CBD reduced seizures in children with severe epilepsy beyond just Dravet and Lennox-Gastaut syndromes | Research

The takeaway

Among 78 children and young adults with refractory epilepsy, 31% achieved 50% or greater seizure reduction at 3 months, with Dravet and Lennox-Gastaut patients responding best (70%) and clobazam co-medication improving outcomes.

Pediatric neurologists, epileptologists, and families of children with refractory epilepsy.

70% of Dravet/LGS patients achieved 50%+ seizure reduction at 3 months

What the researchers found

At 3 months, 31.4% of patients achieved 50% or greater seizure reduction and 68.6% showed some improvement. Dravet and Lennox-Gastaut patients had much higher response rates (70% achieving 50% reduction) compared to other epilepsies (22%). Clobazam co-medication increased seizure reduction. Response rates declined over time: 20% maintained 50% reduction at 24 months.

Why it matters

While CBD is approved for Dravet and Lennox-Gastaut syndromes, this study shows it may also benefit children with other severe epilepsies, though the waning response over time needs monitoring.

The numbers in context

Patients: 78. With seizure registration: 51. 50% reduction at 3 months: 31.4%. At 6 months: 31.1%. At 12 months: 28.1%. At 24 months: 20.0%. Dravet/LGS at 3 months: 70%. Other epilepsies: 22%. Any reduction at 3 months: 68.6%.

How the study worked

Retrospective cohort study of 78 patients treated with off-label cannabidiol at the Filadelfia Epilepsy Hospital, Denmark from 2016-2019. Assessed seizure frequency registration or perceived effect over up to 24 months.

What this study cannot tell us

Retrospective, uncontrolled design. Off-label use with varying doses. Only 51 of 78 patients had seizure frequency registration. No placebo comparison.

How to read the evidence

Real-world clinical data with up to 24 months follow-up, but uncontrolled retrospective design.

When this study was published

Published in 2021 with data from 2016-2019.

The bigger picture

The declining response over time (from 31% to 20% achieving 50% reduction) suggests tolerance may develop, reinforcing the need for ongoing evaluation and willingness to discontinue if benefits fade.

Questions still open

Is the declining response over time due to tolerance or natural disease progression? Would higher CBD doses maintain efficacy? What factors predict which non-Dravet/LGS patients respond?

Common questions

Does CBD work for epilepsies other than Dravet and Lennox-Gastaut?

In this study, 22% of patients with other severe epilepsies achieved 50% or greater seizure reduction at 3 months, lower than Dravet/LGS (70%) but still meaningful.

Does CBD effectiveness last over time?

Response rates declined from 31% at 3 months to 20% at 24 months, suggesting some tolerance development and the importance of ongoing monitoring.

Read the original research

Cannabidiol treatment of severe refractory epilepsy in children and young adults.

Danish medical journal, 68(5)

View on PubMed ↗

Citation

Zilmer, Monica; Olofsson, Kern. (2021). Cannabidiol treatment of severe refractory epilepsy in children and young adults.. Danish medical journal, 68(5).