{"id":314922,"date":"2025-04-13T15:30:10","date_gmt":"2025-04-13T13:30:10","guid":{"rendered":"https:\/\/greenowl.fr\/blog\/?p=314922"},"modified":"2026-04-20T14:41:38","modified_gmt":"2026-04-20T12:41:38","slug":"lepidiolex-medicament-cannabidiol","status":"publish","type":"post","link":"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/","title":{"rendered":"Epidyolex (cannabidiol) : le seul m\u00e9dicament \u00e0 base de CBD autoris\u00e9 en France"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_63 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<p class=\"ez-toc-title\">Sommaire<\/p>\n<label for=\"ez-toc-cssicon-toggle-item-69f3e2708323c\" class=\"ez-toc-cssicon-toggle-label\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #336449;color:#336449\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #336449;color:#336449\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/label><input type=\"checkbox\"  id=\"ez-toc-cssicon-toggle-item-69f3e2708323c\" checked aria-label=\"Toggle\" \/><nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Statut_reglementaire_et_acces_en_France\" title=\"Statut r\u00e9glementaire et acc\u00e8s en France\u00a0\">Statut r\u00e9glementaire et acc\u00e8s en France\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Comment_Epidyolex_agit-il\" title=\"Comment\u00a0Epidyolex\u00a0agit-il ?\u00a0\">Comment\u00a0Epidyolex\u00a0agit-il ?\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Posologie_et_administration\" title=\"Posologie et administration\u00a0\">Posologie et administration\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Composition_et_excipients_notables\" title=\"Composition et excipients notables\u00a0\">Composition et excipients notables\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Efficacite_clinique_dans_le_syndrome_de_Dravet\" title=\"Efficacit\u00e9 clinique dans le syndrome de\u00a0Dravet\u00a0\">Efficacit\u00e9 clinique dans le syndrome de\u00a0Dravet\u00a0<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Tolerance_dans_le_syndrome_de_Dravet\" title=\"Tol\u00e9rance dans le syndrome de\u00a0Dravet\u00a0\">Tol\u00e9rance dans le syndrome de\u00a0Dravet\u00a0<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Efficacite_clinique_dans_le_syndrome_de_Lennox-Gastaut\" title=\"Efficacit\u00e9 clinique dans le syndrome de Lennox-Gastaut\u00a0\">Efficacit\u00e9 clinique dans le syndrome de Lennox-Gastaut\u00a0<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Tolerance_dans_le_SLG\" title=\"Tol\u00e9rance dans le SLG\u00a0\">Tol\u00e9rance dans le SLG\u00a0<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Efficacite_clinique_dans_la_sclerose_tubereuse_de_Bourneville\" title=\"Efficacit\u00e9 clinique dans la scl\u00e9rose tub\u00e9reuse de Bourneville\u00a0\">Efficacit\u00e9 clinique dans la scl\u00e9rose tub\u00e9reuse de Bourneville\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Quels_sont_les_effets_indesirables%E2%80%AFpossibles%E2%80%AF\" title=\"Quels sont les effets ind\u00e9sirables\u202fpossibles\u202f?\u00a0\">Quels sont les effets ind\u00e9sirables\u202fpossibles\u202f?\u00a0<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Surveillance_hepatique_obligatoire\" title=\"Surveillance h\u00e9patique obligatoire\u00a0\">Surveillance h\u00e9patique obligatoire\u00a0<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Interactions_medicamenteuses\" title=\"Interactions m\u00e9dicamenteuses\u00a0\">Interactions m\u00e9dicamenteuses\u00a0<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Comparaison_avec_dautres_traitements_antiepileptiques\" title=\"Comparaison avec d&#8217;autres traitements anti\u00e9pileptiques\u00a0\">Comparaison avec d&#8217;autres traitements anti\u00e9pileptiques\u00a0<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/lepidiolex-medicament-cannabidiol\/#Sources\" title=\"Sources\u00a0\u00a0\">Sources\u00a0\u00a0<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<p><b><span data-contrast=\"auto\">\u00c0 retenir\u00a0<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"1\" data-aria-level=\"1\"><em>Epidyolex\u00a0est une avanc\u00e9e th\u00e9rapeutique majeure pour certaines \u00e9pilepsies r\u00e9fractaires s\u00e9v\u00e8res\u00a0<\/em><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"2\" data-aria-level=\"1\"><em>Il est disponible en pharmacie de ville depuis janvier 2023\u00a0<\/em><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"3\" data-aria-level=\"1\"><em>La prescription est strictement encadr\u00e9e (neurologues\/neurop\u00e9diatres) avec surveillance h\u00e9patique r\u00e9guli\u00e8re\u00a0<\/em><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"4\" data-aria-level=\"1\"><em>Selon les donn\u00e9es cliniques, il