Efficacy of medicinal cannabis for appetite-related symptoms in people with cancer: A systematic review.

Razmovski-Naumovski, V; Luckett, T; Amgarth-Duff, I; Agar, MR

Efficacy of medicinal cannabis for appetite-related symptoms in people with cancer: A systematic review.

Razmovski-Naumovski, V Luckett, T

Amgarth-Duff, I Agar, MR

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Publisher:: SAGE Publications
Publication Type:: Journal Article
Citation:: Palliative Medicine, 2022, 36, (6), pp. 912-927
Issue Date:: 2022-06

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Field	Value	Language
dc.contributor.author	Razmovski-Naumovski, V
dc.contributor.author	Luckett, T https://orcid.org/0000-0001-6121-5409
dc.contributor.author	Amgarth-Duff, I
dc.contributor.author	Agar, MR
dc.date.accessioned	2022-09-29T06:12:37Z
dc.date.available	2022-09-29T06:12:37Z
dc.date.issued	2022-06
dc.identifier.citation	Palliative Medicine, 2022, 36, (6), pp. 912-927
dc.identifier.issn	0269-2163
dc.identifier.issn	1477-030X
dc.identifier.uri	http://hdl.handle.net/10453/162175
dc.description.abstract	BACKGROUND: Anorexia (loss of appetite) is a prevalent and distressing symptom in people with cancer, with limited effective interventions. Medicinal cannabis has shown promise in improving appetite-related symptoms in people with cancer. AIM: To assess the efficacy of medicinal cannabis for improving appetite-related symptoms in people with cancer, considering measures and outcomes, interventions and toxicity. DESIGN: Systematic review with narrative approach to synthesis and meta-analysis. DATA SOURCES: Databases (MEDLINE, CINAHL, CENTRAL), websites and trials registries were searched from inception to February 2021. Included studies were randomised controlled trials (RCT) in English peer-reviewed journals comparing medicinal cannabis with placebo and/or another intervention. Study quality was assessed using the Cochrane risk of bias tool. RESULTS: Five studies were included that compared medicinal cannabis interventions (dronabinol, nabilone and cannabis extract) either with placebo (n = 4) or megestrol acetate (n = 1). Measures and trial endpoints varied, but efficacy was demonstrated in one trial only, in which dronabinol significantly improved chemosensory perception and other secondary outcomes (taste of food, premeal appetite, proportion of calories consumed as protein) compared with placebo. Cannabis interventions were generally well tolerated across studies, regardless of the product or dose, although the comprehensive measurement of toxicities was limited. CONCLUSION: Evidence from RCTs that medicinal cannabis increases appetite in people with cancer is limited. Measures, outcomes and interventions were variable, and toxicities have not been comprehensively evaluated. Future research should carefully consider biological mechanisms to guide more nuanced selection of endpoints and interventions, including product, dose and administration.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SAGE Publications
dc.relation.ispartof	Palliative Medicine
dc.relation.isbasedon	10.1177/02692163221083437
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
dc.subject.classification	Gerontology
dc.subject.mesh	Analgesics
dc.subject.mesh	Appetite
dc.subject.mesh	Cannabis
dc.subject.mesh	Dronabinol
dc.subject.mesh	Humans
dc.subject.mesh	Medical Marijuana
dc.subject.mesh	Neoplasms
dc.subject.mesh	Analgesics
dc.subject.mesh	Appetite
dc.subject.mesh	Cannabis
dc.subject.mesh	Dronabinol
dc.subject.mesh	Humans
dc.subject.mesh	Medical Marijuana
dc.subject.mesh	Neoplasms
dc.subject.mesh	Humans
dc.subject.mesh	Cannabis
dc.subject.mesh	Neoplasms
dc.subject.mesh	Analgesics
dc.subject.mesh	Appetite
dc.subject.mesh	Dronabinol
dc.subject.mesh	Medical Marijuana
dc.title	Efficacy of medicinal cannabis for appetite-related symptoms in people with cancer: A systematic review.
dc.type	Journal Article
utslib.citation.volume	36
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
utslib.for	1199 Other Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2022-09-29T06:12:36Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	36
utslib.citation.issue	6

Abstract:

BACKGROUND: Anorexia (loss of appetite) is a prevalent and distressing symptom in people with cancer, with limited effective interventions. Medicinal cannabis has shown promise in improving appetite-related symptoms in people with cancer. AIM: To assess the efficacy of medicinal cannabis for improving appetite-related symptoms in people with cancer, considering measures and outcomes, interventions and toxicity. DESIGN: Systematic review with narrative approach to synthesis and meta-analysis. DATA SOURCES: Databases (MEDLINE, CINAHL, CENTRAL), websites and trials registries were searched from inception to February 2021. Included studies were randomised controlled trials (RCT) in English peer-reviewed journals comparing medicinal cannabis with placebo and/or another intervention. Study quality was assessed using the Cochrane risk of bias tool. RESULTS: Five studies were included that compared medicinal cannabis interventions (dronabinol, nabilone and cannabis extract) either with placebo (n = 4) or megestrol acetate (n = 1). Measures and trial endpoints varied, but efficacy was demonstrated in one trial only, in which dronabinol significantly improved chemosensory perception and other secondary outcomes (taste of food, premeal appetite, proportion of calories consumed as protein) compared with placebo. Cannabis interventions were generally well tolerated across studies, regardless of the product or dose, although the comprehensive measurement of toxicities was limited. CONCLUSION: Evidence from RCTs that medicinal cannabis increases appetite in people with cancer is limited. Measures, outcomes and interventions were variable, and toxicities have not been comprehensively evaluated. Future research should carefully consider biological mechanisms to guide more nuanced selection of endpoints and interventions, including product, dose and administration.

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http://hdl.handle.net/10453/162175