Sagy Iftach, Bar-Lev Schleider Lihi, Abu-Shakra Mahmoud, Novack Victor
Department of Rheumatology, Rabin Medical Center, Petach Tikva 49100, Israel.
Cannabis Clinical Research Institute, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva 84101, Israel.
J Clin Med. 2019 Jun 5;8(6):807. doi: 10.3390/jcm8060807.
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.
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.
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 ( < 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%).
Medical cannabis appears to be a safe and effective alternative for the treatment of fibromyalgia symptoms. Standardization of treatment compounds and regimens are required.
慢性疼痛可用医用大麻治疗。然而，几乎没有证据支持医用大麻在纤维肌痛治疗中的作用。本研究的目的是调查医用大麻治疗纤维肌痛的特点、安全性和有效性。
一项前瞻性观察性研究，对2015年至2017年间在一家专业医用大麻诊所愿意回答问卷的纤维肌痛患者进行为期六个月的随访。
在367名纤维肌痛患者中，平均年龄为52.9±15.1岁，其中301名（82.0%）为女性。28名患者（7.6%）在六个月随访前停止治疗。六个月的缓解率为70.8%。疼痛强度（0-10级）从基线时的中位数9.0降至5.0（<0.001），194名患者（81.1%）实现了治疗反应。在多变量分析中，60岁以上（比值比[OR]0.34，95%置信区间0.16-0.72）、对大麻治疗的担忧（OR 0.36，95%置信区间0.16-0.80）、痉挛（OR 2.26，95%置信区间1.08-4.72）和既往使用过大麻（OR 2.46，95%置信区间1.06-5.74）与治疗结果相关。最常见的不良反应为轻度，包括头晕（7.9%）、口干（6.7%）和胃肠道症状（5.4%）。
医用大麻似乎是治疗纤维肌痛症状的一种安全有效的替代方法。需要对治疗化合物和方案进行标准化。