pourrait aider \u00e0 r\u00e9duire des crises d\u2019environ 30 \u00e0 50 %\u00a0\u00a0<\/em><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"5\" data-aria-level=\"1\"><em>Le profil de tol\u00e9rance\u00a0est\u00a0jug\u00e9 acceptable \u00e0 long terme\u00a0<\/em><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"6\" data-aria-level=\"1\"><em>Il n\u2019est pas\u00a0curatif mais\u00a0peut\u00a0am\u00e9liorer\u00a0la qualit\u00e9 de vie des patients et de leur entourage\u00a0<\/em><\/li>\n<\/ul>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Epidyolex est une avanc\u00e9e dans le traitement de certaines formes rares et graves d&#8217;\u00e9pilepsie. C&#8217;est\u00a0<\/span><a href=\"https:\/\/www.ema.europa.eu\/fr\/documents\/overview\/epidyolex-epar-medicine-overview_fr.pdf\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">le premier m\u00e9dicament \u00e0 base de cannabidiol\u00a0\u00e0 avoir obtenu une Autorisation de Mise sur le March\u00e9 (AMM) en Europe<\/span><\/a><span data-contrast=\"auto\">, le 19 septembre 2019. Disponible en officine depuis janvier 2023, il est rembours\u00e9 pour les patients \u00e9ligibles.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Ce traitement buvable \u00e0 base de\u00a0cannabidiol, un compos\u00e9 non psychoactif extrait du\u00a0cannabis, ne provoque pas d&#8217;effets psychotropes.\u00a0Contrairement au THC, le CBD n&#8217;a aucune\u00a0action sur les r\u00e9cepteurs cannabino\u00efdes classiques responsables des effets \u00ab planants \u00bb : il agit par d&#8217;autres voies, ce qui en fait une mol\u00e9cule d&#8217;int\u00e9r\u00eat th\u00e9rapeutique.\u00a0Il est utilis\u00e9 en th\u00e9rapie d&#8217;appoint pour traiter des crises \u00e9pileptiques r\u00e9fractaires aux traitements conventionnels, dans trois indications pr\u00e9cises : le syndrome de\u00a0Dravet\u00a0(SD), le syndrome de Lennox-Gastaut (SLG) et la scl\u00e9rose tub\u00e9reuse de Bourneville (STB).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">Fabricant<\/span><b><span data-contrast=\"auto\">\u00a0:\u00a0<\/span><\/b><span data-contrast=\"auto\">Jazz Pharmaceuticals.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"2\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">Forme : solution buvable \u00e0 100 mg\/mL, flacon de 100\u00a0mL\u00a0avec seringues doseuses et adaptateur.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Statut_reglementaire_et_acces_en_France\"><\/span><b><span data-contrast=\"none\">Statut r\u00e9glementaire et acc\u00e8s en France<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span data-contrast=\"auto\">Avant sa commercialisation officielle,\u00a0Epidyolex\u00a0a connu plusieurs phases d&#8217;acc\u00e8s :<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"auto\">2018 : disponibilit\u00e9 via Autorisation Temporaire d&#8217;Utilisation (ATU) en France.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"2\" data-aria-level=\"1\"><span data-contrast=\"auto\">19 septembre 2019 : obtention de l&#8217;AMM europ\u00e9enne centralis\u00e9e par l&#8217;EMA.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"3\" data-aria-level=\"1\"><span data-contrast=\"auto\">2020 : avis favorable de la HAS au remboursement pour le SLG et le SD (SMR important) ; extension d&#8217;indication pour la STB.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"4\" data-aria-level=\"1\"><span data-contrast=\"auto\">21 d\u00e9cembre 2022 : fin de l&#8217;Autorisation d&#8217;Acc\u00e8s Compassionnel (AAC).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"5\" data-aria-level=\"1\"><span data-contrast=\"auto\">Janvier 2023 : commercialisation officielle en pharmacie de ville.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">La prescription est r\u00e9serv\u00e9e aux m\u00e9decins sp\u00e9cialistes en neurologie ou neurop\u00e9diatrie. Le renouvellement est soumis \u00e0 cette restriction.\u00a0Epidyolex\u00a0est class\u00e9 en Liste I.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Remboursement :\u00a0<\/span><\/b><span data-contrast=\"auto\">la HAS a attribu\u00e9 un SMR important pour le SLG et le SD. Pour la STB, le SMR est mod\u00e9r\u00e9 chez les patients\u00a0pharmacor\u00e9sistants, et insuffisant pour les patients non\u00a0pharmacor\u00e9sistants\u00a0(ces derniers ne sont donc pas pris en charge par l&#8217;Assurance maladie).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Comment_Epidyolex_agit-il\"><\/span><b><span data-contrast=\"none\">Comment\u00a0Epidyolex\u00a0agit-il ?