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克罗恩病中使用大麻:随机对照试验的系统评价和荟萃分析

Cannabis use in Crohn's disease: a systematic review and meta-analysis of randomized controlled trials (RCTs).

作者信息

Vaid Rayyan, Fareed Areeba, Qader Rabia, Hussain Aariz, Shaikh Wajiha, Zameer Ushna, Ochani Sidhant

机构信息

Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan.

Department of Medicine, Khairpur Medical College, Khairpur Mir's, Pakistan.

出版信息

Ir J Med Sci. 2025 Apr;194(2):439-446. doi: 10.1007/s11845-024-03844-w. Epub 2025 Jan 17.

Abstract

OBJECTIVE

This meta-analysis aims to systematically evaluate the efficacy and safety of cannabis in the management of Crohn's disease (CD) by synthesizing evidence from randomized controlled trials (RCTs). By adhering to the 2020 PRISMA guidelines and registering the study protocol with PROSPERO, this research intends to offer robust, evidence-based recommendations for healthcare practitioners on the therapeutic potential and clinical implications of cannabis use in CD management.

METHODS

A literature search encompassing PubMed, Google Scholar, and the Cochrane Library was conducted to identify relevant RCTs comparing cannabis to placebo or standard therapy in CD patients. Inclusion criteria focused on outcomes such as remission rates, C-reactive protein (CRP) levels, quality of life (QoL), and adverse events (AEs). Statistical analysis using RevMan 5.3 involved weighted mean differences (MD) and 95% confidence intervals to compare outcomes between the cannabis and control groups.

RESULTS

The meta-analysis revealed significant findings regarding the impact of cannabis on CD management. The cannabis group exhibited significantly higher clinical remission rates at 8 weeks compared to the control group, with low heterogeneity [MD = - 67.98; 95% CI: (- 100.68, - 35.29)]. However, a statistically significant improvement in QoL was observed in the placebo group compared to the cannabis-treated group [MD = 19.62; 95% CI (14.24 to 25.00)]. There was a non-significant lowering in serum CRP levels compared to the placebo group [MD: - 0.51; 95% CI: (- 1.05, 0.02)].

CONCLUSION

The study concludes that cannabis shows promise as a therapeutic option for CD, demonstrating higher remission rates and potential benefits for disease management. However, it also highlights the need for larger, standardized research studies to solidify conclusions regarding efficacy, safety, and biomarker responses in CD patients.

摘要

目的

本荟萃分析旨在通过综合随机对照试验(RCT)的证据,系统评估大麻在克罗恩病(CD)管理中的疗效和安全性。通过遵循2020年PRISMA指南并在PROSPERO上注册研究方案,本研究旨在为医疗从业者提供关于大麻在CD管理中的治疗潜力和临床意义的有力、基于证据的建议。

方法

进行了一项文献检索,涵盖PubMed、谷歌学术和Cochrane图书馆,以识别将大麻与安慰剂或标准疗法在CD患者中进行比较的相关RCT。纳入标准集中于缓解率、C反应蛋白(CRP)水平、生活质量(QoL)和不良事件(AE)等结果。使用RevMan 5.3进行的统计分析涉及加权平均差(MD)和95%置信区间,以比较大麻组和对照组之间的结果。

结果

荟萃分析揭示了关于大麻对CD管理影响的重要发现。与对照组相比,大麻组在8周时的临床缓解率显著更高,异质性较低[MD = - 67.98;95% CI:(- 100.68,- 35.29)]。然而,与大麻治疗组相比,安慰剂组的QoL有统计学显著改善[MD = 19.62;95% CI(14.24至25.00)]。与安慰剂组相比,血清CRP水平有非显著降低[MD:- 0.51;95% CI:(- 1.05,0.02)]。

结论

该研究得出结论,大麻显示出作为CD治疗选择的前景,在疾病管理方面表现出更高的缓解率和潜在益处。然而,它也强调需要进行更大规模、标准化的研究,以巩固关于CD患者疗效、安全性和生物标志物反应的结论。

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