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药用大麻治疗慢性难治性疼痛:口服制剂不良事件谱及对健康相关生活质量影响的调查

Medicinal Cannabis for the Treatment of Chronic Refractory Pain: An Investigation of the Adverse Event Profile and Health-Related Quality of Life Impact of an Oral Formulation.

作者信息

Abelev Sarah, Warne Leon N, Benson Melissa, Hardy Mark, Nayee Sunny, Barlow John

机构信息

Applied Cannabis Research, Sydney, New South Wales, Australia.

Little Green Pharma, Perth, Washington, Australia.

出版信息

Med Cannabis Cannabinoids. 2022 Feb 9;5(1):20-31. doi: 10.1159/000521492. eCollection 2022 Jan-Dec.

Abstract

INTRODUCTION

Medicinal cannabis is prescribed in Australia for patients with chronic refractory pain conditions. However, measures of safety and effectiveness of different cannabinoids are lacking. We designed an observational study to capture effectiveness, adverse events (AEs), and health-related quality of life (HRQoL) measures in patients prescribed an oral medicinal cannabis formulation at Cannabis Access Clinics through the Cannabis Access Clinics Observational study (CACOS).

OBJECTIVES

We aimed to evaluate effectiveness, reported AEs, and change in patient-reported outcomes in individuals prescribed a cannabinoid oil formulation for management of chronic pain.

METHODS

A cross-sectional analysis was conducted on patients prescribed an oil formulation of Δ9-tetrahydrocannabinol and cannabidiol for pain symptoms of at least 3-month duration. Clinician-reported AEs were organized by system, organ, class, and frequency. Analysis of patient-reported responses to a questionnaire was conducted using published minimal clinically important differences to determine meaningful change in HRQoL over time.

RESULTS

More than half ( = 91/151, 60.3%) of the participants experienced at least one AE during the observation period (mean 133 ± 116 days). No serious AEs were reported. Patient-reported pain impact scores were significantly reduced across the cohort ( = 0.034), and pain intensity scores verged on significance ( = 0.053). The majority of patients saw meaningful improvements in sleep (49.3%) and fatigue (35.6%).

CONCLUSION

This analysis presents real-world data collected as part of standard of care. More than one-third of patients benefited from oral medicinal cannabis, which is impactful given the refractory nature of their pain. Amelioration of the impact of pain confirms continued prescribing of this formulation and validates our observational methodology as a tool to determine the therapeutic potency of medicinal cannabinoids.

摘要

引言

在澳大利亚,医用大麻被开给患有慢性顽固性疼痛病症的患者。然而,不同大麻素的安全性和有效性衡量标准尚缺。我们设计了一项观察性研究,通过大麻准入诊所观察性研究(CACOS),在大麻准入诊所中,对开具口服医用大麻制剂的患者进行有效性、不良事件(AE)及健康相关生活质量(HRQoL)衡量指标的评估。

目的

我们旨在评估为管理慢性疼痛而开具大麻素油制剂的个体的有效性、报告的不良事件以及患者报告结局的变化。

方法

对开具Δ9-四氢大麻酚和大麻二酚油制剂以缓解至少持续3个月疼痛症状的患者进行横断面分析。临床医生报告的不良事件按系统、器官、类别和频率进行整理。使用已公布的最小临床重要差异对患者报告的问卷回复进行分析,以确定随时间推移HRQoL的有意义变化。

结果

超过一半(=91/151,60.3%)的参与者在观察期(平均133±116天)内经历了至少一次不良事件。未报告严重不良事件。整个队列中患者报告的疼痛影响评分显著降低(=0.034),疼痛强度评分接近显著水平(=0.053)。大多数患者在睡眠(49.3%)和疲劳(35.6%)方面有有意义的改善。

结论

本分析呈现了作为护理标准一部分收集的真实世界数据。超过三分之一的患者从口服医用大麻中受益,鉴于其疼痛的顽固性,这一效果显著。疼痛影响的改善证实了该制剂的持续处方,并验证了我们的观察方法作为确定医用大麻素治疗效力的工具的有效性。

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