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拇指掌指关节骨关节炎患者医用大麻的评估

Assessment of Medical Cannabis in Patients With Osteoarthritis of the Thumb Basal Joint.

作者信息

Fader Lauren, Scharf Zachary, DeGeorge Brent R

机构信息

Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.

School of Medicine, University of Virginia, Charlottesville, VA.

出版信息

J Hand Surg Am. 2023 Mar;48(3):257-262.e1. doi: 10.1016/j.jhsa.2021.10.018. Epub 2021 Dec 8.

Abstract

PURPOSE

With the increasingly widespread availability of cannabidiol-derived products, more patients with hand and wrist pain are seeking evidence for use of these products. We explored current utilization practices of medical cannabis for treatment of pain in patients with a diagnosis of thumb basal joint arthritis. Secondary aims were to determine patient and thumb arthritis disease characteristics of cannabis users and nonusers and to investigate patient perceptions of the efficacy of medical cannabis in various formulations for the treatment of thumb arthritis pain.

METHODS

Patients with thumb basal joint arthritis were identified using International Classification of Diseases, Tenth Revision codes between May and June 2020. All patients received an invitation to complete a survey regarding perceptions of cannabis and related products. Medical records were retrospectively reviewed to gather demographic information and thumb basal joint arthritis factors, including laterality, date of initial diagnosis, and prior treatment.

RESULTS

The survey was completed by 103 patients. Twenty-five percent reported a history of oral medical cannabis use, and 21% reported topical medical cannabis use. Twelve of 25 oral users and 7 of 21 topical users believed that the product was effective in relieving pain and consequently worth the financial cost. Of the patients surveyed, 69% would be interested in trialing an oral formulation and 80% would be interested in trialing a topical formulation for treatment of their thumb pain.

CONCLUSIONS

Patients with thumb basal joint arthritis use cannabis-related products, with mixed reports on efficacy. Large numbers of these patients would be interested in trialing either oral or topical formulations of medical cannabis for treatment of their thumb basal joint pain.

CLINICAL RELEVANCE

It is important for medical providers to understand the current data available regarding analgesic properties of cannabidiol-related products to respond to patient inquiries about the use of cannabinoids in treating medical conditions.

摘要

目的

随着大麻二酚衍生产品的可得性日益广泛,越来越多的手和腕部疼痛患者在寻求使用这些产品的依据。我们探讨了医用大麻目前在诊断为拇指腕掌关节关节炎患者疼痛治疗中的应用情况。次要目的是确定大麻使用者和非使用者的患者及拇指关节炎疾病特征,并调查患者对各种剂型医用大麻治疗拇指关节炎疼痛疗效的看法。

方法

使用国际疾病分类第十版编码在2020年5月至6月期间识别拇指腕掌关节关节炎患者。所有患者均收到一份关于对大麻及相关产品看法的调查问卷邀请。对病历进行回顾性审查以收集人口统计学信息和拇指腕掌关节关节炎相关因素,包括患侧、初始诊断日期和既往治疗情况。

结果

103名患者完成了调查。25%的患者报告有口服医用大麻的使用史,21%的患者报告有外用医用大麻的使用史。25名口服使用者中有12名以及21名外用使用者中有7名认为该产品能有效缓解疼痛,因此物有所值。在接受调查的患者中,69%的患者有兴趣试用口服剂型,80%的患者有兴趣试用外用剂型来治疗拇指疼痛。

结论

拇指腕掌关节关节炎患者使用与大麻相关的产品,关于疗效的报告不一。这些患者中有大量人有兴趣试用口服或外用剂型的医用大麻来治疗拇指腕掌关节疼痛。

临床意义

医疗服务提供者了解目前关于大麻二酚相关产品镇痛特性的可用数据,对于回应患者关于使用大麻素治疗疾病的询问很重要。

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