<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span data-contrast=\"auto\">Le\u00a0cannabidiol\u00a0contenu dans\u00a0Epidyolex\u00a0est une mol\u00e9cule purifi\u00e9e \u00e0 partir du chanvre (Cannabis sativa L.), formul\u00e9e \u00e0 une concentration pharmaceutique pr\u00e9cise de 100 mg\/mL. Il s&#8217;agit d&#8217;un CBD de grade m\u00e9dicament, soumis aux m\u00eames exigences de qualit\u00e9, tra\u00e7abilit\u00e9 et puret\u00e9 que tout autre principe actif, ce qui le distingue fondamentalement des produits CBD disponibles en vente libre.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Le m\u00e9canisme pr\u00e9cis par lequel le CBD r\u00e9duit les crises d&#8217;\u00e9pilepsie n&#8217;est pas totalement \u00e9lucid\u00e9. Il ne se lie pas directement aux r\u00e9cepteurs cannabino\u00efdes classiques (CB1 et CB2), mais agit en modulant d&#8217;autres cibles c\u00e9r\u00e9brales :<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"6\" data-aria-level=\"1\"><span data-contrast=\"auto\">Les r\u00e9cepteurs TRPV (impliqu\u00e9s dans la nociception et l&#8217;excitabilit\u00e9 neuronale)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"7\" data-aria-level=\"1\"><span data-contrast=\"auto\">Les r\u00e9cepteurs \u00e0 l&#8217;ad\u00e9nosine (effet anticonvulsivant)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"8\" data-aria-level=\"1\"><span data-contrast=\"auto\">Le r\u00e9cepteur GPR55 (impliqu\u00e9 dans la r\u00e9gulation de l&#8217;excitabilit\u00e9)<\/span><br \/>\n<span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">Cette modulation multimodale permettrait de r\u00e9duire l&#8217;hyperexcitabilit\u00e9 neuronale \u00e0 l&#8217;origine des crises. Des \u00e9tudes pr\u00e9cliniques ont confirm\u00e9 l&#8217;effet anticonvulsivant du CBD, conduisant \u00e0 des essais cliniques de grande envergure chez l&#8217;humain.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Epidyolex\u00a0est toujours utilis\u00e9 en compl\u00e9ment d&#8217;autres m\u00e9dicaments anti\u00e9pileptiques (polyth\u00e9rapie). La dose est adapt\u00e9e au poids et \u00e0 l&#8217;indication, avec une titration progressive.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:240}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Posologie_et_administration\"><\/span><b><span data-contrast=\"none\">Posologie et administration<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span data-contrast=\"auto\">Le dosage est progressif, selon des paliers de 2,5 mg\/kg deux fois par jour, jusqu&#8217;\u00e0 la dose d&#8217;entretien ou maximale tol\u00e9r\u00e9e.\u00a0[5]\u00a0Le tableau ci-dessous r\u00e9sume les doses selon l&#8217;indication\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<table data-tablestyle=\"MsoNormalTable\" data-tablelook=\"0\" aria-rowcount=\"4\">\n<tbody>\n<tr aria-rowindex=\"1\">\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">\u00c9tape<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">SLG \/ Syndrome de\u00a0Dravet<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">Scl\u00e9rose tub\u00e9reuse (STB)<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">Remarque<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<\/tr>\n<tr aria-rowindex=\"2\">\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Initiation<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">2,5 mg\/kg \u00d7 2\/j (5 mg\/kg\/j)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">2,5 mg\/kg \u00d7 2\/j (5 mg\/kg\/j)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Dur\u00e9e : 1 semaine<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<\/tr>\n<tr aria-rowindex=\"3\">\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Entretien<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">5 mg\/kg \u00d7 2\/j (10 mg\/kg\/j)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">5 mg\/kg \u00d7 2\/j (10 mg\/kg\/j)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Dose habituelle<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<\/tr>\n<tr aria-rowindex=\"4\">\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Dose max.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">10 mg\/kg \u00d7 2\/j (20 mg\/kg\/j)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">12,5 mg\/kg \u00d7 2\/j (25 mg\/kg\/j)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Paliers de 2,5 mg\/kg \u00d7 2\/j<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><span data-contrast=\"auto\">L&#8217;arr\u00eat du traitement doit toujours se faire progressivement par paliers. Une interruption brutale peut provoquer une recrudescence s\u00e9v\u00e8re des crises, voire un \u00e9tat de mal \u00e9pileptique.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Important\u202f<\/span><\/b><span data-contrast=\"auto\">:\u00a0Epidyolex\u00a0ne doit pas \u00eatre administr\u00e9 aux enfants de moins de 2 ans.