NICE has published a draft of the upcoming guideline on the use of cannabis-based medicinal products (CBMPs) for intractable nausea and vomiting, chronic pain, spasticity, and severe treatment-resistant epilepsy.
In the draft recommendations, NICE addresses whether the use of a CBMP for each condition is supported by the evidence, and where CBMPs should only be offered as part of participation in a clinical trial. Some of the draft recommendations include:
- nabilone can be considered (bearing in mind potential adverse drug interactions) as an add‑on treatment for adults with chemotherapy‑induced nausea and vomiting that persists despite optimised conventional anti-emetics
- none of the assessed CBMPs are recommended for use in chronic pain in adults, though cannibidiol (CBD) can be offered as part of a clinical trial
- none of the assessed CBMPs are recommended for use in spasticity unless as part of a clinical trial
- there is no good-quality evidence for CBMPs for severe treatment‑resistant epilepsy, so no recommendations could be made.
Separate technology appraisals are being developed for CBD as an adjuvant treatment for seizures associated with Lennox–Gastaut syndrome or Dravet syndrome, so these are not covered by the draft guideline.
The finalised version of the guideline is due to be released on 11 November 2019.