Safety and Efficacy of Medical Cannabis in Fibromyalgia.

Iftach Sagy,Mahmoud Abu-Shakra,Lihi Bar-Lev Schleider,Victor Novack

doi:10.3390/jcm8060807

Iftach Sagy, Mahmoud Abu-Shakra + Show 2 more

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https://doi.org/10.3390/jcm8060807

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Abstract

Background: Chronic pain may be treated by medical cannabis. Yet, there is scarce evidence to support the role of medical cannabis in the treatment of fibromyalgia. The aim of the study was to investigate the characteristics, safety, and effectiveness of medical cannabis therapy for fibromyalgia. Methods: A prospective observational study with six months follow-up period based on fibromyalgia patients who were willing to answer questionnaire in a specialized medical cannabis clinic between 2015 and 2017. Results: Among the 367 fibromyalgia patients, the mean age was 52.9 ± 15.1, of whom 301 (82.0%) were women. Twenty eight patients (7.6%) stopped the treatment prior to the six months follow-up. The six months response rate was 70.8%. Pain intensity (scale 0–10) reduced from a median of 9.0 at baseline to 5.0 (p < 0.001), and 194 patients (81.1%) achieved treatment response. In a multivariate analysis, age above 60 years (odds ratio [OR] 0.34, 95% C.I 0.16–0.72), concerns about cannabis treatment (OR 0.36, 95% C.I 0.16–0.80), spasticity (OR 2.26, 95% C.I 1.08–4.72), and previous use of cannabis (OR 2.46 95% C.I 1.06–5.74) were associated with treatment outcome. The most common adverse effects were mild and included dizziness (7.9%), dry mouth (6.7%), and gastrointestinal symptoms (5.4%). Conclusion: Medical cannabis appears to be a safe and effective alternative for the treatment of fibromyalgia symptoms. Standardization of treatment compounds and regimens are required.

Highlights

Fibromyalgia is a common syndrome of chronic pain, often accompanied by sleeping disturbances, cognitive impairment, and psychiatric and somatic symptoms [1,2]
We found a significant improvement in pain intensity and significant improvement in patients’ overall quality of life and fibromyalgia-related symptoms after six months of medical cannabis therapy
The questionnaire that was used did not include specific symptoms of fibromyalgia. At this stage of medical cannabis research, we are not in a position to identify and synthesize single or multiple agents that are responsible for the therapeutic effects. Notwithstanding these limitations, the present observational study innovates by showing that medical cannabis may be an effective and safe treatment to fibromyalgia in a large cohort with six months follow up

Summary

Introduction

Fibromyalgia is a common syndrome of chronic pain, often accompanied by sleeping disturbances, cognitive impairment, and psychiatric and somatic symptoms [1,2]. A handful of studies have examined the effect of medical cannabis on fibromyalgia. These studies had rather small sample sizes (31–40 subjects) and a short duration of follow up, which makes the generalizability of the results questionable [10,11,12]. In the current analysis of the prospective registry, we aim to investigate the safety and effectiveness of fibromyalgia patients receiving medical cannabis. The aim of the study was to investigate the characteristics, safety, and effectiveness of medical cannabis therapy for fibromyalgia. Methods: A prospective observational study with six months follow-up period based on fibromyalgia patients who were willing to answer questionnaire in a specialized medical cannabis clinic between 2015 and 2017. Conclusion: Medical cannabis appears to be a safe and effective alternative for the treatment of fibromyalgia symptoms.

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