cannabidiol for treating seizures caused by tuberous sclerosis complex
Last edited 03/2023 and last reviewed 03/2023
NICE state (1):
Cannabidiol (CBD) is recommended as an add-on treatment option for seizures caused by tuberous sclerosis complex in people aged 2 years and over, only if:
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their seizures are not controlled well enough by 2 or more antiseizure medications (either used alone or in combination) or these treatments were not tolerated
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seizure frequency is checked every 6 months, and cannabidiol is stopped if the frequency has not fallen by at least 30% compared with the 6 months before starting treatment
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the company provides cannabidiol according to the commercial arrangement
The NICE committee state that:
- "...usual care for seizures caused by tuberous sclerosis complex includes antiseizure medications. Cannabidiol is licensed as an add-on treatment option for people aged 2 years and over. The company has positioned it for use when seizures are not controlled well enough by 2 or more antiseizure medications or when these were not tolerated.
- clinical trial evidence shows that cannabidiol plus usual care reduces seizure frequency and increases the number of seizure-free days compared with placebo plus usual care..."
Notes:
- study evidence shows that in patients with tuberous sclerosis (TSC) (2)
- long-term add-on CBD treatment was well tolerated and sustainably reduced seizures through 48 weeks, with most patients/caregivers reporting global improvement
- treatment with CBD produced a sustained reduction in TSC-associated seizures, including countable focal and generalized seizures but excluding absence, myoclonic, focal sensory, and infantile/epileptic spasms, as well as in total seizures, which included all of the above-mentioned seizures types. In the randomized, placebo-controlled phase of the trial, CBD produced an approximate 40% reduction in the frequency of seizures associated with TSC
- NICE (March 2023). Cannabidiol for treating seizures caused by tuberous sclerosis complex
- Thiele EA, Bebin EM, Filloux F, Kwan P, Loftus R, Sahebkar F, Sparagana S, Wheless J. Long-term cannabidiol treatment for seizures in patients with tuberous sclerosis complex: An open-label extension trial. Epilepsia. 2022 Feb;63(2):426-439.