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\uf0b7\" data-font=\"Symbol\" data-listid=\"5\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\uf0b7&quot;,&quot;469777815&quot;:&quot;multilevel&quot;}\" data-aria-posinset=\"1\" data-aria-level=\"1\"><span data-contrast=\"none\">\u00c0 lire aussi\u202f:\u202f<\/span><a href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-medicinal\/effets-cbd-epilepsie\/\"><span data-contrast=\"none\">Les effets du CBD sur l\u2019\u00e9pilepsie<\/span><\/a><span data-ccp-props=\"{&quot;134233117&quot;:true,&quot;201341983&quot;:0,&quot;335557856&quot;:16777215,&quot;335559685&quot;:1032,&quot;335559739&quot;:144,&quot;335559740&quot;:240}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Composition_et_excipients_notables\"><\/span><b><span data-contrast=\"none\">Composition et excipients notables<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span data-contrast=\"auto\">Chaque\u00a0mL\u00a0de solution buvable contient 100 mg de\u00a0CBD. Parmi les excipients, deux m\u00e9ritent une attention particuli\u00e8re :<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"9\" data-aria-level=\"1\"><span data-contrast=\"auto\">L\u2019huile de s\u00e9same\u00a0est\u00a0contre-indiqu\u00e9e en cas d&#8217;allergie aux graines de s\u00e9same.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"10\" data-aria-level=\"1\"><span data-contrast=\"auto\">L\u2019\u00e9thanol (alcool)\u00a0est\u00a0pr\u00e9sent en quantit\u00e9 non n\u00e9gligeable. \u00c0\u00a0prendre en compte chez l&#8217;enfant et les patients \u00e0 risque.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">Le conditionnement comprend un flacon de 100\u00a0mL\u00a0en verre ambr\u00e9, avec fermeture de s\u00e9curit\u00e9 enfant, deux seringues de 1\u00a0mL, deux seringues de 5\u00a0mL\u00a0et deux adaptateurs de flacon.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Efficacite_clinique_dans_le_syndrome_de_Dravet\"><\/span><b><span data-contrast=\"none\">Efficacit\u00e9 clinique dans le syndrome de\u00a0Dravet<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span data-contrast=\"auto\">Le syndrome de\u00a0Dravet\u00a0est une forme rare d&#8217;\u00e9pilepsie infantile\u00a0qui d\u00e9bute\u00a0avant l&#8217;\u00e2ge d&#8217;un an, le plus souvent li\u00e9e \u00e0 une mutation du g\u00e8ne SCN1A. Il se manifeste par des crises prolong\u00e9es, souvent r\u00e9sistantes aux traitements classiques comme le valproate ou le clobazam.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Une \u00e9tude randomis\u00e9e contr\u00f4l\u00e9e contre placebo (Devinsky\u00a0et al., NEJM 2017) a port\u00e9 sur 120 enfants et jeunes adultes recevant soit\u00a0Epidyolex\u00a0\u00e0 20 mg\/kg\/j, soit un placebo, en compl\u00e9ment de leur traitement habituel, pendant 14 semaines.\u00a0[1]\u00a0R\u00e9sultats principaux :<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"11\" data-aria-level=\"1\"><span data-contrast=\"auto\">R\u00e9duction des crises convulsives : \u221239 % dans le groupe CBD (de 12,4 \u00e0 5,9 crises\/mois) contre \u22125 % sous placebo (p = 0,01).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"12\" data-aria-level=\"1\"><span data-contrast=\"auto\">R\u00e9pondeurs (r\u00e9duction \u2265 50 %) : 43 % sous CBD vs 27 % sous placebo.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"13\" data-aria-level=\"1\"><span data-contrast=\"auto\">Am\u00e9lioration de l&#8217;\u00e9tat g\u00e9n\u00e9ral : 62 % des patients sous CBD jug\u00e9s am\u00e9lior\u00e9s par leurs parents vs 34 % sous placebo (p = 0,02).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"14\" data-aria-level=\"1\"><span data-contrast=\"auto\">5 % des patients sous CBD ont atteint une absence totale de crises.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\n<p><\/span><\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Tolerance_dans_le_syndrome_de_Dravet\"><\/span><b><span data-contrast=\"none\">Tol\u00e9rance dans le syndrome de\u00a0Dravet<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:240,&quot;335559739&quot;:120,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span data-contrast=\"auto\">Les effets ind\u00e9sirables les plus fr\u00e9quents sont la somnolence, la diarrh\u00e9e, la perte d&#8217;app\u00e9tit et la fatigue. La plupart sont l\u00e9gers \u00e0 mod\u00e9r\u00e9s. Une interaction pharmacologique avec le clobazam a \u00e9t\u00e9 document\u00e9e (augmentation des taux plasmatiques actifs). Une surveillance h\u00e9patique est indispensable, en particulier en cas de\u00a0co-prescription de valproate.