Safety and Efficacy of Cannabidiol Versus First-Line Anti-Epileptic Drugs (AEDS) of the Treatment of Dravet Syndrome: A Systematic Review and Meta-Analysis

OBJECTIVES:

To evaluate and compare the safety and efficacy profiles of cannabidiol with first-line antiepileptics (clobazam, valproic acid and topiramate) for Dravet Syndrome

METHODS:

This systematic review included all randomized control trials representing the following, criteria: patients with medical history to support the clinical diagnosis of DS, aged 2-60 years (infants, children, and adolescents), participants on first-line antiepileptic agents or cannabidiol as monotherapy for a minimum 4-week period, and subjects with a minimum of a one-month drug-free period before initiating the drug therapy under study.

RESULTS:

Six studies were finalized from the retrieved 1845 after systematic search and screening. It included a total of 501 patients. CBD showed more efficacy when compared to placebo. Throughout the trial, there was a higher incidence of treatment-emergent adverse events in the CBD group when compared to the placebo and they demonstrated that CBD along with first line antiepileptics was better in reducing seizure frequency, with an overall risk ratio (RR=2.07) at 95% confidence interval of 1.55-2.77.

CONCLUSIONS:

Add-on cannabidiol (CBD) with conventional treatment for DS showed a greater reduction in all types of seizure frequencies from baseline when compared to placebo. Overall, CBD had a greater efficacy as an adjuvant and was well tolerated by the subjects with no death reports.