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Dubois C, Danielson EC, Beestrum M, Eurich DT. Medical cannabis and its efficacy/effectiveness on the management of osteoarthritis pain and function. Curr Med Res Opin 2024; 40:1195-1202. [PMID: 38832841 DOI: 10.1080/03007995.2024.2363945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/31/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE Despite pharmacological treatments for osteoarthritis (OA), more individuals are choosing medical cannabis for OA symptom management and for mitigating opioid prescriptions for OA. This systematic review examines the global evidence of medical cannabis use on OA pain and function. METHODS The search was completed in MEDLINE (PubMed), Embase, and CINAHL within the past 10 years (2012-2022). We limited the search to English language articles. We did not include grey literature or case studies. Participant demographics included all adult individuals with OA who were using medical cannabis for OA. Study quality and risk of bias were evaluated using the Grading of Recommendations, Assessment, Development and Evaluations framework; and the Risk of Bias in Non-randomized Studies of Interventions tool. We used a narrative synthesis approach. RESULTS Overall, 7 studies were included: 2 randomized controlled trials (RCT) and 5 observational studies. Only 1 of the 2 RCTs reported improvements in pain for cannabis users. All 5 observational studies reported an improvement in pain levels, reduction of opioid use, and/or improvement in overall OA function. Despite high risk of bias ratings and low study quality, the consensus across studies was that medical cannabis use was effective for a subgroup of individuals suffering from OA pain. CONCLUSIONS There is low quality evidence to support medical cannabis use as a substitute for primary pharmacological treatment of OA. However, this does not negate the observations that medical cannabis may provide therapeutic relief for a subset of patients. SYSTEMATIC REVIEW PROPSERO REGISTRATION CRD42022354026.
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Affiliation(s)
- Cerina Dubois
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | | | - Molly Beestrum
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Landa L, Trojan V, Demlova R, Jurica J, Hrib R. Cannabidiol and the possibilities of its use in veterinary medicine of dogs and horses: A brief review. VET MED-CZECH 2022; 67:455-462. [PMID: 38715968 PMCID: PMC11071133 DOI: 10.17221/127/2021-vetmed] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 04/12/2022] [Indexed: 08/22/2024] Open
Abstract
In connection with the use of cannabinoids for therapeutic purposes in human medicine, there is increased attention for their use in veterinary medicine, particularly by the owners of companion animals and horses. Therefore, veterinarians are expected to face this interest and have the corresponding knowledge on these substances. Presently, it is not possible to use medical marijuana (in terms of the dried cannabis flowers) for veterinary purposes in many countries, but there is increasing evidence that isolated cannabinoids also have beneficial effects (namely cannabidiol - CBD). Thus, this review summarises the possible therapeutic implications of CBD within the scope of evidence-based medicine, particularly in dogs and horses in association with the treatment of pain, epilepsy and anxiety in order to provide veterinarians with a concise overview of scientific findings in this field.
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Affiliation(s)
- Leos Landa
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Clinical Pharmacology Unit, Centre for Translational Medicine, International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | - Vaclav Trojan
- Clinical Pharmacology Unit, Centre for Translational Medicine, International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
| | - Regina Demlova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Jan Jurica
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Radovan Hrib
- Clinical Pharmacology Unit, Centre for Translational Medicine, International Clinical Research Centre, St. Anne’s University Hospital, Brno, Czech Republic
- Centre for Pain Management, Department of Anesthesiology and Intensive Care, St. Anne’s University Hospital, Brno, Czech Republic
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Abstract
Purpose of Review This review will address the many uncertainties surrounding the medical use of cannabidiol (CBD). We will begin with an overview of the legal and commercial environment, examine recent preclinical and clinical evidence on CBD, explore questions concerning CBD raised by healthcare professionals and patients, investigate dosing regimens and methods of administration, and address current challenges in the accumulation of sound evidence. Recent Findings CBD has potential for relief of symptoms of pain, sleep, and mood disturbance in rheumatology patients, but sound clinical evidence is lacking. CBD is safe when accessed from a regulated source, whereas wellness products are less reliable regarding content and contaminants. Dosing for symptom relief has not yet been established. Summary As many rheumatology patients are trying CBD as a self-management strategy, the healthcare community must urgently accrue sound evidence for effect.
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Cannabis for Rheumatic Disease Pain: a Review of Current Literature. Curr Rheumatol Rep 2022; 24:119-131. [PMID: 35486218 DOI: 10.1007/s11926-022-01065-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Changing attitudes about marijuana have led to an increase in use of medicinal marijuana, especially for painful chronic conditions. Patients ask rheumatologists for guidance on this topic. This review provides up-to-date information on the safety and efficacy of medicinal cannabis for rheumatic disease pain. RECENT FINDINGS The number of publications related to rheumatic disease and cannabis has increased, but recent literature skews heavily toward reviews vs primary research. Data supporting a role for cannabinoids in rheumatic disease continue to grow. Observational and survey studies show increased use of medicinal cannabis, both by people with rheumatic disease and the general population, and suggest that patients find these treatments beneficial. Prospective studies, however, including randomized controlled clinical trials, are rare and sorely needed. As medicinal cannabis use for rheumatic diseases rises, despite lack of evidence, we review the sparse data available and provide tips for conversations about medicinal cannabis for rheumatologists.
