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

OBJECTIVES:

To systematically review all 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 Cochrane register, Embase, Medline, Scopus (last search on 11 November 2016).

RESULTS:

After screening 8469 articles, two randomized controlled trials and one open label study enrolling a total of 426 patients, were included. Cannabinoids relevantly decreased incontinence episodes in all three studies. Pooling data showed mean difference in incontinence episodes per 24 hours 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 NULTD in patients with MS. However, evidence base is poor and more high-quality, well-designed, adequately powered and sampled studies are urgently needed to reach definitive conclusions. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.