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BJU Int. 2017 Apr;119(4):515-521. doi: 10.1111/bju.13759. Epub 2017 Feb 23.

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

Author information

1
Neuro-Urology, Spinal Cord Injury Center and Research, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
2
Brain Research Institute, University of Zürich, Zürich, Switzerland.
3
Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland.
4
Department of Urology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
5
Medignition Inc., Research Consultants, Zürich, Switzerland.
6
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.
7
Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology, London, UK.

Abstract

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.

KEYWORDS:

cannabinoids; meta-analysis; multiple sclerosis; neuro-urology; neurogenic lower urinary tract dysfunction; systematic review

PMID:
28058780
DOI:
10.1111/bju.13759
[Indexed for MEDLINE]
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