Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN, 46202, USA.
Dig Dis Sci. 2020 Jan;65(1):322-328. doi: 10.1007/s10620-019-05756-7. Epub 2019 Jul 30.
Utilization and safety of cannabidiol (CBD) in patients with autoimmune hepatitis (AIH) are currently unknown. We aimed to identify the frequency of CBD use, impact on symptoms, and safety profile.
An invitation to complete a CBD-specific questionnaire was posted every other day to well-established autoimmune hepatitis Facebook communities (combined membership of 2600 individuals) during a 10-day study period. Age ≥ 18 years and an AIH diagnosis by a physician were the eligibility criteria for participation in the survey.
In total, 371 AIH patients (median age 49 years, 32% reported advanced fibrosis) completed the questionnaire. Respondents were 91% women, 89% Caucasian, and 89% from North America. Ninety-three (25%) respondents were ever CBD users, with 55 of them (15% of the survey responders) identified as current users. Among ever users, 45.7% reported their treating doctors were aware of their CBD use. The most common reason cited for CBD use was pain (68%), poor sleep (62%), and fatigue (38%). Most respondents using CBD for these symptoms reported a significant improvement in pain (82%), sleep (87%), and fatigue (61%). In ever CBD users, 17.3% were able to stop a prescription medication because of CBD use: pain medication (47%), immunosuppression (24%), and sleep aids (12%). Side effects attributed to CBD use were reported in 3% of CBD users, yet there were no reported emergency department visits or hospitalizations.
CBD use was not uncommon in patients with AIH, and its use was associated with reports of improvement in extrahepatic symptoms.
目前,尚不清楚大麻二酚(CBD)在自身免疫性肝炎(AIH)患者中的使用情况和安全性。本研究旨在明确 CBD 的使用频率、对症状的影响以及安全性。
在为期 10 天的研究期间,我们每天向两个成熟的 AIH 脸书社区(合计 2600 名成员)发布参与 CBD 特定问卷调查的邀请。参与调查的标准为年龄≥18 岁且经医生诊断为 AIH。
共有 371 名 AIH 患者(中位年龄 49 岁,32%报告存在晚期纤维化)完成了问卷调查。应答者中 91%为女性,89%为白种人,89%来自北美。93 名(25%)应答者曾使用 CBD,其中 55 名(占应答者的 15%)为当前使用者。在曾使用者中,45.7%报告其治疗医生知晓他们使用 CBD。使用 CBD 的最常见原因是疼痛(68%)、睡眠差(62%)和疲劳(38%)。大多数因这些症状而使用 CBD 的应答者报告疼痛(82%)、睡眠(87%)和疲劳(61%)显著改善。在曾使用 CBD 的患者中,17.3%因 CBD 而停用了处方药物:止痛药(47%)、免疫抑制剂(24%)和助眠药(12%)。3%的 CBD 使用者报告出现了与 CBD 相关的副作用,但没有报告急诊就诊或住院的情况。
CBD 在 AIH 患者中并不少见,其使用与报告的肝外症状改善相关。