Association Between Cannabis Use and Complications Related to Crohn’s Disease: A Retrospective Cohort Study

Mbachi, Chimezie; Attar, Bashar M.; Wang, Yuchen; Paintsil, Isaac; Benjamín,; Fugar, Setri; Agrawal, Rohit; Simons-Linares, Roberto; Jaiswal, Palashkumar; Trick, William E.; Kotwal, Vikram

doi:10.1007/s10620-019-05556-z

Cited by 18 publications

(26 citation statements)

References 24 publications

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“…More recent investigations had demonstrated that the endocannabinoid system is strongly activated during inflammations, both in animal models and in tissue samples from patients ( Kulkarni-Narla and Brown 2000 ; Barrie and Manolios 2017 ; Donvito et al, 2018 ; Almogi-Hazan and Or 2020 ). Studies in murine models of colitis ( Silvestri et al, 2020 ) and retrospective observational studies in Cannabis users have been done, showing significant improvements of symptoms which translated into less need of medications ( Naftali et al, 2013 ; Storr et al, 2014 ; Mbachi et al, 2019 ) but these findings are not necessarily associated with mitigating disease progression or decreasing severity. Clinical trials with Cannabis sativa in patients suffering from inflammatory bowel diseases have shown improvement in quality of life but failed to provide evidence for a reduction of inflammation markers ( Kienzl, Storr, and Schicho 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Cannabidiol Isolated From Cannabis sativa L. Protects Intestinal Barrier From In Vitro Inflammation and Oxidative Stress

et al. 2021

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The relevance and incidence of intestinal bowel diseases (IBD) have been increasing over the last 50 years and the current therapies are characterized by severe side effects, making essential the development of new strategies that combine efficacy and safety in the management of human IBD. Herbal products are highly considered in research aimed at discovering new approaches for IBD therapy and, among others, Cannabis sativa L. has been traditionally used for centuries as an analgesic and anti-inflammatory remedy also in different gastrointestinal disorders. This study aims to investigate the effects of different C. sativa isolated compounds in an in vitro model of intestinal epithelium. The ability of treatments to modulate markers of intestinal dysfunctions was tested on Caco-2 intestinal cell monolayers. Our results, obtained by evaluation of ROS production, TEER and paracellular permeability measurements and tight junctions evaluation show Cannabidiol as the most promising compound against intestinal inflammatory condition. Cannabidiol is able to inhibit ROS production and restore epithelial permeability during inflammatory and oxidative stress conditions, suggesting its possible application as adjuvant in IBD management.

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Section: Discussionmentioning

confidence: 99%

Cannabidiol Isolated From Cannabis sativa L. Protects Intestinal Barrier From In Vitro Inflammation and Oxidative Stress

et al. 2021

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“…Of all studies investigating medical cannabis in patients with Crohn's disease, 3 studies investigated symptom mitigation as the primary outcome, 1 study investigated safety outcomes, and 6 investigated other outcomes or used a cross-sectional design [14,116,[126][127][128][129]. In studies that investigated symptom mitigation, 1 study indicated an improvement [130], 1 study indicated mixed findings [61], and one was inconclusive [131]. Safety outcomes were reported by one study, which indicated worsening safety outcomes [132].…”

Section: Crohn's Diseasementioning

confidence: 99%

A Mapping Literature Review of Medical Cannabis Clinical Outcomes and Quality of Evidence in Approved Conditions in the USA from 2016 to 2019

