CBD yields comparable benefits in kids, adults with Lennox-Gastaut and Dravet syndrome

Children with Lennox-Gastaut syndrome (LGS) and Dravet's syndrome (DS) achieve improvements in both seizure management and nonseizure outcomes following treatment with cannabidiol (CBD)—a success echoed in their adult counterparts, as shown in a study presented at AAN 2023.

“Caregivers for adult and paediatric patients reported similar improvements with CBD across the following seizure-related outcomes: seizure frequency and severity, seizure-free days per week, and complete seizure freedom in the past month,” according to the investigators.

There were also favourable changes, regardless of age, seen in alertness, cognition, executive function, emotional and social function, language and communication, physical function, sleep, and daily activities, they added.

“Nearly all caregivers (93 percent) of paediatric and adult patients reported planning to continue CBD,” the investigators said.

The subgroup analyses were based on data from BECOME, a global outcomes survey of caregivers of 315 children (mean age 9 years, 52 percent boys) and 183 adults (mean age 28 years, 53 percent men) with LGS or DS who received at least 3 months of CBD treatment (100 mg/mL oral solution).

Children were treated with CBD for an average of 1.9 years, with a median dose of 16 mg/kg/day. On the other hand, adults received CBD for an average of 2.2 years, with a median dose of 11/mg/kg/day.

Seizure outcomes

Any improvement (possible, definite minor, or definite major) in seizure frequency was reported in 84 percent of paediatric and adult patients each, while worsening was reported in 7 percent and 5 percent, respectively. For seizure severity, 77 percent of children and 75 percent of adults were reported to have improvements, while 10 percent and 6 percent had worsening. [AAN 2023, abstract 006]

Decreased frequency of specific seizure type was seen in both children and adults, without significant between-group difference: convulsive (72 percent each), drop (71 percent each), nonconvulsive/nondrop (66 percent and 69 percent), and night-time seizures (61 percent and 63 percent).

Meanwhile, increases in seizure-free days per week for at least one type of seizure were comparable, being reported in 65 percent of children and 70 percent of adults. Complete seizure freedom in the past month was noted in 18 percent of children and 15 percent of adults.

Paediatric and adult patients also had parallel reductions in rescue medication use (57 percent each), emergency room visits (56 percent and 51 percent), hospitalizations (55 percent and 50 percent), and occurrence of seizure-related injuries (48 percent and 49 percent), as reported by their caregivers.

Nonseizure outcomes

Any improvement in alertness, cognition, and executive function was reported in 87 percent of children and 81 percent of adults. The most frequently reported improvement for children was in the ability to learn new things (76 percent). For adults, the most frequently reported improvement was in alertness (70 percent). [AAN 2023, abstract 008]

Positive changes in emotional and social functioning were noted in 82 percent of children and 80 percent of adults. Meanwhile, a numerically greater proportion of children had reported improvements in the domains of physical functioning (53 percent vs 33 percent), sleep (53 percent vs 48 percent), and daily activities (56 percent vs 44 percent).

Any improvement in language and communication was observed in 85 percent of nonverbal children vs 68 percent of nonverbal adults and in 81 percent of verbal children vs 63 percent of verbal adults. The most frequently reported improvements were in the ability to look up or smile upon mention of their name in nonverbal children (76 percent) and nonverbal adults (61 percent).

Continued treatment

“Although most caregivers of paediatric (93 percent) and adult (88 percent) patients cited seizure-related improvements as a reason for continuing [CBD treatment], 70 percent of caregivers of paediatric patients and 73 percent of caregivers of adult patients cited nonseizure-related improvements as the reason,” according to the investigators.

Taken together, data from the present subgroup analyses may have important implications, given that LGS and DS are lifelong diseases with symptoms that evolve over time, the investigators pointed out. [Front Neurol 2017;8:505]