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英国医用大麻登记处:医用大麻治疗慢性疼痛病症的临床疗效分析。

UK Medical Cannabis registry: an analysis of clinical outcomes of medicinal cannabis therapy for chronic pain conditions.

机构信息

Imperial College London, London, UK.

Sapphire Medical Clinics, London, UK.

出版信息

Expert Rev Clin Pharmacol. 2022 Apr;15(4):473-485. doi: 10.1080/17512433.2022.2017771. Epub 2021 Dec 31.

Abstract

OBJECTIVES

To explore pain-specific, general health-related quality of life (HRQoL), and safety outcomes of chronic pain patients prescribed cannabis-based medicinal products (CBMPs).

METHODS

A case series was performed using patients with chronic pain from the UK Medical Cannabis Registry. Primary outcomes were changes in Brief Pain Inventory short-form (BPI), Short-form McGill Pain Questionnaire-2 (SF-MPQ-2), Visual Analogue Scale-Pain (VAS), General Anxiety Disorder-7 (GAD-7), Sleep Quality Scale (SQS), and EQ-5D-5L, at 1, 3, and 6 months from baseline. Statistical significance was defined at p-value<0.050.

RESULTS

190 patients were included. Median initial Δ-tetrahydrocannabinol and cannabidiol daily doses were 2.0mg (range:0.0-442.0mg) and 20.0mg (range:0.0-188.0mg) respectively. Significant improvements were observed within BPI, SF-MPQ-2, GAD-7, SQS, EQ-5D-5 L index, and VAS measures at all timepoints (p<0.050). Seventy-five adverse events (39.47%) were reported, of which 37 (19.47%) were rated as mild, 23 (12.11%) as moderate, and 14 (7.37%) as severe. Nausea (n=11; 5.8%) was the most frequent adverse event.

CONCLUSION

An association was identified between patients with chronic pain prescribed CBMPs and improvements in pain-specific and general HRQoL outcomes. Most adverse events were mild to moderate in severity, indicating CBMPs were well tolerated. Inherent limitations of study design limit its overall applicability.

摘要

目的

探索慢性疼痛患者使用大麻类药物后疼痛特异性、一般健康相关生活质量(HRQoL)和安全性结局。

方法

本病例系列研究使用了英国医用大麻登记处的慢性疼痛患者。主要结局指标为基线后 1、3 和 6 个月时Brief Pain Inventory 简表(BPI)、Short-form McGill Pain Questionnaire-2(SF-MPQ-2)、视觉模拟评分量表-疼痛(VAS)、广泛性焦虑障碍-7 项量表(GAD-7)、睡眠质量量表(SQS)和 EQ-5D-5L 的变化。统计学显著性定义为 p 值<0.050。

结果

共纳入 190 例患者。初始Δ-四氢大麻酚和大麻二酚日剂量中位数分别为 2.0mg(范围:0.0-442.0mg)和 20.0mg(范围:0.0-188.0mg)。在所有时间点,BPI、SF-MPQ-2、GAD-7、SQS、EQ-5D-5L 指数和 VAS 测量值均有显著改善(p<0.050)。报告了 75 例不良事件(39.47%),其中 37 例(19.47%)为轻度,23 例(12.11%)为中度,14 例(7.37%)为重度。最常见的不良事件是恶心(n=11;5.8%)。

结论

本研究发现,慢性疼痛患者使用大麻类药物与疼痛特异性和一般 HRQoL 结局的改善有关。大多数不良事件的严重程度为轻度至中度,表明大麻类药物具有良好的耐受性。研究设计的固有局限性限制了其总体适用性。

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