Studies

Empirical research status Summary of scientific studies
on cannabis as medicine.

Cannabis as medicine: Scientific studies

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Medicinal cannabis has a number of mechanisms of action that can contribute to improving the quality of life of critically ill patients. Of particular relevance are the analgesic, antiemetic and appetite-inducing potentials.

The potential of cannabis in medicine has been demonstrated by numerous empirical studies and meta-analytical reviews. In the following we give an overview of the current scientific studies in relation to various indications.
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Studies

Chronic pain

STUDY

Carter et al. (2014). Re-branding cannabis: the next generation of chronic pain medicine? Pain Management, 5(1), 13-21.

STUDY DESIGN

Metaanalysis/Review

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

Evidence of therapeutic options in chronic pain patients with cannabis or cannabis as a supplement to low opiate dose.



STUDY

Romero-Sandoval et al. (2017). Cannabis and Cannabinoids for Chronic Pain. Current Rheumatology Reports, 19(11), 67.

STUDY DESIGN

Metaanalysis/Review

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

– Inhaled cannabis is better tolerated
– Application can be better controlled pulmonarily than orally administered cannabinoids
– Inhaled cannabis blossoms lead to a decrease in non-tumor pain



STUDY

Bellnier et al. (2018). Preliminary evaluation of the efficacy, safety, and costs associated with the treatment of chronic pain with medical cannabis. Mental Health Clinician, 8(3), 110-115.

STUDY DESIGN

Mirror-Image study (retrospective), N=29

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

– Medical cannabis improves quality of life
– Decrease of chronic pain and associated opiate intake
Neuropathic pain

STUDY

Wilsey et al. (2013). Lowdose vaporized cannabis significantly improves neuropathic pain. The Journal of Pain, 14(2), 136-148.

STUDY DESIGN

Cross-Over study (placebo-controlled, double-blind), N=39

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

– Significant pain reduction compared to placebo subjekts
– Low side effects due to cannabis-based therapy



STUDY

Eisenberg et al. (2014). The Pharmacokinetics, Efficacy, Safety, and Ease of Use of a Novel Portable Metered-Dose Cannabis Inhaler in Patients With Chronic Neuropathic Pain: A Phase 1a Study. Journal of Pain and Palliative Care Pharmacotherapy, 23(3), 216-225.

STUDY DESIGN


Phase-I-study, N=8

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

– Significant reduction of pain intensy
– Measured using visual analogue scale (VAS scale)



STUDY

Nugent et al. (2017). The Effects of Cannabis Among Adults with Chronic Pain and an Overview of General Harms: A Systematic Review. Ann Intern Med, 167, 319-331.

STUDY DESIGN

Metaanalysis/Review

INVESTIGATION PRODUCT

Cannabis blossoms

RESULTS

Cannabinoids can effectively relieve neuropathic pain.



STUDY

Lee et al. (2018). Medical Cannabis for Neuropathic Pain. Current Pain and Headache Reports, 22(1), 8.

STUDY DESIGN

Metaanalysis/Review of randomized and controlled studies, N=234
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INVESTIGATIONAL PRODUCT

Cannabis extracts (inhaled)

RESULTS

Effective reduction of pain through cannabis-based therapy.
HIV-associated sensory neuropathy

STUDY

Abrams et al. (2007). Cannabis in painful HIV-associated sensory neuropathy A randomized placebo-controlled trial. Neurology, 68(7), 515-521.

STUDY

Randomized, placebo-controlled study (prospective), N=50

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

The cannabis therapy could reduce the pain sensation by 30% compared to the control group with placebo.
Palliative Oncology

STUDY

Johnson et al. (2010). Multicenter, doubleblind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. J Pain Symptom Manage, 39:167-179.

STUDY DESIGN

Parallel group study (randomized, double-blind, placebo-controlled), N=177

INVESTIGATIONAL PRODUCT

Drugs containing cannabis

RESULTS

The cannabis therapy was able to significantly reduce the pain in cancer patients. In particular, patients who cannot be sufficiently painlessly treated with opioids benefit from additional medication with cannabinoids.



STUDY

Bar-Sela et al. (2013). The medical necessity for medicinal cannabis: prospective, observational study evaluating treatment in cancer patients on supportive or palliative care. Evidence-Based Complementary and Alternative Medicine, 510392.

STUDY DESIGN

Observational study (prospective), N=131

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

The cannabis therapy could significantly reduce the symptoms (CTAE scale).



