Cannabinoids to Improve Health-Related Quality of Life in Patients with Neurological or Oncological Disease: A Meta-Analysis

Vera Belgers; Jantine G Röttgering; Linda Douw; Martin Klein; Johannes C F Ket; Peter M van de Ven; Thomas Würdinger; Myra E van Linde; Johanna M Niers; Markus Weber; Marcel G Olde Rikkert; Jose Lopez-Sendon; Oscar Arrieta; Kristina B Svendsen; Marcos H N Chagas; Carlos M O de Almeida; Mathilde C M Kouwenhoven; Philip C de Witt Hamer

doi:10.1089/can.2021.0187

Cannabinoids to Improve Health-Related Quality of Life in Patients with Neurological or Oncological Disease: A Meta-Analysis

Vera Belgers, Jantine G Röttgering, Linda Douw, Martin Klein, Johannes C F Ket, Peter M van de Ven, Thomas Würdinger, Myra E van Linde, Johanna M Niers, Markus Weber, Marcel G Olde Rikkert, Jose Lopez-Sendon, Oscar Arrieta, Kristina B Svendsen, Marcos H N Chagas, Carlos M O de Almeida, Mathilde C M Kouwenhoven, Philip C de Witt Hamer

Department of Clinical Medicine

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Abstract

Background: Cannabinoids have been suggested to alleviate frequently experienced symptoms of reduced mental well-being such as anxiety and depression. Mental well-being is an important subdomain of health-related quality of life (HRQoL). Reducing symptoms and maintaining HRQoL are particularly important in malignant primary brain tumor patients, as treatment options are often noncurative and prognosis remains poor. These patients frequently report unprescribed cannabinoid use, presumably for symptom relieve. As studies on brain tumor patients specifically are lacking, we performed a meta-analysis of the current evidence on cannabinoid efficacy on HRQoL and mental well-being in oncological and neurological patients. Methods: We performed a systematic PubMed, PsychINFO, Embase, and Web of Science search according to PRISMA guidelines on August 2 and 3, 2021. We included randomized controlled trials (RCTs) that assessed the effects of tetrahydrocannabinol (THC) or cannabidiol (CBD) on general HRQoL and mental well-being. Pooled effect sizes were calculated using Hedges g. Risk of bias of included studies was assessed using Cochrane's Risk of Bias tool. Results: We included 17 studies: 4 in oncology and 13 in central nervous system (CNS) disease. Meta-analysis showed no effect of cannabinoids on general HRQoL (g=-0.02 confidence interval [95% CI -0.11 to 0.06]; p=0.57) or mental well-being (g=-0.02 [95% CI -0.16 to 0.13]; p=0.81). Conclusions: RCTs in patients with cancer or CNS disease showed no effect of cannabinoids on HRQoL or mental well-being. However, studies were clinically heterogeneous and since many glioma patients currently frequently use cannabinoids, future studies are necessary to evaluate its value in this specific population.

Original language	English
Journal	Cannabis and cannabinoid research
Volume	8
Issue	1
Pages (from-to)	41-55
Number of pages	15
ISSN	2378-8763
DOIs	https://doi.org/10.1089/can.2021.0187
Publication status	Published - Feb 2023

Keywords

Humans
Cannabinoids
Quality of Life
Dronabinol/adverse effects
Cannabidiol/adverse effects
Anxiety
cannabidiol
anxiety
brain tumors
Δ9-tetrahydrocannabinol
glioma
depression

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Belgers, V., Röttgering, J. G., Douw, L., Klein, M., Ket, J. C. F., van de Ven, P. M., Würdinger, T., van Linde, M. E., Niers, J. M., Weber, M., Olde Rikkert, M. G., Lopez-Sendon, J., Arrieta, O., Svendsen, K. B., Chagas, M. H. N., de Almeida, C. M. O., Kouwenhoven, M. C. M., & de Witt Hamer, P. C. (2023). Cannabinoids to Improve Health-Related Quality of Life in Patients with Neurological or Oncological Disease: A Meta-Analysis. Cannabis and cannabinoid research, 8(1), 41-55. https://doi.org/10.1089/can.2021.0187

