1.7 (1.2) 1.8 (1.2) 1.7 (1.1) |
20 | 1.7 (1.0) | 0.00 (1.10) [-0.62-0.62] 0.09 (1.10) [-0.53-0.71] 0.00 (1.05) [-0.62-0.62] |
0.00 0.09 0.00 |
||||||||||||||
| Hagenbach et al., 2007 [55] |
MAS | Oral THC | (2.5mg, 5.0mg, 10.0mg |
1hr | 6 | 7.57 (7.37) | 7 | 12.00 (6.11) | -0.66 (6.71) [-1.73-0.50] | 0.61 (↓) | |||||||||||
| Pooyania et al., 2010 [77] |
AS – most involved group | Nabilone | 0.5-1.0mg/d | 4wk | 11 | 6.45 | 11 | 7.45 | Insufficient data | Insufficient data | |||||||||||
| AS – 8 muscle groups | Nabilone | 11 | 26.9 | 11 | 29.45 | Insufficient data | Insufficient data | ||||||||||||||
| VAS spasticity, 100-mm scale (0=no spasticity, 100=most spasticity) |
Nabilone | 11 | 44.09 | 11 | 53.18 | Insufficient data | Insufficient data | ||||||||||||||
| Spasm frequency scale | Nabilone | 11 | 3.45 | 11 | 3.45 | Insufficient data | Insufficient data | ||||||||||||||
| Wilsey et al., 2016 [60] |
Spasticity severity scale 11-point | 2.9% THC 6.7% THC |
4-8 puffs | 1, 2, 3, 4, 5, 6 hrs | 42 42 |
NR NR |
42 | NR | Insufficient data | Insufficient data | |||||||||||
Abbreviations: AS: Ashworth Scale, CBD: cannabidiol, MAS: modified Ashworth Scale, THC: tetrahydrocannabinol, VAS: visual analog scale, VRS: verbal rating scale, ↓: decrease. *Mean (SD), if not indicated otherwise. **Based on mean difference scores of intervention vs control group; see formula below [39]. Δ outcome change from baseline.
CG: Control Group, ES: Effect Size, M: Mean, N: number, SD: Standard Deviation, t= Time Point, TG: Treatment Group, μweighted: weighted mean, w: Weights, x: Value