\u00a0[1]<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Efficacite_clinique_dans_le_syndrome_de_Lennox-Gastaut\"><\/span><b><span data-contrast=\"none\">Efficacit\u00e9 clinique dans le syndrome de Lennox-Gastaut<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span data-contrast=\"auto\">Le syndrome de Lennox-Gastaut (SLG) est une \u00e9pilepsie p\u00e9diatrique grave, g\u00e9n\u00e9ralement diagnostiqu\u00e9e entre 3 et 5 ans, caract\u00e9ris\u00e9e par des crises polymorphes et r\u00e9sistantes aux traitements. Les crises atoniques (dites \u00ab crises de chute \u00bb ou drop\u00a0attacks) sont particuli\u00e8rement invalidantes.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Un essai clinique de phase III publi\u00e9 dans le NEJM en 2018 a inclus 225 patients sous 1 \u00e0 3 anti\u00e9pileptiques, r\u00e9partis pour recevoir un placebo,\u00a0Epidyolex\u00a0\u00e0 10 mg\/kg\/j ou \u00e0 20 mg\/kg\/j, pendant 14 semaines.\u00a0[2]\u00a0R\u00e9sultats principaux :<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"15\" data-aria-level=\"1\"><span data-contrast=\"auto\">R\u00e9duction des crises de type drop : \u221237,2 % (10 mg\/kg) \u00e0 \u221241,9 % (20 mg\/kg) vs \u221217,2 % sous placebo (p = 0,002 et 0,005).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"16\" data-aria-level=\"1\"><span data-contrast=\"auto\">R\u00e9pondeurs (\u2265 50 %) : ~40 % sous CBD vs 15\u201320 % sous placebo.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"17\" data-aria-level=\"1\"><span data-contrast=\"auto\">Une m\u00e9ta-analyse a montr\u00e9 qu&#8217;Epidyolex\u00a0double environ le taux de r\u00e9pondeurs par rapport au placebo.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"18\" data-aria-level=\"1\"><span data-contrast=\"auto\">Am\u00e9lioration fonctionnelle : ~80 % des patients sous clobazam jug\u00e9s am\u00e9lior\u00e9s par les soignants vs ~45 % sous placebo.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Tolerance_dans_le_SLG\"><\/span><b><span data-contrast=\"none\">Tol\u00e9rance dans le SLG<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:240,&quot;335559739&quot;:120,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span data-contrast=\"auto\">Les effets secondaires incluent\u00a0une\u00a0somnolence,\u00a0une\u00a0perte d&#8217;app\u00e9tit,\u00a0la\u00a0diarrh\u00e9e et\u00a0la\u00a0fatigue, plus fr\u00e9quents \u00e0 20 mg\/kg\/j. Une \u00e9l\u00e9vation des transaminases h\u00e9patiques a \u00e9t\u00e9 observ\u00e9e, en\u00a0association avec le valproate. Six patients sous 20 mg\/kg et un sous 10 mg\/kg ont interrompu le traitement.\u00a0[2]<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<h4><b><span data-contrast=\"none\">Quels sont les b\u00e9n\u00e9fices concrets pour les patients ?<\/span><\/b><\/h4>\n<p><span data-contrast=\"auto\">Pour un enfant pr\u00e9sentant 80 crises de chute par mois, une r\u00e9duction de 40 % repr\u00e9sente environ 30 crises en moins, soit une diminution significative des risques de blessures graves. Les familles rapportent fr\u00e9quemment une meilleure vigilance diurne et une participation accrue aux activit\u00e9s quotidiennes. Il convient toutefois de surveiller les effets s\u00e9datifs, surtout en cas de polyth\u00e9rapie.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Efficacite_clinique_dans_la_sclerose_tubereuse_de_Bourneville\"><\/span><b><span data-contrast=\"none\">Efficacit\u00e9 clinique dans la scl\u00e9rose tub\u00e9reuse de Bourneville<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span data-contrast=\"auto\">La scl\u00e9rose tub\u00e9reuse de Bourneville (STB) est une maladie g\u00e9n\u00e9tique rare\u00a0qui provoque\u00a0la formation de tumeurs b\u00e9nignes dans plusieurs organes, dont le cerveau. Plus de 80 % des personnes atteintes d\u00e9veloppent de l&#8217;\u00e9pilepsie, souvent pr\u00e9coce et r\u00e9sistante aux traitements classiques. L&#8217;AMM pour cette indication a \u00e9t\u00e9 obtenue en 2020.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Une \u00e9tude de phase III (CARE1, 2020) a \u00e9valu\u00e9\u00a0Epidyolex\u00a0chez 224 patients \u00e2g\u00e9s de 1 \u00e0 57 ans, pr\u00e9sentant des crises r\u00e9sistantes (\u2265 8 crises\/mois sous au moins un anti\u00e9pileptique), randomis\u00e9s pour recevoir pendant 16 semaines un placebo, du CBD \u00e0 25 mg\/kg\/j ou \u00e0 50 mg\/kg\/j.\u00a0[3]<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Note<\/span><\/b><span data-contrast=\"auto\">\u00a0: les doses de 25 et 50 mg\/kg\/j correspondent aux bras de l&#8217;essai clinique. La dose maximale autoris\u00e9e dans l&#8217;AMM pour la STB est de 25 mg\/kg\/jour.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\"><strong>R\u00e9sultats principaux<\/strong> :<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"19\" data-aria-level=\"1\"><span data-contrast=\"auto\">R\u00e9duction m\u00e9diane des crises : \u221248,6 % (CBD 25 mg\/kg) et \u221247,5 % (CBD 50 mg\/kg) vs \u221226,5 % sous placebo.