Clinical Takeaway
Cannabinoids have been studied across a wide range of pediatric medical conditions, with evidence drawn from interventional trials, observational data, and surveys. The current body of research reflects both potential therapeutic applications and important safety considerations that clinicians must weigh carefully when considering cannabinoid use in patients under 18. This living systematic review will continue to update as new evidence emerges, making it a useful ongoing reference for clinicians navigating pediatric cannabinoid decisions.
#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 addresses a critical evidence gap by systematically synthesizing safety and efficacy data for cannabinoid use in pediatric populations, where clinical evidence remains sparse despite growing off-label use. The continuous updating methodology ensures clinicians have access to emerging evidence on pediatric cannabinoid safety profiles and therapeutic outcomes, enabling more informed risk-benefit assessments in conditions where conventional treatments have failed. Given the neurodevelopmental vulnerabilities of children and the regulatory uncertainty surrounding pediatric cannabinoid applications, this consolidated evidence base is essential for establishing evidence-based prescribing guidelines and identifying appropriate clinical indications.
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 represents a commendable effort to synthesize the scattered pediatric cannabinoid literature, yet clinicians should recognize several important limitations that constrain clinical utility at present. The evidence base remains predominantly observational and skewed toward seizure disorders, particularly epilepsy, where mechanistic plausibility and some supportive data exist; robust randomized controlled trials in other pediatric conditions are largely absent. Significant confounders plague the existing literature, including variable cannabinoid formulations and ratios, heterogeneous dosing regimens, inconsistent outcome measures, publication bias favoring positive results, and the challenge of assessing benefit in conditions where placebo effects run high or natural disease course is unpredictable. Families increasingly request cannabinoid therapies for pediatric conditions ranging from anxiety to chronic pain, yet we must counsel them honestly that evidence outside seizure management remains preliminary. When discussing cannabinoids with families managing a child with refractory epilepsy, we can reference emerging supportive evidence; for other ind