Medical Cannabis in the Treatment of Patients with Autism Spectrum Disorder (1648)

Objective: Evaluate efficacy and safety of medical cannabis (MC) for pain and epilepsy in patients with autism spectrum disorder (ASD).

Background: MC is approved for treatment of ASD in 14 states (not NY). In NY it is approved for epilepsy and pain. Common challenges with ASD include aggression, self-injurious behavior (SIB), elopement, pain, and epilepsy. Some individuals can also have severe behavior symptoms. Most of these patients try multiple medications with concerning side effects (SE). This study reports a case series of patients with ASD treated with MC.

Design/Methods: Retrospective chart review of 20 patients with ASD (6 with epilepsy/14 with pain) on MC treatment included written evaluation by patient or caregiver. Autism/Caregiver Global Impression of Change (ACGIC) Scale measuring: 1.Quality of life (QOL) 2.Activity limitations 3.Symptoms 4.Mood. A 10-point Likert Scale measured: 1.Chronic pain change 2.Epilepsy change 3.Secondary efficacies. MC product information: dosing, route, frequency, dispensary, and cost reported.

Results:

1. Patients with epilepsy had improvement in seizure frequency (p =0.0032) and severity (p=0.0332).

2. Patients with pain had improvement in degree of overall pain (p<0.0001).

3. Autism/Caregiver Global Impression of Change (ACGIC) scale revealed improvement in all areas (p<0.0001): quality of life, activity limitations, symptoms, and mood.

4. Secondary effects: patients experienced improvement in sleep (p<0.0001), mood (p<0.0001), and aggression towards self and/or others (p<0.0001). Improvement was also seen in patient communication abilities (p=0.0001) and attention/concentration (p=0.0002).

5. Each patient tried an average of 6.4 other medications. 50% of patients discontinued or reduced the use of other medications.

6. 3 patients reported mild adverse SE from MC; no SE caused discontinuation of MC.

Conclusions: There is a paucity of research on the use of MC treatment with ASD. This study supports previous research for MC treatment of pain and epilepsy while exploring indications for behavioral issues and QOL improvement in ASD patients.

Disclosure: Dr. McVige has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Amgen, Avanir, Depomed, Eli Lilly & Company, Oxtellar, Promius, Supernus, and Teva Pharmaceuticals. Dr. McVige has received research support from Amgen, Avanir, Eli Lilly, Gammacore, Impax, Teva, Boston Biomedical, Delmar Pharmaceuticals, Alder Biopharmaceuticals, and Harry Dent Family Foundation. Dr. Headd has nothing to disclose. Dr. Alwahaidy has nothing to disclose. Dr. Lis has nothing to disclose. Dr. Kaur has received research support from Dent Family Foundation. Dr. Albert has nothing to disclose. Dr. Mechtler has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Alder Pharmaceuticals, Allergan, Amgen, Avanir, Biohaven, Boston Biomedical Inc., CellDex, DelMar Pharmaceuticals, electroCore, Novartis, Orbis Pharmaceuticals, Promius, Teva Pharmaceuticals, and Jushi. Dr. Mechtler has received research support from Alder Pharmaceuticals, Allergan, Amgen, Avanir, Biohaven, Boston Biomedical Inc., CellDex, DelMar Pharmaceuticals, electroCore, Novartis, Orbis Pharmaceuticals, Promius, Teva Pharmaceuticals, and Jushi.