Rheumatoid arthritis: Can medicinal cannabis be a therapeutic adjuvant?

One of the most common uses of medicinal cannabis is in the treatment of chronic pain. Rheumatoid arthritis (RA) is an autoimmune disease, where the immune system interprets healthy cells in the synovial membranes as potential enemies, causing a chronic inflammatory process. The most frequently affected sites are the joints of the hands, wrists and knees, so patients have chronic joint pain and other symptoms that significantly compromise their quality of life, such as reduced mobility and functional status. 

A considerable number of patients with RA are refractory to Methotrexate (MTX), the main drug used in the management of the disease. Therefore, the importance of studying other therapeutic adjuvants that can provide better control of symptoms and quality of life for these patients.

 

Cannabidiol (CBD) has been one of the chemical elements of the Cannabis plant most exploited in cases of rheumatoid arthritis, due to its analgesic and anti-inflammatory properties. Continue reading and understand the relationship between Rheumatoid Arthritis and medical cannabis.

 

cannabis likeadjuvantin the treatment of rheumatoid arthritis

Occurrence rates of rheumatoid arthritis are associated with an aging population and an increase in the obesity rate.  In the USA alone, the frequency of this disease has tripled in the last 20 years as a result of these two factors. The search for safe and effective therapeutic tools to control the disease has become increasingly necessary.

Although many studies are still in progress, there is a growing body of scientific evidence that indicates the analgesic and anti-inflammatory potential of cannabinoids in the adjunctive treatment of rheumatoid arthritis. This type of pain is commonly manifested by a combination of inflammatory, nociceptive and neuropathic pain, each of which requires its own therapeutic approach.

CBD, in turn, demonstrates action in all these pain conditions, as indicated by studies that relate Cannabis-based therapy to the general relief of RA symptoms in animal and human models of the disease.

 

Furthermore, as it is a non-psychotoxic element, CBD has an extensive dosage safety profile, configuring itself as a viable therapeutic tool in different and varied patient profiles.

 

Scientific evidence explaining this relationship

Scientific research indicates that the Endocannabinoid System is a promising target in the treatment of rheumatoid arthritis. The CB2-type endocannabinoid receptors are widely present in organs and tissues of the immune system, highlighting the anti-inflammatory and immunomodulatory potential of these receptors.

is what it shows this experiment which evaluated the analgesic potential of two CB2 receptor agonists in a chemically induced model of rheumatoid arthritis in rats. The drugs were tested in acute and chronic treatment regimens, showing more effective analgesia in chronic conditions.

 

>> See the full experiment at: CB2 agonism controls pain and subchondral bone degeneration induced by mono-iodoacetate: Implications GPCR functional bias and tolerance development.

 

Another example is this study which suggests the potential of CBD in modulating pro-inflammatory cytokine production in vitro and in canine models of induced inflammation. 

The results showed that CBD attenuates the production of pro-inflammatory cytokines IL-6 and TNF-α, while increasing the levels of anti-inflammatory cytokines IL-10, thus decreasing the perception of pain and increasing the mobility of the animals according to the condition. dosage used.

 

>> See the full survey at: A randomized, double-blind, placebo-controlled study of daily cannabidiol for the treatment of canine osteoarthritis pain.

 

Also, there is evidence of the potential of CBD in relieving rheumatoid arthritis pain. in this North American research Performed with 196 patients regularly using medical Cannabis to improve symptoms and manage chronic pain (including arthritis), depression and nausea.

 

The results showed that:

• 76% reported an improvement score of 8 or more (on a 10-point scale) in their clinical condition and 

• 68% reported a score of 8 or greater regarding the decrease in chronic pain with regular medical cannabis use.

 

>> See the full survey at: Mixed methods study of the potential therapeutic benefits from medical cannabis for patients in Florida.

 

Already this North American study compared the medical use of Cannabis in a significant number of patients diagnosed with multiple sclerosis (153), rheumatoid arthritis (582) and cancer (622). These patients were age 60 or older and enrolled in the Illinois State Medical Cannabis Program.

The authors found that most patients with these three clinical conditions used medical cannabis to seek relief from pain symptoms and improve sleep patterns. Reported therapeutic effects were broadly comparable between groups, and regardless of diagnosis, regular cannabis use was able to alleviate symptoms of chronic pain, sleep disorders, and digestive problems in these patients.

The results of this analysis made clear the broad spectrum of performance of cannabis, and its potential to impact common processes and symptoms across such distinct clinical conditions.

 

>> See the full study at: Cannabis Use among Older Persons with Arthritis, Cancer and Multiple Sclerosis: Are We Comparing Apples and Oranges?

 

It is important to point out that  regardless of the clinical picture, specialized education in the area is fundamental for an assertive prescriptive strategy for cannabis-based medicines.

Each of us has a unique Endocannabinoid System and a unique biochemical structure, therefore, knowing the history of each patient and individualizing treatments is essential to enhance therapeutic results and minimize possible adverse effects. 

​