STUDY

Waissengrin et al. (2015). Patterns of use of medical cannabis among Israeli cancer patients: a single institution experience. Journal of Pain and Symptom Management, 49(2), 223-230.

STUDY DESIGN

Observational study, N=69

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

The cannabis therapy could:

– reduce pain
– improve general well-being
– relieve nausea
– stimulate appetite
Nausea and vomiting during chemotherapy

STUDY

Sallan SE, Zinberg NE, Frei E. (1975). Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. New England Journal of Medicine, 293(16), 795-797.

STUDY DESIGN

Cross-over study (randomized, double-blind, placebo-kontrolled), N=20

INVESTIGATIONAL PRODUCT

Cannabis-based drugs

RESULTS

Antiemetic effect in subjects with cannabis compared to placebo.



STUDY

Duran et al. (2010). Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. British Journal of Clinical Pharmacology, 70(5), 656-663.

STUDY DESIGN

Phase-II-study (randomized, double-blind, placebo-controlled), N=7

INVESTIGATIONAL PRODUCT

Cannabis extract, CBD

RESULTS

The cannabis therapy increases the antiemetic effect of the standard therapy compared to the placebo.
Anorexia and cachexia: HIV/AIDS associated

STUDY

Beal et al. (1995). Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. Journal of pain and symptom management, 10(2), 89-97.

STUDY DESIGN

Parallel group study (randomizes, double-blind, placebo-controlled), N=139

INVESTIGATIONAL PRODUCT

Dronabinol/THC (oral)

RESULTS

– increase in appetite
– Reduction of nausea
– Twice as much weight gain was observed compared to pkacebo



STUDY

Haney et al. (2007). Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep. JAIDS Journal Acquired Immune Deficiency Syndromes 45(5), 545-554.

STUDY DESIGN

Within-Subject study (randomized, placebo-controlled), N=10

INVESTIGATIONAL PRODUCT

Cannabis blossoms and Dronabinol

RESULTS

Cannabis therapy leads to increased calorie intake.
Anorexia and Cachexia: In Chemotherapy

STUDY

Regelson et al. (1976). Delta-9-tetrahydrocannabinol as an effective antidepressant and appetite-stimulating agent in advanced cancer patients. Pharmacology of Marihuana, 2, 763-776.

STUDY DESIGN

Cross-over study (randomized, double-blind, placebo-controlled), N=10

INVESTIGATIONAL PRODUCT

THC (oral)
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RESULTS

Cannabis therapy led to increased appetite.



STUDY

Whiting et al. (2015). Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. JAMA, 313:2456-2473.

STUDY DESIGN

Meta-analysis/review from 34 Studies

INVESTIGATIONAL PRODUCT

Cannabis blossoms and cannabis extract

RESULTS

Cannabis therapy led to:
– Reduction of central nervous pain in MS
– Reduction of pain caused by spasticity
Spasticity in multiple sclerosis

STUDY

Collin et al. (2010). A doubleblind, randomized, placebocontrolled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosis. Neurological Research, 32(5), 451-459.

STUDY DESIGN

Between-Subject study (placebo-controlled, double-blind), N=337

INVESTIGATIONAL PRODUCT

Cannabis extract

RESULTS

Reduction of therapy-resistant spasticity.



STUDY

Corey-Bloom et al. (2012). Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial. Canadian Medical Association Journal, 184(10), 1143-1150.

STUDY DESIGN

Cross-Over study (placebo-controlled), N=30

INVESTIGATIONAL PRODUCT

Cannabis blossoms

RESULTS

Therapy with cannabis blossoms led to reduction of spasticity, pain and exhaustion.



STUDY

Nielsen et al. (2018). The Use of Cannabis and Cannabinoids in Treating Symptoms of Multiple Sclerosis: A Systematic Review of Reviews. Current Neurology and Neuroscience Reports, 18(2), 8.

STUDY DESIGN

Metaanalysis/review from 32 Studien

INVESTIGATIONAL PRODUCT

Cannabis-based drugs

RESULTS

Evidence for reduction of pain and spasticity in multiple sclerosis.
Central nervous pain in multiple sclerosis

STUDY

Whiting et al. (2015). Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. JAMA, 313:2456-2473.

STUDY DESIGN

Metaanalysis/review from 34 Studien

INVESTIGATIONAL PRODUCT

Cannabis blossoms and cannabis extract

RESULTS

Cannabis therapy led to:

– Reduction of central nervous pain in multiple sclerosis
– Reduction of pain caused by spasticity
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