Time to onset of cannabidiol treatment effect and resolution of adverse events in tuberous sclerosis complex: Post hoc analysis of randomized controlled phase 3 trial GWPCARE6

Objective To estimate the timing of cannabidiol (CBD) treatment effect (seizure reduction and adverse events [AEs]) onset, we conducted a post hoc analysis of GWPCARE6 (NCT02544763), a randomized, placebo‐controlled, phase 3 trial in patients with drug‐resistant epilepsy associated with tuberous scl...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2022-05, Vol.63 (5), p.1189-1199
Main Authors: Wu, Joyce Y., Cock, Hannah R., Devinsky, Orrin, Joshi, Charuta, Miller, Ian, Roberts, Colin M., Sanchez‐Carpintero, Rocio, Checketts, Daniel, Sahebkar, Farhad
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anticonvulsants - adverse effects
antiseizure medication
Appetite loss
Cannabidiol
Cannabidiol - adverse effects
Cannabinoids
Child
Convulsions & seizures
Diarrhea
Double-Blind Method
Epilepsy
focal seizures
Humans
medication‐resistant seizures
Middle Aged
Patients
Placebos
Seizures
Seizures - chemically induced
Seizures - etiology
Titration
Treatment Outcome
Tuberous sclerosis
Tuberous Sclerosis - complications
Tuberous Sclerosis - drug therapy
tuberous sclerosis complex
Young Adult
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Summary:Objective To estimate the timing of cannabidiol (CBD) treatment effect (seizure reduction and adverse events [AEs]) onset, we conducted a post hoc analysis of GWPCARE6 (NCT02544763), a randomized, placebo‐controlled, phase 3 trial in patients with drug‐resistant epilepsy associated with tuberous sclerosis complex (TSC). Methods Patients received plant‐derived pharmaceutical formulation of highly purified CBD (Epidiolex; 100 mg/ml oral solution) at 25 mg/kg/day (CBD25) or 50 mg/kg/day (CBD50) or placebo for 16 weeks (4‐week titration, 12‐week maintenance). Treatment started at 5 mg/kg/day for all groups and reached 25 mg/kg/day on Day 9 and 50 mg/kg/day on Day 29. Percentage change from baseline in TSC‐associated seizure (countable focal or generalized) count was calculated by cumulative day (i.e., including all previous days). Time to onset and resolution of AEs were evaluated. Results Of 224 patients, 75 were randomized to CBD25, 73 to CBD50, and 76 to placebo. Median (range) age was 11.3 (1.1–56.8) years. Patients had discontinued a median (range) of 4 (0–15) antiseizure medications and were currently taking 3 (0–5). Difference in seizure reduction between CBD and placebo emerged on Day 6 (titrated dose, 15 mg/kg/day) and became nominally significant (p 
ISSN:0013-9580
1528-1167
DOI:10.1111/epi.17199