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"20\" data-aria-level=\"1\"><span data-contrast=\"auto\">R\u00e9pondeurs (\u2265 50 %) : 36 % (25 mg\/kg) et 40 % (50 mg\/kg) vs 22 % sous placebo.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"21\" data-aria-level=\"1\"><span data-contrast=\"auto\">Am\u00e9lioration de l&#8217;\u00e9tat g\u00e9n\u00e9ral : 69 % (25 mg\/kg) et 62 % (50 mg\/kg) vs 40 % sous placebo.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"22\" data-aria-level=\"1\"><span data-contrast=\"auto\">Les b\u00e9n\u00e9fices se sont maintenus sur plus d&#8217;un an sans perte d&#8217;efficacit\u00e9.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><b><span data-contrast=\"auto\">Remboursement et SMR pour la STB :<\/span><\/b><span data-contrast=\"auto\">\u00a0la HAS a accord\u00e9 un SMR mod\u00e9r\u00e9 uniquement pour les patients\u00a0pharmacor\u00e9sistants. Les patients non\u00a0pharmacor\u00e9sistants\u00a0ne b\u00e9n\u00e9ficient pas d&#8217;une prise en\u00a0charge par l&#8217;Assurance maladie.\u00a0[4]<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">\u00c0 lire aussi :\u202f<\/span><a href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-legislation\/peut-on-donner-du-cbd-a-son-enfant\/\"><span data-contrast=\"none\">Peut-on utiliser le CBD pour l\u2019autisme ou le TDAH ?\u202f<\/span><\/a><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Quels_sont_les_effets_indesirables%E2%80%AFpossibles%E2%80%AF\"><\/span><b><span data-contrast=\"none\">Quels sont les effets ind\u00e9sirables\u202fpossibles\u202f?<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:300,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"23\" data-aria-level=\"1\"><span data-contrast=\"auto\">Somnolence (dose-d\u00e9pendante)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"24\" data-aria-level=\"1\"><span data-contrast=\"auto\">Diarrh\u00e9e<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"25\" data-aria-level=\"1\"><span data-contrast=\"auto\">Perte d&#8217;app\u00e9tit<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"26\" data-aria-level=\"1\"><a href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-medicinal\/cbd-et-sommeil\/\"><span data-contrast=\"none\">Fatigue et troubles du sommeil<\/span><\/a><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"27\" data-aria-level=\"1\"><span data-contrast=\"auto\">\u00c9l\u00e9vation des transaminases h\u00e9patiques (ASAT\/ALAT),\u00a0surtout en association avec le valproate<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"28\" data-aria-level=\"1\"><span data-contrast=\"auto\">Modifications de l&#8217;humeur ou du comportement (\u00e0 signaler imm\u00e9diatement au m\u00e9decin)<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\n<p><\/span><\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Surveillance_hepatique_obligatoire\"><\/span><b><span data-contrast=\"none\">Surveillance h\u00e9patique obligatoire<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:300,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span data-contrast=\"auto\">En raison du risque d&#8217;atteinte h\u00e9patocellulaire, un bilan h\u00e9patique (transaminases, bilirubine) doit \u00eatre r\u00e9alis\u00e9 avant l&#8217;initiation, puis \u00e0 1 mois, 3 mois et 6 mois de traitement, puis p\u00e9riodiquement. Cette surveillance doit \u00eatre renforc\u00e9e lors d&#8217;une\u00a0co-prescription avec le valproate.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<h4><b><span data-contrast=\"none\">Contre-indications<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:300,&quot;335559740&quot;:276}\">\u00a0<\/span><\/h4>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"29\" data-aria-level=\"1\"><span data-contrast=\"auto\">Allergie au\u00a0cannabidiol\u00a0ou \u00e0 l&#8217;un des excipients (notamment l&#8217;huile de s\u00e9same).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"30\" data-aria-level=\"1\"><span data-contrast=\"auto\">Enfants de moins de 2 ans.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"31\" data-aria-level=\"1\"><span data-contrast=\"auto\">Grossesse (sauf exception m\u00e9dicalement justifi\u00e9e).\u00a0<\/span><a href=\"https:\/\/greenowl.fr\/grossesse-cbd\/\"><span data-contrast=\"none\">Epidyolex\u00a0n&#8217;est pas recommand\u00e9 pendant la grossesse.<\/span><\/a><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"32\" data-aria-level=\"1\"><span data-contrast=\"auto\">Allaitement d\u00e9conseill\u00e9 (passage du CBD dans le lait maternel non exclu).