Cannabis induces a clinical response in patients with Crohn's disease: a prospective placebo-controlled study
- PMID: 23648372
- DOI: 10.1016/j.cgh.2013.04.034
Cannabis induces a clinical response in patients with Crohn's disease: a prospective placebo-controlled study
Abstract
Background & aims: The marijuana plant Cannabis sativa has been reported to produce beneficial effects for patients with inflammatory bowel diseases, but this has not been investigated in controlled trials. We performed a prospective trial to determine whether cannabis can induce remission in patients with Crohn's disease.
Methods: We studied 21 patients (mean age, 40 ± 14 y; 13 men) with Crohn's Disease Activity Index (CDAI) scores greater than 200 who did not respond to therapy with steroids, immunomodulators, or anti-tumor necrosis factor-α agents. Patients were assigned randomly to groups given cannabis, twice daily, in the form of cigarettes containing 115 mg of Δ9-tetrahydrocannabinol (THC) or placebo containing cannabis flowers from which the THC had been extracted. Disease activity and laboratory tests were assessed during 8 weeks of treatment and 2 weeks thereafter.
Results: Complete remission (CDAI score, <150) was achieved by 5 of 11 subjects in the cannabis group (45%) and 1 of 10 in the placebo group (10%; P = .43). A clinical response (decrease in CDAI score of >100) was observed in 10 of 11 subjects in the cannabis group (90%; from 330 ± 105 to 152 ± 109) and 4 of 10 in the placebo group (40%; from 373 ± 94 to 306 ± 143; P = .028). Three patients in the cannabis group were weaned from steroid dependency. Subjects receiving cannabis reported improved appetite and sleep, with no significant side effects.
Conclusions: Although the primary end point of the study (induction of remission) was not achieved, a short course (8 weeks) of THC-rich cannabis produced significant clinical, steroid-free benefits to 10 of 11 patients with active Crohn's disease, compared with placebo, without side effects. Further studies, with larger patient groups and a nonsmoking mode of intake, are warranted. ClinicalTrials.gov, NCT01040910.
Keywords: C-reactive protein; CBD; CDAI; CRP; Cannabinoids; Crohn's Disease; Crohn's Disease Activity Index; Endocannabinoid; IBD; Inflammation; Inflammatory Bowel Disease; SF-36; Short-Form 36; THC; TNF; cannabidiol; inflammatory bowel disease; tumor necrosis factor; Δ9-tetrahydrocannabinol.
Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
Comment in
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The holistic effects of cannabis in Crohn's disease.Clin Gastroenterol Hepatol. 2014 May;12(5):898. doi: 10.1016/j.cgh.2013.11.013. Epub 2013 Nov 19. Clin Gastroenterol Hepatol. 2014. PMID: 24262941 No abstract available.
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Weeding out the facts: the reality about cannabis and Crohn's disease.Clin Gastroenterol Hepatol. 2014 May;12(5):898-9. doi: 10.1016/j.cgh.2013.11.016. Epub 2013 Nov 20. Clin Gastroenterol Hepatol. 2014. PMID: 24269921 No abstract available.
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Reply: To PMID 23648372.Clin Gastroenterol Hepatol. 2014 May;12(5):899-900. doi: 10.1016/j.cgh.2014.01.007. Epub 2014 Jan 10. Clin Gastroenterol Hepatol. 2014. PMID: 24418092 No abstract available.
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