Efficacy of Cannabinoids on Parkinson’s Disease: An Updated Meta-analysis of Randomized Controlled Trials
Mark Messak1, Ahmed Abdelmageed2, Ahmed Noureldeen Abbas3, Youssef Mandour2, Ahmed Talkhan2, Mahmoud Fadel Eltohami4, Dua’a Kanaan5, Fawaz K. Alfahmi6, Habiba Tariq Saeed7, Lara Hamzeh Hamzeh8, Lamees taman7, Khaled M.H Mohamed9, Ahmed Negida10
1Faculty of Medicine, Helwan University, 2Faculty of Medicine, Mansoura University, 3Faculty of Medicine, Minia University, 4Medical Institute of Tambov State University Named After G.R. Derzhavin, 5School of Medicine, The University of Jordan, 6College of Medicine, Taif University, 7Faculty of Medicine, Tanta University, 8Caucasus International University, 9Pharmaceutical Sciences Department, College of Health and Human Sciences, North Dakota State University, 10Virginia Commonwealth University
Objective:

To provide an updated evaluation examining the therapeutic effect of cannabinoids (CBD) on Parkinson's disease (PD) patients.

Background:

Although levodopa has been a cornerstone of PD treatment for years, it provides only symptomatic relief, and its benefits diminish over time. As the disease progresses and the dosage increases, patients develop motor fluctuations and dyskinesia, impairing their quality of life. All of this highlights the need for alternative treatments. CBD have emerged as potential therapeutic candidates due to their neuroprotective and anti-inflammatory effects; however, the evidence remains inconclusive.

Design/Methods:

A literature search was conducted through PubMed, Scopus, and Web of Science to identify RCTs evaluating CBD in PD. Quality assessment was done using the RoB-2 tool. Random-effects meta-analyses were performed in R, reporting mean differences (MD) or standardized mean differences (SMD; Hedges g) with 95% confidence intervals (CIs). A sensitivity analysis was performed to assess the robustness of the results. In crossover trials, effect sizes and standard errors (SE) were extrapolated from the reported CIs, taking into account the paired design.

Results:

Eleven RCTs were identified, six of which were eligible for meta-analysis. CBD did not significantly improve PD severity (SMD= 0.16, 95%CI [-0.13 to 0.44], p=0.27), motor examination (SMD= -0.08, 95%CI [-0.35 to 0.20], p=0.57), motor activities of daily living (SMD= -0.08, 95%CI [-0.49 to 0.33], p=0.71), non-motor symptoms (SMD= -0.03, 95%CI [-0.72 to 0.67], p=0.94),  quality of life (MD= 1.16, 95%CI [-3.22 to 5.55], p= 0.60), depression (MD= 0.66, 95% CI[-0.37 to 1.69], p=0.21), anxiety (MD= 0.24, 95%CI [-0.76 to 1.24], p=0.64). Most analyses showed no heterogeneity, except for non-motor symptoms (I²=64.3%, p=0.06), where excluding Peball et al resolved the heterogeneity (I²=0%, p=0.94).

Conclusions:

Current evidence is still insufficient to support a significant therapeutic effect of CBD on PD patients. Clarification of its therapeutic role requires larger, more rigorous trials with standardized protocols.

10.1212/WNL.0000000000215479
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