Vela Jonathan, Dreyer Lene, Petersen Kristian Kjær, Arendt-Nielsen Lars, Duch Kirsten Skjærbæk, Kristensen Salome
Department of Rheumatology, Aalborg University Hospital, Aalborg, Denmark.
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Pain. 2022 Jun 1;163(6):1206-1214. doi: 10.1097/j.pain.0000000000002466. Epub 2021 Aug 27.
Cannabidiol (CBD) is increasingly used as analgesic medication although the recent International Association for the Study of Pain Presidential Task Force on cannabis and cannabinoid analgesia found a lack of trials examining CBD for pain management. This trial examines CBD as add-on analgesic therapy in patients with hand osteoarthritis or psoriatic arthritis experiencing moderate pain intensity despite therapy. Using a randomized, double-blind, placebo-controlled design, patients received synthetic CBD 20 to 30 mg or placebo daily for 12 weeks. The primary outcome was pain intensity during the past 24 hours (0-100 mm); safety outcomes were percentage of patients experiencing adverse events and a characterization of serious adverse events. Explorative outcomes included change in Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale (PCS), and Health Assessment Questionnaire Disability Index. One hundred thirty-six patients were randomized, of which 129 were included in the primary analysis. Between-group difference in pain intensity at 12 weeks was 0.23 mm (95% confidence interval -9.41 to 9.90; P = 0.96). Twenty-two percent patients receiving CBD and 21% receiving placebo experienced a reduction in pain intensity of more than 30 mm. We found neither clinically nor statistically significant effects of CBD for pain intensity in patients with hand osteoarthritis and psoriatic arthritis when compared with placebo. In addition, no statistically significant effects were found on sleep quality, depression, anxiety, or pain catastrophizing scores.
大麻二酚（CBD）越来越多地被用作镇痛药，尽管最近国际疼痛研究协会关于大麻和大麻素镇痛的主席特别工作组发现，缺乏关于CBD用于疼痛管理的试验。本试验研究了CBD作为辅助镇痛疗法在手部骨关节炎或银屑病关节炎患者中的应用，这些患者尽管接受了治疗，但仍经历中度疼痛。采用随机、双盲、安慰剂对照设计，患者每天接受20至30毫克合成CBD或安慰剂，持续12周。主要结局是过去24小时内的疼痛强度（0-100毫米）；安全性结局是发生不良事件的患者百分比以及严重不良事件的特征。探索性结局包括匹兹堡睡眠质量指数、医院焦虑抑郁量表、疼痛灾难化量表（PCS）和健康评估问卷残疾指数的变化。136名患者被随机分组，其中129名纳入主要分析。12周时两组间疼痛强度的差异为0.23毫米（95%置信区间-9.41至9.90；P=0.96）。接受CBD的患者中有22%、接受安慰剂的患者中有21%的疼痛强度降低超过30毫米。与安慰剂相比，我们发现CBD对手部骨关节炎和银屑病关节炎患者的疼痛强度既无临床显著影响也无统计学显著影响。此外，在睡眠质量、抑郁、焦虑或疼痛灾难化评分方面未发现统计学显著影响。
