Cannabinoids for treating neurogenic lower urinary tract dysfunction in patients with multiple sclerosis: a systematic review and meta-analysis.

Autor: Abo Youssef N; Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Schneider MP; Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.; Brain Research Institute, University of Zürich, Zürich, Switzerland.; Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland., Mordasini L; Department of Urology, Cantonal Hospital Lucerne, Lucerne, Switzerland., Ineichen BV; Brain Research Institute, University of Zürich, Zürich, Switzerland.; Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland., Bachmann LM; Medignition Inc., Research Consultants, Zürich, Switzerland., Chartier-Kastler E; Department of Urology, Academic Hospital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Pierre et Marie Curie Medical School, Sorbonne Universités, Paris 6 University, Paris, France., Panicker JN; Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, UK., Kessler TM; Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
Jazyk: angličtina
Zdroj: BJU international [BJU Int] 2017 Apr; Vol. 119 (4), pp. 515-521. Date of Electronic Publication: 2017 Feb 23.
DOI: 10.1111/bju.13759
Abstrakt: Objectives: To review systematically all the available evidence on efficacy and safety of cannabinoids for treating neurogenic lower urinary tract dysfunction (NLUTD) in patients with multiple sclerosis (MS).
Patients and Methods: The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by electronic search of the Cochrane register, Embase, Medline, Scopus (last search on 11 November 2016).
Results: After screening 8 469 articles, we included two randomized controlled trials and one open-label study, in which a total of 426 patients were enrolled. Cannabinoids relevantly decreased the number of incontinence episodes in all three studies. Pooling data showed the mean difference in incontinence episodes per 24 h to be -0.35 (95% confidence interval -0.46 to -0.24). Mild adverse events were frequent (38-100%), but only two patients (0.7%) reported a serious adverse event.
Conclusions: Preliminary data imply that cannabinoids might be an effective and safe treatment option for NLUTD in patients with MS; however, the evidence base is poor and more high-quality, well-designed and adequately powered and sampled studies are urgently needed to reach definitive conclusions.
(© 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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