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. 2022 May 5;2022(5):CD013444. doi: 10.1002/14651858.CD013444.pub2

Comparison 1. Cannabis and cannabinoids versus placebo.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Spasticity: number of participants reporting reduction of 30% in the spasticity NRS (follow up 6‐14 weeks) 5 1143 Odds Ratio (M‐H, Random, 95% CI) 2.51 [1.56, 4.04]
1.2 Spasticity: NRS as continuous outcome (follow up 2‐14 weeks) 7 1262 Mean Difference (IV, Random, 95% CI) ‐0.55 [‐0.94, ‐0.17]
1.3 Pain: number of participants reporting pain relief of 50% or greater in the NRS‐PI (follow up 3 weeks) 1 48 Odds Ratio (M‐H, Fixed, 95% CI) 4.23 [1.11, 16.17]
1.4 Pain: NRS‐PI as continuous outcome (follow up 3‐16 weeks) 8 1451 Mean Difference (IV, Random, 95% CI) ‐0.54 [‐0.91, ‐0.18]
1.5 Withdrawn due to adverse events (follow up 3‐48 weeks) 19 3110 Odds Ratio (M‐H, Random, 95% CI) 2.41 [1.51, 3.84]
1.6 PGIC: number of participants reporting much or very much improvement in the PGIC (follow up 4‐48 weeks) 8 1215 Odds Ratio (M‐H, Random, 95% CI) 1.80 [1.37, 2.36]
1.7 Health related quality of life: change score from baseline (follow up  3‐48 weeks) 8 1942 Std. Mean Difference (IV, Random, 95% CI) ‐0.08 [‐0.17, 0.02]
1.8 Health related quality of life:  change score from baseline for each domain of SF‐36 (follow up 12‐14 weeks) 4   Mean Difference (IV, Random, 95% CI) Subtotals only
1.8.1 Physical functioning 4   Mean Difference (IV, Random, 95% CI) ‐0.13 [‐2.05, 1.80]
1.8.2 Role physical 3   Mean Difference (IV, Random, 95% CI) ‐0.28 [‐3.18, 2.63]
1.8.3 Bodily pain 3   Mean Difference (IV, Random, 95% CI) 4.24 [0.07, 8.40]
1.8.4 General health 3   Mean Difference (IV, Random, 95% CI) ‐0.12 [‐2.53, 2.29]
1.8.5 Vitality 3   Mean Difference (IV, Random, 95% CI) 1.38 [‐2.85, 5.62]
1.8.6 Social functioning 3   Mean Difference (IV, Random, 95% CI) ‐1.39 [‐6.78, 4.01]
1.8.7 Role emotion 3   Mean Difference (IV, Random, 95% CI) ‐2.09 [‐5.50, 1.32]
1.8.8 Mental health 4   Mean Difference (IV, Random, 95% CI) 0.41 [‐1.69, 2.50]
1.9 SAEs: number of participants with SAEs (follow up 3‐48 weeks) 20 3124 Odds Ratio (M‐H, Random, 95% CI) 1.38 [0.96, 1.99]
1.10 Specific AEs: number of participants reporting nervous system disorders (follow up 4‐48 weeks) 7 1154 Odds Ratio (M‐H, Random, 95% CI) 2.61 [1.53, 4.44]
1.11 Specific AEs: number of participants reporting psychiatric disorders (follow up 4‐48 weeks) 6 1122 Odds Ratio (M‐H, Fixed, 95% CI) 1.94 [1.31, 2.88]
1.12 Specific AEs: number of participants reporting drug tolerance (follow up 14‐48 weeks) 2 458 Odds Ratio (M‐H, Fixed, 95% CI) 3.07 [0.12, 75.95]
1.13 Spasticity: Ashworth or Modified Ashworth (follow up 2‐50 weeks) 11 1777 Mean Difference (IV, Random, 95% CI) ‐0.23 [‐0.44, ‐0.03]
1.14 Fatigue as continuous outcome (follow up 4‐14 weeks) 5 928 Std. Mean Difference (IV, Random, 95% CI) 0.04 [‐0.26, 0.34]
1.15 Sleep quality: NRS as continuous outcome (follow up 4‐14 weeks) 7 1205 Mean Difference (IV, Random, 95% CI) ‐0.66 [‐1.10, ‐0.22]
1.16 Sleep quality: number of participants reporting an improvement in the NRS sleep (follow up 6‐14 weeks) 2 756 Odds Ratio (M‐H, Random, 95% CI) 1.79 [1.30, 2.46]
1.17 Depression: Beck Depression Inventory as continuous outcome 3 495 Mean Difference (IV, Random, 95% CI) 0.17 [‐0.90, 1.24]
1.18 Activities of daily living: Barthel index as continuous outcome  4 1134 Mean Difference (IV, Random, 95% CI) ‐0.08 [‐0.32, 0.16]
1.19 Number of caregivers reporting improvement on the CGIC (follow up 4‐48 weeks) 4 582 Odds Ratio (M‐H, Random, 95% CI) 1.66 [1.15, 2.41]