Bapir Lara, Erridge Simon, Nicholas Martha, Pillai Manaswini, Dalavaye Nishaanth, Holvey Carl, Coomber Ross, Hoare Jonathan, Khan Shaheen, Weatherall Mark W, Rucker James J, Platt Michael, Sodergren Mikael H
Imperial College Medical Cannabis Research Group Department of Surgery and Cancer, Imperial College London, London, UK.
Department of Medicine, Sapphire Medical Clinics, London, UK.
Expert Rev Neurother. 2023 Mar;23(3):281-295. doi: 10.1080/14737175.2023.2181696. Epub 2023 Feb 26.
There is growing evidence on the efficacy of cannabis-based medicinal products (CBMPs) for chronic pain (CP). Due to the interaction between CP and anxiety, and the potential impact of CBMPs on both anxiety and CP, this article aimed to compare the outcomes of CP patients with and without co-morbid anxiety following CBMP treatment.
Participants were prospectively enrolled and categorized by baseline General Anxiety Disorder-7(GAD-7) scores, into 'no anxiety'(GAD-7 < 5) and 'anxiety'(GAD-7 ≥ 5) cohorts. Primary outcomes were changes in Brief Pain Inventory Short-Form, Short-form McGill Pain Questionnaire-2, Pain Visual Analogue Scale, Sleep Quality Scale (SQS), GAD-7 and EQ-5D-5L index values at 1, 3 and 6 months.
1254 patients (anxiety = 711; no anxiety = 543) met inclusion criteria. Significant improvements in all primary outcomes were observed at all timepoints (p < 0.050), except GAD-7 in the no anxiety group(p > 0.050). The anxiety cohort reported greater improvements in EQ-5D-5L index values, SQS and GAD-7(p < 0.050), but there were no consistent differences in pain outcomes.
A potential association between CBMPs and improvements in pain and health-related quality of life (HRQoL) in CP patients was identified. Those with co-morbid anxiety reported greater improvements in HRQoL.
越来越多的证据表明，基于大麻的药用产品（CBMPs）对慢性疼痛（CP）有效。由于CP与焦虑之间的相互作用，以及CBMPs对焦虑和CP的潜在影响，本文旨在比较接受CBMP治疗的合并焦虑症和未合并焦虑症的CP患者的治疗结果。
前瞻性招募参与者，并根据基线广泛性焦虑障碍-7（GAD-7）评分将其分为“无焦虑”（GAD-7<5）和“焦虑”（GAD-7≥5）两组。主要结局指标为在1、3和6个月时，简明疼痛问卷简表、麦吉尔疼痛问卷简表-2、疼痛视觉模拟量表、睡眠质量量表（SQS）、GAD-7和EQ-5D-5L指数值的变化。
1254例患者（焦虑组=711例；无焦虑组=543例）符合纳入标准。除无焦虑组的GAD-7外（p>0.050），在所有时间点观察到所有主要结局指标均有显著改善（p<0.050）。焦虑组报告EQ-5D-5L指数值、SQS和GAD-7有更大改善（p<0.050），但疼痛结局指标无一致差异。
确定了CBMPs与CP患者疼痛及健康相关生活质量（HRQoL）改善之间的潜在关联。合并焦虑症的患者报告HRQoL改善更大。
