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使用大麻素治疗类风湿性关节炎和银屑病关节炎时患者报告的疼痛、僵硬和疲劳减轻的结果。

Patient-Reported Outcomes of Pain, Stiffness, and Fatigue Reduction in Rheumatoid and Psoriatic Arthritis With Cannabinoid Use.

作者信息

Purohit Richa, Mathai Reanne, Camargo Macias Kathlyn, Chalise Sweta, Jehu Tara, Bhaskar Neha, Bhanusali Neha

机构信息

Department of Internal Medicine, Concentra Urgent Care, Orlando, USA.

Rheumatology, University of Central Florida College of Medicine, Orlando, USA.

出版信息

Cureus. 2024 Oct 25;16(10):e72366. doi: 10.7759/cureus.72366. eCollection 2024 Oct.

Abstract

Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are autoimmune conditions that can progressively destroy joints, causing chronic, often debilitating pain, and drastically affecting the quality of life. Novel pharmaceutical remedies have recently been developed, which allow for better symptom management. However, the complex pain experienced is challenging to control fully, leading this patient population to seek alternative treatments. Though cannabis has been legalized for medical use in most states in the United States, the safety and efficacy of its use in inflammatory arthritis have still not been satisfactorily established. We conducted a cross-sectional study on patients with RA and PsA who visited a rheumatology outpatient clinic from October 2019 to March 2020. We conducted a brief, voluntary, and anonymous Qualtrics survey of specific questions regarding their use of cannabinoids and their forms, sources, methods, side effects, and perceived efficacy. The survey initially involved 302 eligible candidates, but only 290 patients completed it. Among them, 84.9% (n, 247) reported a diagnosis of RA, while 15.1% (n, 44) reported PsA. Demographically, 82.3% (n, 238) were female, and 17.7% (n, 52) were male, with mean ages of 57.1 years for RA and 56.2 years for PsA. Around 16.95% (n=40) of RA and 11.63% (n=5) of PsA patients reported cannabinoid use, primarily inhaled for RA and topical/liquid for PsA. Post-cannabis use, a significant decrease in pain scale was noted (mean difference: 2.267, p < 0.001), with improvements in stiffness, fatigue, and swelling reported. Side effects were minimal, and most patients were willing to discuss cannabinoid treatment with their physician (80.9% RA [n=199], 86.4% PsA [n=38]). In conclusion, our study indicates that a notable portion of the patients with inflammatory arthritis including RA and PsA reported a history of use or ongoing cannabinoid use. Furthermore, the patients reported a short-term reduction of pain, fatigue, and swelling, though it is unclear if these findings are related to a placebo effect.

摘要

类风湿性关节炎(RA)和银屑病关节炎(PsA)是自身免疫性疾病,可逐渐破坏关节,导致慢性的、常常使人衰弱的疼痛,并严重影响生活质量。最近已开发出新型药物疗法,可更好地控制症状。然而,所经历的复杂疼痛难以完全控制,导致这一患者群体寻求替代疗法。尽管大麻在美国大多数州已被批准用于医疗用途,但其在炎性关节炎中的安全性和有效性仍未得到令人满意的确立。我们对2019年10月至2020年3月期间到风湿病门诊就诊的RA和PsA患者进行了一项横断面研究。我们针对他们使用大麻素的情况、形式、来源、方法、副作用以及感知到的疗效等特定问题,开展了一项简短、自愿且匿名的Qualtrics调查。该调查最初有302名符合条件的候选人,但只有290名患者完成了调查。其中,84.9%(n = 247)报告诊断为RA,而15.1%(n = 44)报告为PsA。从人口统计学角度看,82.3%(n = 238)为女性,17.7%(n = 52)为男性,RA患者的平均年龄为57.1岁,PsA患者的平均年龄为56.2岁。约16.95%(n = 40)的RA患者和11.63%(n = 5)的PsA患者报告使用过大麻素,RA患者主要通过吸入使用,PsA患者则主要使用外用/液体剂型。使用大麻后,疼痛评分显著降低(平均差异:2.267,p < 0.001),同时报告僵硬、疲劳和肿胀情况有所改善。副作用极小,大多数患者愿意与医生讨论大麻素治疗(RA患者中80.9% [n = 199],PsA患者中86.4% [n = 38])。总之,我们的研究表明,包括RA和PsA在内的炎性关节炎患者中有相当一部分报告有使用大麻素的病史或正在使用大麻素。此外,患者报告疼痛、疲劳和肿胀有短期减轻,不过尚不清楚这些发现是否与安慰剂效应有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe5c/11585972/0b4633c1bafe/cureus-0016-00000072366-i01.jpg

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