Nearly one in five patients suffering from rheumatologic diseases actively consume cannabis, with an improvement in pain, write researchers at Clermont-Ferrand University Hospital in France in an article in the journal Rheumatology.
Doctors should address cannabis use during consultations with patients, “essentially with cannabis-based standardised pharmaceutical products”, the scientists propose.
Cannabis use assessment and its impact on pain in rheumatologic diseases: A systematic review and meta-analysis
Rheumatolody. Published on 7 November 2020.
Authors
M Guillouard, N Authier, B Pereira, M Soubrier and S Mathieu
Author affiliations:
Clermont-Ferrand University Hospital
Université Clermont Auvergne
French Monitoring Centre for Analgesic Drugs
Abstract
Despite classic analgesic or effective treatments in rheumatic diseases, such as synthetic DMARDs in RA, patients remain in pain and often turn to non-prescribed pharmacological alternatives, such as cannabis self-therapeutic use. However, this medical use of cannabis has not been thoroughly studied.
Methods
We performed a systematic literature review up to June 2020. The incidence of cannabis consumption was calculated by metaproportion. Differences between cannabis users and non-users were expressed as standardized mean differences using the inverse-variance method. We also assessed the effects of cannabis on pain.
Results
A total of 2900 patients reported cannabis consumption in a sample of 10 873 patients [incidence 40.4% (95% confidence interval (CI): 0.28, 0.54)], and 15.3% (95% CI: 0.07, 0.27) specified that they were currently taking cannabis.
Cannabis use was higher in the four fibromyalgia studies [68.2% (95% CI: 0.41, 0.90), n = 611] compared with seven articles concerning RA or lupus [26.0% (95% CI: 0.14, 0.41), n = 8168].
Cannabis consumption was associated with a decrease in pain intensity [VAS pain at baseline 8.2 (2.9) vs 5.6 (3.5) mm over time; pooled effect size −1.75 (95% CI: −2.75, −0.76)]. Cannabis users were younger [58.4 (11.4) vs 63.6 (12.1) years; P <0.001], more often smokers [OR 2.91 (95% CI: 1.84, 4.60)] or unemployed [OR 2.40 (95% CI: 1.31, 4.40)], and had higher pain intensity [5.0 (2.4) vs 4.1(2.6) mm; P <0.001] than non-users.
Conclusion
Nearly 20% of patients suffering from rheumatologic diseases actively consume cannabis, with an improvement in pain.
The issue of cannabis use in the management of these patients should be addressed during medical consultation, essentially with cannabis-based standardized pharmaceutical products.
[link url="https://academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keaa534/5960204?redirectedFrom=fulltext"]Cannabis use assessment and its impact on pain in rheumatologic diseases: A systematic review and meta-analysis[/link]