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title = "Cannabinoids to Improve Health-Related Quality of Life in Patients with Neurological or Oncological Disease: A Meta-Analysis",

abstract = "Background: Cannabinoids have been suggested to alleviate frequently experienced symptoms of reduced mental well-being such as anxiety and depression. Mental well-being is an important subdomain of health-related quality of life (HRQoL). Reducing symptoms and maintaining HRQoL are particularly important in malignant primary brain tumor patients, as treatment options are often noncurative and prognosis remains poor. These patients frequently report unprescribed cannabinoid use, presumably for symptom relieve. As studies on brain tumor patients specifically are lacking, we performed a meta-analysis of the current evidence on cannabinoid efficacy on HRQoL and mental well-being in oncological and neurological patients. Methods: We performed a systematic PubMed, PsychINFO, Embase, and Web of Science search according to PRISMA guidelines on August 2 and 3, 2021. We included randomized controlled trials (RCTs) that assessed the effects of tetrahydrocannabinol (THC) or cannabidiol (CBD) on general HRQoL and mental well-being. Pooled effect sizes were calculated using Hedges g. Risk of bias of included studies was assessed using Cochrane's Risk of Bias tool. Results: We included 17 studies: 4 in oncology and 13 in central nervous system (CNS) disease. Meta-analysis showed no effect of cannabinoids on general HRQoL (g=-0.02 confidence interval [95% CI -0.11 to 0.06]; p=0.57) or mental well-being (g=-0.02 [95% CI -0.16 to 0.13]; p=0.81). Conclusions: RCTs in patients with cancer or CNS disease showed no effect of cannabinoids on HRQoL or mental well-being. However, studies were clinically heterogeneous and since many glioma patients currently frequently use cannabinoids, future studies are necessary to evaluate its value in this specific population.",

keywords = "Humans, Cannabinoids, Quality of Life, Dronabinol/adverse effects, Cannabidiol/adverse effects, Anxiety, cannabidiol, anxiety, brain tumors, Δ9-tetrahydrocannabinol, glioma, depression",

author = "Vera Belgers and R{\"o}ttgering, {Jantine G} and Linda Douw and Martin Klein and Ket, {Johannes C F} and {van de Ven}, {Peter M} and Thomas W{\"u}rdinger and {van Linde}, {Myra E} and Niers, {Johanna M} and Markus Weber and {Olde Rikkert}, {Marcel G} and Jose Lopez-Sendon and Oscar Arrieta and Svendsen, {Kristina B} and Chagas, {Marcos H N} and {de Almeida}, {Carlos M O} and Kouwenhoven, {Mathilde C M} and {de Witt Hamer}, {Philip C}",

year = "2023",

month = feb,

doi = "10.1089/can.2021.0187",

language = "English",

volume = "8",

pages = "41--55",

journal = "Cannabis and cannabinoid research",

issn = "2378-8763",

publisher = "Mary Ann Liebert Inc.",

number = "1",

}

Belgers, V, Röttgering, JG, Douw, L, Klein, M, Ket, JCF, van de Ven, PM, Würdinger, T, van Linde, ME, Niers, JM, Weber, M, Olde Rikkert, MG, Lopez-Sendon, J, Arrieta, O, Svendsen, KB, Chagas, MHN, de Almeida, CMO, Kouwenhoven, MCM & de Witt Hamer, PC 2023, 'Cannabinoids to Improve Health-Related Quality of Life in Patients with Neurological or Oncological Disease: A Meta-Analysis', Cannabis and cannabinoid research, vol. 8, no. 1, pp. 41-55. https://doi.org/10.1089/can.2021.0187

Cannabinoids to Improve Health-Related Quality of Life in Patients with Neurological or Oncological Disease: A Meta-Analysis. / Belgers, Vera; Röttgering, Jantine G; Douw, Linda et al.
In: Cannabis and cannabinoid research, Vol. 8, No. 1, 02.2023, p. 41-55.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Review › Research › peer-review

TY - JOUR

T1 - Cannabinoids to Improve Health-Related Quality of Life in Patients with Neurological or Oncological Disease

