Considerable Lack of Rigorous Studies on Cannabinoid Use in Rheumatic Disease

HealthDay News –  A meta-analysis published in Arthritis Care & Research found a relative lack of strong clinical trials supporting the use of medicinal cannabinoids for rheumatic disease, showing that the few trials available had small study participants and were vulnerable to high risk of bias. 

Numerous side effects including dizziness, drowsiness, and gastrointestinal effects were found to be common.  Further limiting research was the lack of standardized, pharmaceutical preparations studied in randomized controlled trials compared to standard treatment.

Mary-Ann Fitzcharles, MBChB, from the McGill University Health Center in Montreal, and colleagues conducted a systematic review to examine the efficacy, tolerability, and safety of cannabinoids in the management of rheumatic diseases. Data were included for four short-term studies involving 203 patients (58 with rheumatoid arthritis, 71 with fibromyalgia, and 74 with osteoarthritis [OA]).

The researchers found that cannabinoids had a significant effect on pain in two studies, sleep in two studies, and improved quality of life in one study; the OA study was terminated prematurely due to futility. All three completed studies had high risk of bias. 

For almost half of the patients, dizziness, cognitive issues, and drowsiness were reported, as well as nausea. During the study duration there were no serious adverse events reported for cannabinoids.

“Pain relief and effect on sleep may have some potential therapeutic benefit, but with considerable mild to moderate adverse events,” the authors write. 

Summary and Clinical Applicability

To date, there is a relative lack of rigorous, comprehensive clinical trial data on the efficacy of treating rheumatic disease with medicinal cannabinoids. 

“In view of the considerable limitations of the studies examined in this review, including small sample sizes, short duration, only modest efficacy, and a high rate of mild to moderate adverse effects, it is not currently possible to recommend this category of treatments as therapy for patients with rheumatic diseases”, the authors concluded.

Reference

Fitzcharles MA, Ste-marie PA, Häuser W, et al. Efficacy, Tolerability, and Safety of Cannabinoid Treatments in the Rheumatic Diseases: A Systematic Review of Randomized Controlled Trials. Arthritis Care Res (Hoboken). 2016;68(5):681-8.