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Nabilone for Chronic Pain Management: A Review of Clinical Effectiveness and Guidelines – An Update

Last updated: November 8, 2018
Project Number: RC1040-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of nabilone for the treatment of chronic pain due to any disease in adults?
  2. What are the evidence-based guidelines regarding the use of nabilone for the treatment of chronic pain due to any disease in adults?

Key Message

Based on two systematic reviews (SRs) that included an evaluation of nabilone for management of chronic pain, there was limited evidence that nabilone may be better than placebo or known analgesics (such as amitriptyline) in relieving chronic pain. The two evidence-based guidelines that were identified recommended against the use or did not find sufficient evidence to support the use of nabilone for pain management or chronic non-cancer pain; however one of the two guidelines provided a weak recommendation for the consideration of nabilone as a third-line therapy for persistent problematic neuropathic pain (NP) or palliative (end-of-life) cancer pain. Limited evidence was identified regarding the safety of nabilone specifically, but the evidence that was available suggested that cannabinoids are associated with more adverse events (AEs) than placebo, though the majority of reported AEs were non-serious.