Clinical Takeaway
Cannabinoids have been studied across a range of medical conditions in children under 18, with evidence drawn from interventional trials, observational studies, and surveys. The current body of research captures both potential benefits and safety signals, though study quality and design vary considerably. Clinicians should weigh available evidence carefully and prioritize shared decision-making when considering cannabinoid therapies for pediatric patients.
#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 establishing an ongoing surveillance mechanism for cannabinoid safety and efficacy in the pediatric population, where clinical use is expanding despite limited systematic data. The continuous updating framework enables clinicians to access current evidence on cannabinoid-related adverse events and therapeutic outcomes in children, informing treatment decisions and regulatory guidance in a rapidly evolving therapeutic area. Given the neurobiological differences between pediatric and adult populations, this systematized assessment of pediatric-specific cannabinoid data is essential for establishing evidence-based prescribing practices and identifying populations most likely to benefit from these agents.
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 an important attempt to synthesize the fragmented evidence on pediatric cannabinoid use, yet clinicians should recognize several substantial limitations that constrain its immediate applicability. The evidence base remains heavily skewed toward epilepsy and chemotherapy-related conditions, with most studies being observational or retrospective, creating significant potential for publication bias and confounding by indication. Long-term safety data in developing brains is sparse, dosing protocols are highly variable across studies, and outcome measurements lack standardization, making cross-study comparisons and definitive efficacy claims problematic. Until prospective, adequately powered randomized trials accumulate and regulatory pathways mature, pediatric cannabinoid prescribing should remain limited to well-defined indications such as treatment-resistant epilepsy where benefit-risk calculus has been more rigorously established, with careful documentation of patient selection, dosing rationale, and both efficacy and adverse effect monitoring in the medical record.