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Lippert A, Renner B. Herb-Drug Interaction in Inflammatory Diseases: Review of Phytomedicine and Herbal Supplements. J Clin Med 2022; 11:1567. [PMID: 35329893 PMCID: PMC8951360 DOI: 10.3390/jcm11061567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023] Open
Abstract
Many people worldwide use plant preparations for medicinal purposes. Even in industrialized regions, such as Europe, where conventional therapies are accessible for the majority of patients, there is a growing interest in and usage of phytomedicine. Plant preparations are not only used as alternative treatment, but also combined with conventional drugs. These combinations deserve careful contemplation, as the complex mixtures of bioactive substances in plants show a potential for interactions. Induction of CYP enzymes and pGP by St John's wort may be the most famous example, but there is much more to consider. In this review, we shed light on what is known about the interactions between botanicals and drugs, in order to make practitioners aware of potential drug-related problems. The main focus of the article is the treatment of inflammatory diseases, accompanied by plant preparations used in Europe. Several of the drugs we discuss here, as basal medication in chronic inflammatory diseases (e.g., methotrexate, janus kinase inhibitors), are also used as oral tumor therapeutics.
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Affiliation(s)
- Annemarie Lippert
- Institute of Clinical Pharmacology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, 01069 Dresden, Germany;
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Mena M, Dalbah L, Levi L, Padilla M, Enciso R. Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis. J Dent Anesth Pain Med 2020; 20:337-356. [PMID: 33409363 PMCID: PMC7783375 DOI: 10.17245/jdapm.2020.20.6.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/23/2020] [Accepted: 11/23/2020] [Indexed: 01/19/2023] Open
Abstract
This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.
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Affiliation(s)
- Mariam Mena
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA
| | - Lana Dalbah
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA
- Post-graduate Orthodontic Department, European University College, Dubai, United Arab Emirates
| | - Lauren Levi
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA
- New York University School of Dentistry, New York, New York, USA
| | - Mariela Padilla
- Assistant Director of Online Programs, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA
| | - Reyes Enciso
- Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
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Formato M, Crescente G, Scognamiglio M, Fiorentino A, Pecoraro MT, Piccolella S, Catauro M, Pacifico S. (‒)-Cannabidiolic Acid, a Still Overlooked Bioactive Compound: An Introductory Review and Preliminary Research. Molecules 2020; 25:molecules25112638. [PMID: 32517131 PMCID: PMC7321064 DOI: 10.3390/molecules25112638] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 12/17/2022] Open
Abstract
Cannabidiolic acid (CBDA) is the main phytocannabinoid in fiber and seed-oil hemp (Cannabis sativa L.) plants, but its potential health-related capabilities have been masked for years by a greater scientific interest towards its neutral derivative cannabidiol (CBD). This review aims to collect from the literature and critically discuss all the information about this molecule, starting from its biosynthesis, and focusing on its bioactivity, as an anti-inflammatory, anti-emetic, anti-convulsant, and anti-cancerogenic drug. Furthermore, in the awareness that, despite its multiple bioactive effects, currently poor efforts have been made to achieve its reliable purification, herein, we propose a relatively simple, fast, and inexpensive procedure for its recovery from pollen of industrial hemp cultivars. Spectroscopic and spectrometric techniques allowed us to unequivocally identify pure isolated CBDA and to distinguish it from the constitutional isomer tetrahydrocannabinolic acid (THCA-A).
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Affiliation(s)
- Marialuisa Formato
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy; (M.F.); (G.C.); (M.S.); (A.F.); (M.T.P.); (S.P.)
| | - Giuseppina Crescente
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy; (M.F.); (G.C.); (M.S.); (A.F.); (M.T.P.); (S.P.)
| | - Monica Scognamiglio
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy; (M.F.); (G.C.); (M.S.); (A.F.); (M.T.P.); (S.P.)
| | - Antonio Fiorentino
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy; (M.F.); (G.C.); (M.S.); (A.F.); (M.T.P.); (S.P.)
| | - Maria Tommasina Pecoraro
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy; (M.F.); (G.C.); (M.S.); (A.F.); (M.T.P.); (S.P.)
| | - Simona Piccolella
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy; (M.F.); (G.C.); (M.S.); (A.F.); (M.T.P.); (S.P.)
| | - Michelina Catauro
- Department of Engineering, University of Campania “Luigi Vanvitelli”, Via Roma 29, I-81031 Aversa, Italy;
| | - Severina Pacifico
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy; (M.F.); (G.C.); (M.S.); (A.F.); (M.T.P.); (S.P.)
- Correspondence:
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