W. Benjamin Nowell
Nearly 60% of patients with arthritis reported using cannabidiol products to relieve pain and other symptoms despite limited evidence showing efficacy of these products, according to findings presented at the EULAR Annual Congress.
â€śWe werenâ€™t entirely surprised that so many participants reported their use of these substancesÂ for what they deem medical reasons, particularly since these products are becoming easier to obtain, less stigmatized and more widely publicized,â€ť W. Benjamin Nowell, PhD, director of Patient-Centered Research at CreakyJoints and an ArthritisPower co-principal investigator told Healio Rheumatology. â€śPlus, despite the efforts of rheumatologists and their patients to find an effective arthritis treatment and management strategy, there are still many patients who seek additional relief for chronic symptoms.â€ť
To investigate patient behavior and information needs surrounding cannabidiol (CBD) and tetrahydrocannabinol (THC), Nowell and colleagues sent a 77-item survey to 1,059 participants from the CreakyJoints and ArthritisPower research registries. Rheumatoid arthritis was the primary diagnosis in 46% of the cohort, and less than 30% reported satisfaction with their current treatment regimen.
According to survey results, 57% of patients reported trying medical marijuana or CBD, with a number of reasons motivating their use, including: Addressing symptoms despite other medication use (44%); addressing symptoms while taking less or no medication (30%); nothing else worked to treat the condition (18%); former recreational user and wanted to try it for their diagnosis (13%), and; it became legal in their state (13%).
The researchers found that 52% of patients reported ever using CBD, and 37% reported using medical marijuana. Among the medical marijuana users, 67% reported currently using it and 62% noted using it at least once daily. Friends, physicians, and online information were the primary sources where patients learned about CBD or medical marijuana as a treatment for rheumatic diseases.
â€śWhatâ€™s most concerning about the study results is that so many people with serious conditions are trying marijuana for medical use or cannabidiol in the absence of high-quality evidence about their safety, effectiveness and appropriate dosing,â€ť Nowell said.
Survey results also demonstrated that more than half of the cohort (53%) used medical marijuana in lieu of prescribed medications, while 62.8% used the drug in lieu of over-the-counter medications. In addition, 64.6% of patients had informed their health care profession about medical marijuana use; however, less than 60% of patients noted that their health care professional did not consider marijuana or CBD as treatment options.
â€śThe survey found that a third of participants chose not to tell their health care provider about their use of these substances,â€ť Nowell said. â€śOf those who had informed their health care providers about their medical marijuana use, 58% reported that their doctor did not take it into account when making changes to their treatment, nor did they offer advice about proper dosage and administration.â€ť
Regardless of marijuana or CBD use, about two-thirds of the cohort wanted information about its use, with 38.6% desiring information about efficacy and 54.3% inquiring after information about how it interacts with other medications. Although most patients (55%) preferred acquiring this information from a health care professional, many (34%) were also receptive to online educational resources for these materials.
â€śOur study underscores the urgent need to conduct randomized controlled trials to study their effectiveness at addressing symptoms common to arthritis as well as their potential to interact with other medications,â€ť Nowell said. â€śOnly sufficiently powered, double-blinded randomized controlled trials that minimize bias on the part of both researchers and participants will be able to indicate whether medical marijuana and CBD products are safe and effective for rheumatic and musculoskeletal disease. To date, there are no studies underway in the United States, with one of the biggest barriers being that marijuana is considered a Schedule 1 substance.â€ťÂ â€”by Rob Volansky
Gavigan K, et al. THU0644. Presented at: EULAR Annual Congress; June 12-15; Madrid, Spain.
Disclosure: Nowell reports no relevant financial disclosures.