Cannabis-Based Medicines and Medical Cannabis in Rheumatic Diseases: A Treasure Chest or Pandora’s box
Interest in cannabinoids as a therapy in rheumatic diseases has grown exponentially. With legalization of medical and recreational cannabis in many jurisdictions worldwide, patients have easier access and opportunity to explore medicinal use. We report on the evidence for effect of cannabinoids in rheumatic diseases and critically address the current challenges surrounding use.
Preclinical study of cannabinoids points to an effect on pain and inflammation, fundamental features of rheumatic diseases. The findings of the few randomized controlled trials (RCTSs) of cannabis-based medicines in rheumatic diseases are limited by short study duration, small study samples, and methodology flaws. There are no RCTs of medical cannabis in rheumatic diseases. Therefore, current guidelines mostly recommend against use of any cannabinoid product for rheumatology patients.
Even with limited clinical evidence, patients are increasingly showing interest in cannabis. Rheumatologists must be diligent in exploring other established treatment options prior to a trial of cannabinoids in any form. Cannabis holds potential as a treasure chest for rheumatic disease treatment, but with true effect and risks largely unknown and requiring study. Governments’ move to legalize medical cannabis has bypassed the established procedures of drug approval and opened Pandora’s box.
KeywordsCannabinoids Rheumatic disease Medicinal herbal cannabis
Compliance with Ethical Standards
Conflict of Interest
Dr. Fitzcharles declares that she has no conflicts of interest.
Dr. Häuser received travel and hotel reimbursement from Bioevents. Dr. Häuser is the head of the task force of a position paper of the European Pain Federation on cannabis-based medicines and medical cannabis for chronic pain, and a member of the task force of the German Pain Society of a position paper on cannabis-based medicines and medical cannabis for chronic pain.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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