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">\u00c0 lire\u00a0aussi :\u00a0<\/span><a href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-medicinal\/trisomie-21\/\"><span data-contrast=\"none\">Le CBD peut-il aider dans la trisomie 21 ?<\/span><\/a><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">\u00c0 lire aussi :\u00a0<\/span><a href=\"https:\/\/greenowl.fr\/blog\/blog-cbd-medicinal\/thyroide-cbd\/\"><span data-contrast=\"none\">Peut-on prendre du CBD en cas de probl\u00e8me de thyro\u00efde ?<\/span><\/a><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\"><\/p>\n<p><\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Interactions_medicamenteuses\"><\/span><b><span data-contrast=\"none\">Interactions m\u00e9dicamenteuses<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:300,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span data-contrast=\"auto\">Epidyolex\u00a0interagit avec de nombreux m\u00e9dicaments\u00a0qui n\u00e9cessite\u00a0une vigilance particuli\u00e8re et parfois un ajustement posologique :<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"33\" data-aria-level=\"1\"><span data-contrast=\"auto\">Anti\u00e9pileptiques : clobazam, valproate, ph\u00e9nyto\u00efne,\u00a0stiripentol,\u00a0lamotrigine, carbamaz\u00e9pine, midazolam, loraz\u00e9pam.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"34\" data-aria-level=\"1\"><span data-contrast=\"auto\">Inhibiteurs enzymatiques :\u00a0k\u00e9toconazole,\u00a0fluconazole, clarithromycine, \u00e9rythromycine.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"35\" data-aria-level=\"1\"><span data-contrast=\"auto\">Inducteurs enzymatiques : rifampicine, millepertuis,\u00a0enzalutamide.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"36\" data-aria-level=\"1\"><span data-contrast=\"auto\">Autres m\u00e9dicaments : om\u00e9prazole, v\u00e9rapamil, tacrolimus, propofol, simvastatine, th\u00e9ophylline,\u00a0fluvoxamine,\u00a0bupropion, morphine, \u00e9favirenz,\u00a0ticlopidine.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<ul>\n<li aria-setsize=\"-1\" data-leveltext=\"\u2022\" data-font=\"Arial,Times New Roman\" data-listid=\"1\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;\u2022&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" data-aria-posinset=\"37\" data-aria-level=\"1\"><span data-contrast=\"auto\">Alimentation : le jus de pamplemousse peut modifier le m\u00e9tabolisme du CBD.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:60,&quot;335559739&quot;:60,&quot;335559740&quot;:276}\">\u00a0<\/span><\/li>\n<\/ul>\n<p><b><span data-contrast=\"auto\">Attention\u202f:\u00a0<\/span><\/b><span data-contrast=\"auto\">Epidyolex\u00a0provoque de la somnolence. Il convient d&#8217;\u00e9valuer la tol\u00e9rance individuelle avant de conduire ou d&#8217;utiliser des machines, notamment chez l&#8217;enfant pratiquant des activit\u00e9s sportives.\u00a0[5]<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Comparaison_avec_dautres_traitements_antiepileptiques\"><\/span><b><span data-contrast=\"none\">Comparaison avec d&#8217;autres traitements anti\u00e9pileptiques<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:400,&quot;335559739&quot;:200,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span data-contrast=\"auto\">Epidyolex\u00a0ne remplace pas les anti\u00e9pileptiques de premi\u00e8re ligne, mais les compl\u00e8te. Il\u00a0peut\u00a0apporter\u00a0une option suppl\u00e9mentaire lorsque les traitements existants sont insuffisants ou mal tol\u00e9r\u00e9s.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<table data-tablestyle=\"MsoNormalTable\" data-tablelook=\"0\" aria-rowcount=\"4\">\n<tbody>\n<tr aria-rowindex=\"1\">\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">Traitement<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">Efficacit\u00e9<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">R\u00e9pondeurs \u226550%<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">Indication<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">Avantages<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><b><span data-contrast=\"none\">Inconv\u00e9nients<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<\/tr>\n<tr aria-rowindex=\"2\">\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Epidyolex<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">\u221230 \u00e0 50%<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">40\u201343%<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Traitement adjuvant<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Non s\u00e9datif \u00e0 doses standards, non t\u00e9ratog\u00e8ne<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Polyth\u00e9rapie requise, surveillance h\u00e9patique<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<\/tr>\n<tr