Shrestha Karun, Subedi Prakriti, Regmi Anil, Ghimire Manoj, Poudel Sajana, Hashim Mahmoud, Hasan Mohammed, Tagoe Clement
Department of Internal Medicine, St. Barnabas Hospital, SBH Health System, Bronx, New York, USA.
Department of Internal Medicine, Parkview Health, Fort Wayne, Indiana, USA.
Proc (Bayl Univ Med Cent). 2025 Mar 24;38(3):259-264. doi: 10.1080/08998280.2025.2473863. eCollection 2025.
Despite advancements in rheumatoid arthritis (RA) treatment, effective pain management remains challenging, with many patients also experiencing insomnia, anxiety, and depression. Cannabis, with its analgesic properties, offers a promising nonopioid alternative. This study evaluated outcomes in hospitalized RA patients using cannabis through the National Inpatient Sample (NIS) database.
This retrospective study analyzed NIS data (2016-2021) using ICD-10 codes to identify RA patients. Demographic and clinical characteristics and inpatient outcomes were compared between cannabis users and nonusers.
RA patients using cannabis (n = 42,415) were younger (mean age 51.8 vs 67.8 years), less likely to be female (60.65% vs 73.71%), and more likely to be African American (24.02% vs 12.86%) and Native American (2.25% vs 0.86%). Cannabis use was associated with lower mortality (0.98% vs 2.71%) and hospital charges ($57,773 vs $63,681). After adjusting for age, gender, race, and comorbidities, cannabis use was linked to decreased mortality (odds ratio [OR]: 0.50), depression (OR: 0.47), chronic pain (OR: 0.45), and anxiety (OR: 0.55). Conversely, cannabis use increased the risk of opioid use (OR: 1.10), nicotine dependence (OR: 1.35), and alcohol use (OR: 1.35).
RA patients using cannabis had lower mortality, depression, chronic pain, and anxiety, but higher risks of opioid, nicotine, and alcohol use. Further research is needed on the long-term effects of cannabis in RA management.
尽管类风湿关节炎（RA）治疗取得了进展，但有效的疼痛管理仍然具有挑战性，许多患者还伴有失眠、焦虑和抑郁。大麻具有镇痛特性，提供了一种有前景的非阿片类替代方案。本研究通过国家住院样本（NIS）数据库评估了住院RA患者使用大麻的结果。
这项回顾性研究使用国际疾病分类第十版（ICD - 10）编码分析NIS数据（2016 - 2021年）以识别RA患者。比较了大麻使用者和非使用者的人口统计学和临床特征以及住院结局。
使用大麻的RA患者（n = 42,415）更年轻（平均年龄51.8岁对67.8岁），女性比例更低（60.65%对73.71%），非裔美国人（24.02%对12.86%）和美洲原住民（2.25%对0.86%）比例更高。使用大麻与较低的死亡率（0.98%对2.71%）和住院费用（57,773美元对63,681美元）相关。在调整年龄、性别、种族和合并症后，使用大麻与死亡率降低（比值比[OR]：0.50）、抑郁（OR：0.47）、慢性疼痛（OR：0.45）和焦虑（OR：0.55）相关。相反，使用大麻增加了使用阿片类药物（OR：1.10）、尼古丁依赖（OR：1.35）和酒精使用（OR：1.35）的风险。
使用大麻的RA患者死亡率、抑郁、慢性疼痛和焦虑较低，但使用阿片类药物、尼古丁和酒精的风险较高。需要进一步研究大麻在RA管理中的长期影响。