T2 - A Meta-Analysis

AU - Belgers, Vera

AU - Röttgering, Jantine G

AU - Douw, Linda

AU - Klein, Martin

AU - Ket, Johannes C F

AU - van de Ven, Peter M

AU - Würdinger, Thomas

AU - van Linde, Myra E

AU - Niers, Johanna M

AU - Weber, Markus

AU - Olde Rikkert, Marcel G

AU - Lopez-Sendon, Jose

AU - Arrieta, Oscar

AU - Svendsen, Kristina B

AU - Chagas, Marcos H N

AU - de Almeida, Carlos M O

AU - Kouwenhoven, Mathilde C M

AU - de Witt Hamer, Philip C

PY - 2023/2

Y1 - 2023/2

N2 - Background: Cannabinoids have been suggested to alleviate frequently experienced symptoms of reduced mental well-being such as anxiety and depression. Mental well-being is an important subdomain of health-related quality of life (HRQoL). Reducing symptoms and maintaining HRQoL are particularly important in malignant primary brain tumor patients, as treatment options are often noncurative and prognosis remains poor. These patients frequently report unprescribed cannabinoid use, presumably for symptom relieve. As studies on brain tumor patients specifically are lacking, we performed a meta-analysis of the current evidence on cannabinoid efficacy on HRQoL and mental well-being in oncological and neurological patients. Methods: We performed a systematic PubMed, PsychINFO, Embase, and Web of Science search according to PRISMA guidelines on August 2 and 3, 2021. We included randomized controlled trials (RCTs) that assessed the effects of tetrahydrocannabinol (THC) or cannabidiol (CBD) on general HRQoL and mental well-being. Pooled effect sizes were calculated using Hedges g. Risk of bias of included studies was assessed using Cochrane's Risk of Bias tool. Results: We included 17 studies: 4 in oncology and 13 in central nervous system (CNS) disease. Meta-analysis showed no effect of cannabinoids on general HRQoL (g=-0.02 confidence interval [95% CI -0.11 to 0.06]; p=0.57) or mental well-being (g=-0.02 [95% CI -0.16 to 0.13]; p=0.81). Conclusions: RCTs in patients with cancer or CNS disease showed no effect of cannabinoids on HRQoL or mental well-being. However, studies were clinically heterogeneous and since many glioma patients currently frequently use cannabinoids, future studies are necessary to evaluate its value in this specific population.

AB - Background: Cannabinoids have been suggested to alleviate frequently experienced symptoms of reduced mental well-being such as anxiety and depression. Mental well-being is an important subdomain of health-related quality of life (HRQoL). Reducing symptoms and maintaining HRQoL are particularly important in malignant primary brain tumor patients, as treatment options are often noncurative and prognosis remains poor. These patients frequently report unprescribed cannabinoid use, presumably for symptom relieve. As studies on brain tumor patients specifically are lacking, we performed a meta-analysis of the current evidence on cannabinoid efficacy on HRQoL and mental well-being in oncological and neurological patients. Methods: We performed a systematic PubMed, PsychINFO, Embase, and Web of Science search according to PRISMA guidelines on August 2 and 3, 2021. We included randomized controlled trials (RCTs) that assessed the effects of tetrahydrocannabinol (THC) or cannabidiol (CBD) on general HRQoL and mental well-being. Pooled effect sizes were calculated using Hedges g. Risk of bias of included studies was assessed using Cochrane's Risk of Bias tool. Results: We included 17 studies: 4 in oncology and 13 in central nervous system (CNS) disease. Meta-analysis showed no effect of cannabinoids on general HRQoL (g=-0.02 confidence interval [95% CI -0.11 to 0.06]; p=0.57) or mental well-being (g=-0.02 [95% CI -0.16 to 0.13]; p=0.81). Conclusions: RCTs in patients with cancer or CNS disease showed no effect of cannabinoids on HRQoL or mental well-being. However, studies were clinically heterogeneous and since many glioma patients currently frequently use cannabinoids, future studies are necessary to evaluate its value in this specific population.

KW - Humans

KW - Cannabinoids

KW - Quality of Life

KW - Dronabinol/adverse effects

KW - Cannabidiol/adverse effects

KW - Anxiety

KW - cannabidiol

KW - anxiety

KW - brain tumors

KW - Δ9-tetrahydrocannabinol

KW - glioma

KW - depression

UR - http://www.scopus.com/inward/record.url?scp=85148752307&partnerID=8YFLogxK

U2 - 10.1089/can.2021.0187

DO - 10.1089/can.2021.0187

M3 - Review

C2 - 35861789

SN - 2378-8763

VL - 8

SP - 41

EP - 55

JO - Cannabis and cannabinoid research

JF - Cannabis and cannabinoid research

IS - 1

ER -

Cannabinoids to Improve Health-Related Quality of Life in Patients with Neurological or Oncological Disease: A Meta-Analysis

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