Retrospective study links add-on CBD with sustained seizure reduction in…

Use of purified cannabidiol as add-on therapy in children with non-self-limited focal epilepsies of childhood: A multicenter study.

Epilepsy & behavior : E&B • • Highly Relevant
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AI Summary

This retrospective multicenter study asked whether add-on purified CBD was associated with long-term seizure reduction and acceptable tolerability in children with treatment-resistant non-self-limited focal epilepsies. It analyzed 79 children treated at 11 pediatric neurology centers in Argentina and Chile; all had previously received at least four antiseizure medications. There was no comparison group, and follow-up averaged 30 months. At follow-up, 43 of 79 children (54.4%) had at least a 50% reduction in seizure frequency, including four who became seizure-free. The reported response remained stable at measured follow-up points through 30 months.

Adverse events occurred in 23 children (29.1%), were mostly mild and transient, and were generally managed with dose adjustments; drowsiness was most common, and no serious treatment-related events were reported. The study also reported improved interictal EEG abnormalities among seizure responders, while response rates did not differ significantly between children with and without tuberous sclerosis complex. Because this was a retrospective study without a control group, it cannot establish that CBD caused the improvements. This is an abstract-based summary; the abstract does not provide the full study methods or enough information to assess all potential sources of bias.

💡 Key Findings

1
After an average of 30 months, 43 of 79 children (54.4%) had at least a 50% reduction in seizure frequency with add-on purified CBD; four became seizure-free.
Good
65%
2
The reported seizure response remained stable at follow-up points through 30 months.
Good
60%
3
Adverse events occurred in 23 children (29.1%) and were predominantly mild and transient; drowsiness was most common, and no serious treatment-related events were reported.
Good
65%
4
The retrospective study had no comparison group, so it shows an association and cannot establish that CBD caused the seizure reductions.
High
95%

📄 Original Abstract

OBJECTIVE: Evidence for purified cannabidiol (CBD) in children with treatment-resistant non-self-limited focal epilepsies (non-SeLFEs) remains limited. We evaluated its long-term effectiveness and tolerability in a multicenter pediatric cohort. METHODS: We retrospectively analyzed 79 children with treatment-resistant non-SeLFEs treated with adjunctive purified CBD at 11 pediatric neurology centers in Argentina and Chile. All had previously received ≥ 4 ASMs. CBD dosing was individualized according to response and tolerability. Outcomes included changes in seizure frequency and interictal EEG abnormalities, and treatment tolerability. RESULTS: After a mean follow-up of 30 months (range, 6-44), 43/79 patients (54.4 %) achieved a ≥ 50 % reduction in seizure frequency, including four (5.1 %) who became seizure-free. The mean CBD dose was 34 mg/kg/day (range, 10-40). Response remained stable at 12, 18, 24, and 30 months. Responder rates did not differ significantly between patients with TSC and those with non-TSC focal epilepsies. No significant associations were found between response and seizure type, age at seizure onset, epilepsy duration, age at CBD initiation, or concomitant ASMs. Interictal epileptiform abnormalities improved among responders. Adverse events occurred in 23 patients (29.1 %), were predominantly mild and transient, and were generally manageable with dose adjustments; drowsiness was the most common. No serious treatment-related adverse events occurred. CONCLUSION: Adjunctive purified CBD was associated with sustained seizure reduction and good long-term tolerability in children with treatment-resistant non-SeLFEs. Responses were observed across different focal epilepsy etiologies, supporting further evaluation of CBD in this population. Individualized dosing according to response and tolerability may be appropriate in this heterogeneous population.

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