An Updated Analysis of Clinical Outcome Measures Across Patients From the UK Medical Cannabis Registry

Ergisi, Mehmet; Erridge, Simon; Harris, Michael; Kawka, Michal; Nimalan, Devaki; Salazar, Oliver; Loupasaki, Katerina; Ali, Rayyan Al; Holvey, Carl; Coomber, Ross; Usmani, Azfer; Sajad, Mohammed; Beri, Sushil; Hoare, Jonathan; Khan, Saira; Weatherall, Mark; Platt, Michael; Rucker, James; Sodergren, Mikael H.

doi:10.1089/can.2021.0145

Cited by 24 publications

(25 citation statements)

References 32 publications

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“…A questionnaire survey of 1513 New England dispensary members in 2017 revealed that regular use of medical marijuana reduced reliance on opioids, benzodiazepines, antidepressants, alcohol, and anti-anxiety, migraine, and sleep medications in significant proportions of the population [210]. Analysis of patient-reported outcome measures in 312 patients from the UK medical cannabis registry revealed statistically significant improvements at 6 months in the Generalized Anxiety Disorder Scale score (GAD-7, p < 0.001), the EuroQol Group EQ-5D-5L index value (p < 0.001), the EQ-5D Visual Analog Scale score (VAS, p < 0.012), and the Sleep Quality Scale (SQS, p < 0.001) score [211]. The most common adverse effects reported were nausea (3.8%), dry mouth (3.2%), dizziness (2.2%), and somnolence (2.2%) [211].…”

Section: Challenges and Opportunities Of Cannabinoid Researchmentioning

confidence: 99%

“…Analysis of patient-reported outcome measures in 312 patients from the UK medical cannabis registry revealed statistically significant improvements at 6 months in the Generalized Anxiety Disorder Scale score (GAD-7, p < 0.001), the EuroQol Group EQ-5D-5L index value (p < 0.001), the EQ-5D Visual Analog Scale score (VAS, p < 0.012), and the Sleep Quality Scale (SQS, p < 0.001) score [211]. The most common adverse effects reported were nausea (3.8%), dry mouth (3.2%), dizziness (2.2%), and somnolence (2.2%) [211]. Challenges faced with the use of medical marijuana include a narrow therapeutic window, as well as deactivation of cytochrome P450 and other liver enzymes, thus altering the metabolism of a wide range of compounds.…”

Section: Challenges and Opportunities Of Cannabinoid Researchmentioning

confidence: 99%

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Neurological Benefits, Clinical Challenges, and Neuropathologic Promise of Medical Marijuana: A Systematic Review of Cannabinoid Effects in Multiple Sclerosis and Experimental Models of Demyelination

et al. 2022

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Despite current therapeutic strategies for immunomodulation and relief of symptoms in multiple sclerosis (MS), remyelination falls short due to dynamic neuropathologic deterioration and relapses, leading to accrual of disability and associated patient dissatisfaction. The potential of cannabinoids includes add-on immunosuppressive, analgesic, neuroprotective, and remyelinative effects. This study evaluates the efficacy of medical marijuana in MS and its experimental animal models. A systematic review was conducted by a literature search through PubMed, ProQuest, and EBSCO electronic databases for studies reported since 2007 on the use of cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) in MS and in experimental autoimmune encephalomyelitis (EAE), Theiler’s murine encephalomyelitis virus-induced demyelinating disease (TMEV-IDD), and toxin-induced demyelination models. Study selection and data extraction were performed by 3 reviewers, and 28 studies were selected for inclusion. The certainty of evidence was appraised using the Cochrane GRADE approach. In clinical studies, there was low- and moderate-quality evidence that treatment with ~1:1 CBD/THC mixtures as a nabiximols (Sativex®) oromucosal spray reduced numerical rating scale (NRS) scores for spasticity, pain, and sleep disturbance, diminished bladder overactivity, and decreased proinflammatory cytokine and transcription factor expression levels. Preclinical studies demonstrated decreases in disease severity, hindlimb stiffness, motor function, neuroinflammation, and demyelination. Other experimental systems showed the capacity of cannabinoids to promote remyelination in vitro and by electron microscopy. Modest short-term benefits were realized in MS responders to adjunctive therapy with CBD/THC mixtures. Future studies are recommended to investigate the cellular and molecular mechanisms of cannabinoid effects on MS lesions and to evaluate whether medical marijuana can accelerate remyelination and retard the accrual of disability over the long term.

