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英国医用大麻注册中心:医用大麻治疗广泛性焦虑症的临床疗效分析。

UK Medical Cannabis Registry: an analysis of clinical outcomes of medicinal cannabis therapy for generalized anxiety disorder.

机构信息

Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.

Sapphire Medical Clinics, London, UK.

出版信息

Expert Rev Clin Pharmacol. 2022 Apr;15(4):487-495. doi: 10.1080/17512433.2022.2020640. Epub 2022 Jan 18.

Abstract

OBJECTIVES

Anxiety disorders are one of the most common reasons for seeking treatment with cannabis-based medicinal products (CBMPs). Current pharmacological treatments are variable in efficacy and the endocannabinoid system has been identified as a potential therapeutic target. This study aims to detail the changes in health-related quality-of-life (HRQoL) and clinical safety following CBMP therapy for generalized anxiety disorder.

METHODS

A case series from the UK Medical Cannabis Registry was performed. Primary outcomes included changes from baseline in patient-reported outcome measures (the General Anxiety Disorder Scale (GAD-7), EQ-5D-5L (a measure of health-related quality of life), and Sleep Quality Scale (SQS)) at 1, 3 and 6 months. Statistical significance was defined as p<0.050.

RESULTS

Sixty-seven patients were treated for generalized anxiety disorder. Statistically significant improvements were observed in GAD-7, EQ-5D-5L Index Value, EQ5D Visual Analog Scale, and SQS scores at 1, 3 and 6 months (p<0.050). Twenty-five (39.1%) patients reported adverse events during the follow-up period.

CONCLUSION

This study suggests that CBMPs may be associated with improvements in HRQoL outcomes when used as a treatment for generalized anxiety disorder. These findings must be treated with caution considering limitations of study design; however this data may help inform future clinical studies and practice.Anxiety disorders are the most prevalent psychiatric illness type in the United Kingdom, with 8.2 million cases reported in 2010. Generalized anxiety disorder (GAD), the most common anxiety disorder, debilitates, and so reduces the quality of life of those who suffer from the condition.The efficacy of current treatments for GAD varies greatly from person-to-person. The endocannabinoid system in the human body is currently attracting a lot of attention in the scientific community as it can be targeted by chemicals in the cannabis plant to produce therapeutic effects in order to treat GAD. There is, however, a lack of studies investigating the effects of medicinal cannabis in GAD, and so this study aims to explore the drug's effect on quality of life in patients suffering from GAD.Sixty-seven patients who attended the Sapphire Clinics for medicinal cannabis treatment for GAD were included in the study. The results from this study highlight that medicinal cannabis may improve generalized anxiety disorder, general health-related quality of life, and sleep-specific outcomes at 1, 3, and 6 months after starting treatment. There was also a low number of severe, disabling, and life-threatening adverse events experienced by patients. Although this study explores the effects of medicinal cannabis in a real clinical setting, the results were not compared to other types of treatment. Future studies with a comparator are therefore needed before concluding the true effects of medicinal cannabis in patients with GAD.

摘要

目的

焦虑症是寻求使用基于大麻的药用产品(CBMP)治疗的最常见原因之一。目前的药物治疗在疗效上存在差异,内源性大麻素系统已被确定为潜在的治疗靶点。本研究旨在详细描述大麻素治疗广泛性焦虑症后与健康相关的生活质量(HRQoL)和临床安全性的变化。

方法

对英国医疗大麻登记处的病例系列进行了研究。主要结局包括从基线开始,在 1、3 和 6 个月时,患者报告的结局测量(广泛性焦虑症量表(GAD-7)、EQ-5D-5L(衡量健康相关生活质量的指标)和睡眠质量量表(SQS))的变化。统计学意义定义为 p<0.050。

结果

67 名患者因广泛性焦虑症接受治疗。在 1、3 和 6 个月时,GAD-7、EQ-5D-5L 指数值、EQ5D 视觉模拟量表和 SQS 评分均观察到统计学显著改善(p<0.050)。在随访期间,25 名(39.1%)患者报告了不良事件。

结论

本研究表明,当大麻素被用作治疗广泛性焦虑症的药物时,它可能与改善 HRQoL 结局有关。考虑到研究设计的局限性,这些发现必须谨慎对待;然而,这些数据可能有助于为未来的临床研究和实践提供信息。

焦虑症是英国最常见的精神疾病类型,2010 年报告了 820 万例病例。广泛性焦虑症(GAD)是最常见的焦虑症,它使人衰弱,从而降低了患者的生活质量。

目前 GAD 的治疗效果因人而异差异很大。人体内的内源性大麻素系统目前在科学界受到广泛关注,因为它可以被大麻植物中的化学物质靶向,以产生治疗效果,从而治疗 GAD。然而,目前还缺乏研究调查药用大麻在 GAD 中的作用,因此本研究旨在探讨大麻药物对 GAD 患者生活质量的影响。

67 名在 Sapphire 诊所接受大麻素治疗 GAD 的患者被纳入研究。这项研究的结果强调,在开始治疗后 1、3 和 6 个月,药用大麻可能会改善广泛性焦虑症、一般健康相关生活质量和睡眠特定结局。患者也经历了数量较少的严重、致残和危及生命的不良事件。尽管本研究在真实的临床环境中探讨了药用大麻的作用,但结果并未与其他类型的治疗进行比较。因此,在得出药用大麻在 GAD 患者中的真实效果之前,还需要进行具有对照的未来研究。

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