Division of Rheumatology, McGill University Health Centre, Montreal, and Alan Edwards Pain Management Unit, McGill University Health Centre, Montreal, Canada.
JSS Medical Research, St-Laurent, Canada.
Clin Exp Rheumatol. 2021 May-Jun;39 Suppl 130(3):115-119. doi: 10.55563/clinexprheumatol/qcyet7. Epub 2021 Apr 29.
Medications have only small to moderate effects on symptoms in fibromyalgia (FM). Cannabinoids, including medical cannabis (MC) may have potential to fill this gap. Since recreational legalisation of cannabis in Canada, patients have easier access and may be self-medicating with cannabis. We have examined the prevalence and characteristics of MC use in FM patients.
During a two-month period (June-August 2019), consecutive attending rheumatology patients participated in an onsite survey comprising 2 questionnaires: 1) demographic and disease information completed by the rheumatologist, 2) patient anonymous questionnaire of health status, cannabis use (recreational and/or medicinal) and characteristics of use.
In a cohort of 1000 rheumatology attendees, 117 (11.7%) were diagnosed with FM. Ever use of MC was reported by 28 (23.9%; 95%CI: 16.5%-32.7%) FM patients compared to 98 (11.1%; 95%CI: 9.1%-13.4%) non-FM patients. Among FM ever users, 17 (61%) patients continued use of MC. FM ever users vs. FM nonusers tended to be younger, 53 vs. 58 years (p=0.072), were more likely unemployed or disabled 39% vs. 17% (p=0.019) and used more medication types (p=0.013) but did not differ in symptom severity parameters. Cigarette smoking and recreational cannabis were more common in ever users. Global symptom relief on a VAS (1-10) was 7.0±2.3.
FM patients have commonly used MC, with more than half continuing use. Reported symptom relief was substantial. Cigarette smoking and recreational cannabis use may play a facilitatory role in MC use in FM. Adjunctive MC may be a treatment consideration for some FM patients.
药物对纤维肌痛(FM)症状的影响只有小到中度。大麻素,包括医用大麻(MC),可能有潜力填补这一空白。自从加拿大娱乐性合法化大麻以来,患者更容易获得大麻,并且可能自行用大麻进行治疗。我们研究了 FM 患者中 MC 使用的流行率和特征。
在两个月的时间内(2019 年 6 月至 8 月),连续就诊的风湿病患者参加了一项现场调查,该调查包括 2 份问卷:1)由风湿病医生完成的人口统计学和疾病信息,2)患者匿名的健康状况问卷、大麻使用(娱乐性和/或医用)和使用特征。
在 1000 名风湿病就诊者的队列中,有 117 人(11.7%)被诊断为 FM。曾使用 MC 的 FM 患者为 28 人(23.9%;95%CI:16.5%-32.7%),而非 FM 患者为 98 人(11.1%;95%CI:9.1%-13.4%)。在 FM 的曾用者中,17 人(61%)继续使用 MC。FM 的曾用者与非使用者相比,年龄更小,53 岁 vs. 58 岁(p=0.072),更有可能失业或残疾 39% vs. 17%(p=0.019),使用更多类型的药物(p=0.013),但症状严重程度参数无差异。曾使用者中,吸烟和娱乐性使用大麻更为常见。VAS(1-10)上的整体症状缓解为 7.0±2.3。
FM 患者普遍使用 MC,超过一半的人继续使用。报告的症状缓解程度较大。吸烟和娱乐性使用大麻可能在 FM 中 MC 使用中起促进作用。辅助性 MC 可能是一些 FM 患者的治疗考虑因素。