aria-rowindex=\"3\">\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Valproate<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">~50%<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">~55%<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Premi\u00e8re ligne<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Efficace rapidement, large spectre<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">T\u00e9ratog\u00e8ne, effets cognitifs<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<\/tr>\n<tr aria-rowindex=\"4\">\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Clobazam<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">\u221268%<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">~78%<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Adjuvant<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">Efficacit\u00e9 rapide<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<td data-celllook=\"69905\"><span data-contrast=\"auto\">D\u00e9pendance, s\u00e9dation, tol\u00e9rance<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:2,&quot;335551620&quot;:2,&quot;335559739&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><span data-contrast=\"auto\">Ces traitements ne s&#8217;excluent pas mutuellement. Par exemple, un patient atteint du syndrome de\u00a0Dravet\u00a0peut associer valproate, clobazam,\u00a0stiripentol\u00a0et\u00a0Epidyolex\u00a0pour un contr\u00f4le des crises.\u00a0<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Contrairement au valproate,\u00a0Epidyolex\u00a0n&#8217;est pas t\u00e9ratog\u00e8ne, ce qui peut influencer les choix th\u00e9rapeutiques chez les femmes en \u00e2ge de procr\u00e9er. Contrairement au clobazam, il n&#8217;entra\u00eene pas de d\u00e9pendance pharmacologique.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335551550&quot;:6,&quot;335551620&quot;:6,&quot;335559738&quot;:80,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:300,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Sources\"><\/span><b><span data-contrast=\"none\">Sources\u00a0<\/span><\/b><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559738&quot;:300,&quot;335559740&quot;:276}\">\u00a0<\/span><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>[1] Devinsky O et al. \u2014 Cannabidiol in Dravet Syndrome \u2014 New England Journal of Medicine, 2017 \u2014 PubMed 28538134\u00a0<\/em><\/p>\n<p><em>[2] Thiele EA et al. \u2014 Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome \u2014 NEJM, 2018 \u2014 PubMed 29768152\u00a0<\/em><\/p>\n<p><em>[3] Thiele EA et al. \u2014 Cannabidiol for seizures associated with tuberous sclerosis complex \u2014 Lancet Neurology, 2021 \u2014 PubMed 33346789\u00a0<\/em><\/p>\n<p><em>[4] HAS \u2014 Avis de la Commission de la Transparence du 13 mai 2020 et du 1er d\u00e9cembre 2021 \u2014 has-sante.fr\u00a0<\/em><\/p>\n<p><em>[5] VIDAL \u2014 Epidyolex 100 mg\/mL solution buvable \u2014 vidal.fr\u00a0<\/em><\/p>\n<p><em>[6] ANSM \u2014 Notice ATU Epidyolex solution buvable \u2014 ansm.sante.fr\u00a0<\/em><\/p>\n<p><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559740&quot;:276}\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00c0 retenir\u00a0\u00a0 Epidyolex\u00a0est une avanc\u00e9e th\u00e9rapeutique majeure pour certaines \u00e9pilepsies r\u00e9fractaires s\u00e9v\u00e8res\u00a0 Il est disponible en pharmacie de ville depuis janvier 2023\u00a0 La prescription est strictement encadr\u00e9e (neurologues\/neurop\u00e9diatres) avec surveillance h\u00e9patique r\u00e9guli\u00e8re\u00a0 Selon les donn\u00e9es cliniques, il pourrait aider \u00e0 r\u00e9duire des crises d\u2019environ 30 \u00e0 50 %\u00a0\u00a0 Le profil de tol\u00e9rance\u00a0est\u00a0jug\u00e9 acceptable \u00e0 long<\/p>\n","protected":false},"author":2,"featured_media":314924,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[9],"tags":[],"class_list":["post-314922","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-cbd-legislation"],"_links":{"self":[{"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/posts\/314922","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/comments?post=314922"}],"version-history":[{"count":12,"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/posts\/314922\/revisions"}],"predecessor-version":[{"id":316396,"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/posts\/314922\/revisions\/316396"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/media\/314924"}],"wp:attachment":[{"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/media?parent=314922"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/categories?post=314922"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/greenowl.fr\/blog\/wp-json\/wp\/v2\/tags?post=314922"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}