Publication Abstract Display
Type: Published Manuscript
Title: Inhaled cannabis for chronic neuropathic pain: An individual patient data meta-analysis.
Authors: Andreae MH, Carter GM, Shaparin N, Suslov K, Ellis RJ, Ware MA, Abrams DI, Prasad H, Wilsey B, Indyk D, Johnson M, Sacks HS
Year: 2015
Publication: The Journal of Pain
Volume: 16 Issue: 12 Pages: 1221-1232
Abstract:Chronic neuropathic pain, the most frequent condition affecting the peripheral nervous system, remains under-diagnosed and difficult to treat. Inhaled cannabis may alleviate chronic neuropathic pain. Our objective was to synthesize the evidence on inhaled cannabis for chronic neuropathic pain. We performed a systematic review and an individual patient data meta-analysis. We registered our protocol with PROSPERO CRD42011001182. We searched in Cochrane Central, PubMed, EMBASE and AMED. We considered all randomized controlled trials investigating chronic painful neuropathy and comparing inhaled cannabis to placebo. We pooled treatment effects following a hierarchical random-effects Bayesian responder model for the population averaged subject specific effect. Our evidence synthesis of individual patient data from 178 participants with 405 observed responses in five randomized controlled trials following patients for days to weeks and provides evidence that inhaled cannabis results in short term reductions in chronic neuropathic pain for one in every five to six patients treated (NNT 5.6 with a Bayesian 95% credible interval ranging between 3.4 and 14). Our inferences were insensitive to model assumptions, priors and parameter choices. We caution that small number of included studies and participants, the short follow-up, shortcomings in allocation concealment and considerable attrition limit the conclusions that can be drawn from the review. The Bayes factor is 332 corresponding to a posterior probability of effect of 99.7%.

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