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Section: Challenges and Opportunities Of Cannabinoid Researchmentioning

confidence: 99%

Section: Challenges and Opportunities Of Cannabinoid Researchmentioning

confidence: 99%

Neurological Benefits, Clinical Challenges, and Neuropathologic Promise of Medical Marijuana: A Systematic Review of Cannabinoid Effects in Multiple Sclerosis and Experimental Models of Demyelination

et al. 2022

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“…The present study is also limited to respondents from one clinic in the UK. However, Sapphire Medical Clinics were the first clinic registered with appropriate regulators and have set up the UK Medical Cannabis Registry, which is the largest prospective observational cohort dataset of clinical outcomes following CBPM therapy of its kind in Europe [ 9 , 10 , 11 ]. Moreover, they treat patients across all four nations in the UK and Channel Islands, ensuring geographic diversity.…”

Section: Discussionmentioning

confidence: 99%

“…It can also lead to chronic stress and anxiety, in addition to subsequent mental and physical problems that can cause individuals to feel isolated and withdrawn [ 5 , 7 ], therefore limiting access [ 8 ]. Whilst there is a growing body of evidence on the associated effects of CBMPs on health-related quality of life in several health conditions [ 9 , 10 , 11 ], there is a paucity of knowledge on the prevalence and subsequent effects of stigma on the current and prospective UK patients [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Perceived Stigma of Patients Undergoing Treatment with Cannabis-Based Medicinal Products

Troup

Erridge

Ciesluk

et al. 2022

IJERPH

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Cannabis-based medicinal products (CBMPs) are prescribed with increasing frequency. This study aimed to investigate the perceived stigma attached to patients prescribed CBMPs in the UK to establish its prevalence. A qualitative survey was developed by an expert multidisciplinary group and data were collected via Qualtrics. In total, 2319 patients on CBMP therapy were invited to take part in this study. 450 (19.4%) participants completed the questionnaire. In total, 81.3% (n = 366), 76.9% (n = 346), and 61.3% (n = 276) of participants reported feeling very comfortable or comfortable telling friends, family, and medical professionals, respectively, about their treatment. Participants thought that friends (n = 372; 82.7%) and family (n = 339; 75.3%) were very approving or somewhat approving of their CBMP prescription. However, participants thought that only 37.8% (n = 170) of healthcare professionals and 32.9% (n = 148) of society in general were very approving or somewhat approving of their CBMP prescription. 57.1% (n = 257), 55.3% (n = 249), and 40.2% (n = 181) of participants were afraid of what the police or criminal justice system, other government agencies, and healthcare professionals might think about their treatment. This study highlights those patients treated with CBMPs experience a high prevalence of perceived stigma from many corners of society. Future work should be undertaken to explore strategies to reduce perceived stigma at an individual and community level to avoid discrimination of patients, likely increasing appropriate access.

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“…After over 2000 years of medicinal use by many cultures around the world, the most common indication for cannabis and cannabis-based medicine (CBM) use is still to relieve chronic pain (Boehnke et al 2019 ; Ergisi et al 2022 ). The National Academy for Science, Engineering and Medicine in the United States of America reviewed the clinical evidence in 2017 and found that there was substantial evidence that CBM was effective for chronic pain treatment (National Academies of Sciences, Engineering, and Medicine.…”

Section: Efficacy Of Thc/cbd and Cbd-only Medicines For Pain And Ment...mentioning

confidence: 99%

Tetrahydrocannabinol and cannabidiol medicines for chronic pain and mental health conditions

Henson¹,

Vitetta

Hall³

2022

Inflammopharmacol

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Combination tetrahydrocannabinol (THC)/cannabidiol (CBD) medicines or CBD-only medicines are prospective treatments for chronic pain, stress, anxiety, depression, and insomnia. THC and CBD increase signaling from cannabinoid receptors, which reduces synaptic transmission in parts of the central and peripheral nervous systems and reduces the secretion of inflammatory factors from immune and glial cells. The overall effect of adding CBD to THC medicines is to enhance the analgesic effect but counteract some of the adverse effects. There is substantial evidence for the effectiveness of THC/CBD combination medicines for chronic pain, especially neuropathic and nociplastic pain or pain with an inflammatory component. For CBD-only medication, there is substantial evidence for stress, moderate evidence for anxiety and insomnia, and minimal evidence for depression and pain. THC/CBD combination medicines have a good tolerability and safety profile relative to opioid analgesics and have negligible dependence and abuse potential; however, should be avoided in patients predisposed to depression, psychosis and suicide as these conditions appear to be exacerbated. Non-serious adverse events are usually dose-proportional, subject to tachyphylaxis and are rarely dose limiting when patients are commenced on a low dose with gradual up-titration. THC and CBD inhibit several Phase I and II metabolism enzymes, which increases the exposure to a wide range of drugs and appropriate care needs to be taken. Low-dose CBD that appears effective for chronic pain and mental health has good tolerability and safety, with few adverse effects and is appropriate as an initial treatment.

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An Updated Analysis of Clinical Outcome Measures Across Patients From the UK Medical Cannabis Registry

Cited by 24 publications

References 32 publications

Neurological Benefits, Clinical Challenges, and Neuropathologic Promise of Medical Marijuana: A Systematic Review of Cannabinoid Effects in Multiple Sclerosis and Experimental Models of Demyelination

Neurological Benefits, Clinical Challenges, and Neuropathologic Promise of Medical Marijuana: A Systematic Review of Cannabinoid Effects in Multiple Sclerosis and Experimental Models of Demyelination

Perceived Stigma of Patients Undergoing Treatment with Cannabis-Based Medicinal Products

Tetrahydrocannabinol and cannabidiol medicines for chronic pain and mental health conditions

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