Jugl

Okpeku

Costales

et al. 2021

Med Cannabis Cannabinoids

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In 2017, a National Academies of Sciences, Engineering, and Medicine (NASEM) report comprehensively evaluated the body of evidence regarding cannabis health effects through the year 2016. The objectives of this study are to identify and map the most recently (2016–2019) published literature across approved conditions for medical cannabis and to evaluate the quality of identified recent systematic reviews, published following the NASEM report. Following the literature search from 5 databases and consultation with experts, 11 conditions were identified for evidence compilation and evaluation: amyotrophic lateral sclerosis, autism, cancer, chronic noncancer pain, Crohn’s disease, epilepsy, glaucoma, human immunodeficiency virus/AIDS, multiple sclerosis (MS), Parkinson’s disease, and posttraumatic stress disorder. A total of 198 studies were included after screening for condition-specific relevance and after imposing the following exclusion criteria: preclinical focus, non-English language, abstracts only, editorials/commentary, case studies/series, and non-U.S. study setting. Data extracted from studies included: study design type, outcome definition, intervention definition, sample size, study setting, and reported effect size. Few completed randomized controlled trials (RCTs) were identified. Studies classified as systematic reviews were graded using the Assessing the Methodological Quality of Systematic Reviews-2 tool to evaluate the quality of evidence. Few high-quality systematic reviews were available for most conditions, with the exceptions of MS (9 of 9 graded moderate/high quality; evidence for 2/9 indicating cannabis improved outcomes; evidence for 7/9 indicating cannabis inconclusive), epilepsy (3 of 4 graded moderate/high quality; 3 indicating cannabis improved outcomes; 1 indicating cannabis inconclusive), and chronic noncancer pain (12 of 13 graded moderate/high quality; evidence for 7/13 indicating cannabis improved outcomes; evidence from 6/7 indicating cannabis inconclusive). Among RCTs, we identified few studies of substantial rigor and quality to contribute to the evidence base. However, there are some conditions for which significant evidence suggests that select dosage forms and routes of administration likely have favorable risk-benefit ratios (i.e., epilepsy and chronic noncancer pain). The body of evidence for medical cannabis requires more rigorous evaluation before consideration as a treatment option for many conditions, and evidence necessary to inform policy and treatment guidelines is currently insufficient for many conditions.

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“…These were aimed at describing the effects of Cannabis in CD [13], assessing whether treatment with inhaled Cannabis improves the quality of life, reduces disease activity and promotes weight gain [14]. As well as determining whether Cannabis can induce disease remission in patients with Crohn's disease [15], the effects of cannabidiol on Crohn's disease [16], evaluation of efficacy, safety and tolerability of CBD-rich botanical extract in ulcerative colitis (UC) [17] and assessing the prevalence of complications arising due to Crohn's disease among cannabis users and non-users [18]. While some authors considered only one type of IBD, i.e., CD [15,16,18] or UC [17], Lahat et al 2012 considered both UC and CD.…”

Section: Study Objectivesmentioning

confidence: 99%

Cannabis and Its Potential Protective Role Against Inflammatory Bowel Disease: A Scoping Review

Nso¹,

Nyabera²,

Nassar³

et al. 2021

Cureus

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Globally, around 15%-40% of patients suffering from inflammatory bowel disease (IBD) use Cannabis for pain reduction, increased appetite, and reduced need for other medications. Although many patients report having benefited by using Cannabis in IBD, there is still a lack of consensus regarding the use of Cannabis in IBD. The aim is to identify, explore and map literature on the potential protective role of Cannabis against IBD through this scoping review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during the search to answer the focal question: (1) Does Cannabis play a protective role against IBD as assessed by clinical remission; (2) If yes, what is the mechanism of action for this protective role. There were only three randomized controlled trials (RCTs) and three observational studies that satisfied the selection criteria of this scoping review. Although promising results including the improvement in general well-being/ Harvey-Bradshaw Index, health perception enhancement [4.1±1.43 to 7±1.42 (p = 0.0002)], weight gain, Crohn's Disease Activity Index (CDAI) score<150, Mayo scores (4-10), and reduction in clinical complications have been found in some studies, its medical use in IBD is still questionable due to the lack of high-quality evidence. Future RCTs studies should determine the cannabis treatment parameters and validate its safety and effectiveness in the IBD setting. The highlights include: the current literature provides inconclusive evidence concerning the protective role of cannabis for IBD patients; limited research evidence regarding the therapeutic use of cannabinoids for IBD warrants future investigation via RCTs; cannabis provides some benefits to IBD patients by improving their general wellbeing perceptions, Harvey-Bradshaw Index, Mayo scores, and minimizing their clinical complications.

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Association Between Cannabis Use and Complications Related to Crohn’s Disease: A Retrospective Cohort Study

Cited by 18 publications

References 24 publications

Cannabidiol Isolated From Cannabis sativa L. Protects Intestinal Barrier From In Vitro Inflammation and Oxidative Stress

Cannabidiol Isolated From Cannabis sativa L. Protects Intestinal Barrier From In Vitro Inflammation and Oxidative Stress

A Mapping Literature Review of Medical Cannabis Clinical Outcomes and Quality of Evidence in Approved Conditions in the USA from 2016 to 2019

Cannabis and Its Potential Protective Role Against Inflammatory Bowel Disease: A Scoping Review

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