Clinical Takeaway
Cannabinoids have been studied across a range of pediatric medical conditions, with the current evidence base drawing from both interventional trials and real-world observational data. The strongest and most consistent findings support the use of pharmaceutical cannabinoids, particularly cannabidiol, for certain treatment-resistant epilepsy syndromes in children. Safety and efficacy data continue to evolve, and clinical decisions should be guided by condition-specific evidence rather than broad assumptions about pediatric cannabinoid therapy.
#2 Cannabinoids for Medical Purposes in Children: A Living Systematic Review.
Citation: Chhabra Manik et al.. Cannabinoids for Medical Purposes in Children: A Living Systematic Review.. Acta paediatrica (Oslo, Norway : 1992). 2025. PMID: 40437694.
Design: 5 Journal: 0 N: 2 Recency: 2 Pop: 3 Human: 1 Risk: 0
This living systematic review establishes a critical evidence framework for cannabinoid use in pediatric populations, where clinical evidence remains fragmented and safety data are limited despite increasing off-label utilization. By continuously updating the evidence synthesis across major medical databases, this approach enables clinicians to make informed decisions regarding cannabinoid prescribing for conditions such as epilepsy and chemotherapy-induced nausea while identifying evidence gaps that require further investigation. The structured mapping of safety and efficacy outcomes in children is particularly essential given the neurobiological vulnerabilities of developing brains and the absence of standardized dosing protocols in pediatric cannabinoid therapy.
Methodological Considerations:
- Small sample — underpowered for subgroup analysis
Abstract: AIM: We developed a living systematic review (LSR) that will continuously map the safety and reported benefit data related to cannabinoid use for medical purposes in children. METHODS: MEDLINE, Embase, PsycInfo, and the Cochrane Library were searched from inception to April 2023. Studies involving at least one child 20% studies) in studies enrolling children were somnolence, diarrhoea, vomiting, and decreased appetite. CONCLUSION: These findings will continue to be updated to inform practice and reveal knowledge gaps for future research.
🧒 This living systematic review synthesizing cannabinoid safety and efficacy data in pediatric populations addresses a critical evidence gap, though clinicians should note that the included studies likely span highly heterogeneous conditions, dosing regimens, and outcome measures, making broad generalizations difficult. The quality of evidence remains modest for most indications beyond perhaps seizure disorders, and long-term neurodevelopmental effects in growing brains remain incompletely characterized despite theoretical concerns about cannabinoid exposure during critical developmental windows. Publication bias toward positive outcomes, variable regulatory oversight of cannabinoid products, and the challenge of isolating cannabinoid effects from confounding variables (such as concurrent medications or disease severity) further complicate interpretation. Given these limitations, a cautious approach emphasizing documented efficacy in specific conditions like refractory epilepsy, individualized risk-benefit assessment with families, and systematic monitoring remains prudent until higher-quality pediatric trial data emerge.
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