Kang Hansol, Schmoyer Christopher J, Weiss Alexandra, Lewis James D
Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Division of Gastroenterology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Inflamm Bowel Dis. 2025 Feb 6;31(2):450-460. doi: 10.1093/ibd/izae158.
With the increasing legalization of medical and recreational cannabis, patients and providers have growing interest in the role of cannabinoids in treating inflammatory bowel disease. Prior meta-analysis has shown inconclusive evidence for efficacy of cannabinoids. We sought to produce an up-to-date meta-analysis that pools new data to evaluate the therapeutic effects of cannabinoids in both Crohn's disease (CD) and ulcerative colitis (UC).
PubMed, Embase, CENTRAL and CINAHL were queried for randomized-controlled trials evaluating the impact cannabinoids in CD or UC. Random effects modeling was used to compute pooled estimates of risk difference. Heterogeneity was assessed using I2.
Eight studies, including 4 studies of CD, 3 studies of UC, and 1 study of both diseases met inclusion criteria. Among 5 studies of CD, a statistically significant decrease in clinical disease activity following intervention was observed (risk ratios [RR], -0.91; 95% CI, CI:1.54 to CI:0.28, I2 = 71.9%). Clinical disease activity in UC was not significantly lower in the pooled analysis (RR, -2.13; 95% CI, -4.80 to 0.55; I2 = 90.3%). Improvement in quality of life (QoL) was observed in both CD and UC combined (RR, 1.79; 95% CI, 0.92-0.2.66; I2 = 82.8%), as well as individually. No differences were observed in the analysis on endoscopic disease activity and inflammatory markers.
This meta-analysis of clinical trials suggests that cannabinoids are associated with improved quality of life in both CD and UC, as well as improved disease activity but not inflammation.
随着医用大麻和娱乐用大麻的合法化程度不断提高，患者和医疗服务提供者对大麻素在治疗炎症性肠病中的作用越来越感兴趣。先前的荟萃分析显示，关于大麻素疗效的证据尚无定论。我们试图进行一项最新的荟萃分析，汇总新数据以评估大麻素在克罗恩病（CD）和溃疡性结肠炎（UC）中的治疗效果。
检索了PubMed、Embase、CENTRAL和CINAHL数据库，以查找评估大麻素对CD或UC影响的随机对照试验。采用随机效应模型计算风险差异的合并估计值。使用I2评估异质性。
八项研究符合纳入标准，其中包括四项CD研究、三项UC研究和一项同时涉及两种疾病的研究。在五项CD研究中，干预后临床疾病活动度有统计学意义的下降（风险比[RR]，-0.91；95%置信区间[CI]：1.54至0.28，I2 = 71.9%）。在汇总分析中，UC的临床疾病活动度没有显著降低（RR，-2.13；95% CI，-4.80至0.55；I2 = 90.3%）。CD和UC合并以及单独分析时，生活质量（QoL）均有改善（RR，1.79；95% CI，0.92 - 2.66；I2 = 82.8%）。在内镜疾病活动度和炎症标志物分析中未观察到差异。
这项对临床试验的荟萃分析表明，大麻素与CD和UC患者生活质量的改善以及疾病活动度的改善相关，但与炎症无关。
