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Effects of Cannabidiol on Adaptive Behavior and Quality of Life in Pediatric Patients With Treatment-Resistant Epilepsy

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Background and Purpose Data regarding the effects of cannabidiol (CBD) on the quality of life (QOL) are currently inadequate. We assessed the QOL of pediatric patients with epilepsy who were treated with CBD. Methods This prospective, open-label study included pediatric and adolescent patients (aged 2–18 years) with Dravet syndrome or Lennox-Gastaut syndrome. Oral CBD was administered at 10 mg/kg/day. The Korean version of the Quality Of Life in Childhood Epilepsy (QOLCE) questionnaire was administered when CBD treatment began and again after 6 months. Adaptive behavior was measured using the Korean versions of the Child Behavior Checklist (K-CBCL) and the second edition of the Vineland Adaptive Behavior Scales (Vineland-II). Results This study included 41 patients (11 with Dravet syndrome and 30 with LennoxGastaut syndrome), of which 25 were male. The median age was 4.1 years. After 6 months, 26.8% (11/41) of patients experienced a ≥50% reduction in the number of seizures. The total score for the QOLCE questionnaire did not change from baseline to after 6 months of CBD treatment (85.71±39.65 vs. 83.12±48.01, respectively; p=0.630). The score in the motor skills domain of Vineland-II reduced from 48.67±13.43 at baseline to 45.18±14.08 after 6 months of treatment (p=0.005). No other Vineland-II scores and no K-CBCL scores had changed after 6 months of CBD treatment. Conclusions CBD is an efficacious antiseizure drug used to treat Dravet syndrome and Lennox-Gastaut syndrome. However, it did not improve the patient QOL in our study, possibly because all of our patients had profound intellectual disabilities.

Abstract

Background and Purpose Data regarding the effects of cannabidiol (CBD) on the quality of life (QOL) are currently inadequate. We assessed the QOL of pediatric patients with epilepsy who were treated with CBD. Methods This prospective, open-label study included pediatric and adolescent patients (aged 2–18 years) with Dravet syndrome or Lennox-Gastaut syndrome. Oral CBD was administered at 10 mg/kg/day. The Korean version of the Quality Of Life in Childhood Epilepsy (QOLCE) questionnaire was administered when CBD treatment began and again after 6 months. Adaptive behavior was measured using the Korean versions of the Child Behavior Checklist (K-CBCL) and the second edition of the Vineland Adaptive Behavior Scales (Vineland-II). Results This study included 41 patients (11 with Dravet syndrome and 30 with LennoxGastaut syndrome), of which 25 were male. The median age was 4.1 years. After 6 months, 26.8% (11/41) of patients experienced a ≥50% reduction in the number of seizures. The total score for the QOLCE questionnaire did not change from baseline to after 6 months of CBD treatment (85.71±39.65 vs. 83.12±48.01, respectively; p=0.630). The score in the motor skills domain of Vineland-II reduced from 48.67±13.43 at baseline to 45.18±14.08 after 6 months of treatment (p=0.005). No other Vineland-II scores and no K-CBCL scores had changed after 6 months of CBD treatment. Conclusions CBD is an efficacious antiseizure drug used to treat Dravet syndrome and Lennox-Gastaut syndrome. However, it did not improve the patient QOL in our study, possibly because all of our patients had profound intellectual disabilities.

참고문헌 (9)

  1. Devinsky O, "Cannabidiol in patients with treatment-resistant epilepsy : an openlabel interventional trial", Lancet Neurol, 15, pp.270~278 (2016)
  2. Thiele EA, "Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome(GWPCARE4) : a randomised, double-blind, placebo-controlled phase 3 trial", Lancet, 391, pp.1085~1096 (2018)
  3. Devinsky O, "Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome", N Engl J Med, 376, pp.2011~2020 (2017)
  4. Gaston TE, "Quality of life in adults enrolled in an open-label study of cannabidiol(CBD)for treatment-resistant epilepsy", Epilepsy Behav, 95, pp.10~17 (2019)
  5. Rosenberg EC, "Quality of life in childhood epilepsy in pediatric patients enrolled in a prospective, open-label clinical study with cannabidiol", Epilepsia, 58, pp.e96~e100 (2017)
  6. Chung Mo Koo, "Cannabidiol for Treating Lennox-Gastaut Syndrome and Dravet Syndrome in Korea", Journal of Korean Medical Science, 35(50), pp.1~9 (2020), 대한의학회[DOI]
  7. Porter BE, "Report of a parent survey of cannabidiol-enriched cannabis use in pediatric treatment-resistant epilepsy", Epilepsy Behav, 29, pp.574~577 (2013)
  8. Press CA, "Parental reporting of response to oral cannabis extracts for treatment of refractory epilepsy", Epilepsy Behav, 45, pp.49~52 (2015)
  9. Gaston TE, "Cannabidiol(CBD)and cognition in epilepsy", Epilepsy Behav, 124, pp.108316~ (2021)

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