Evans Lilia, Erridge Simon, Varadpande Madhur, Aggarwal Arushika, Cowley Isaac, Clarke Evonne, McLachlan Katy, Coomber Ross, Rucker James J, Platt Michael, Sodergren Mikael H
Medical Cannabis Research Group, Imperial College London, London, UK.
Curaleaf Clinic, London, UK.
Brain Behav. 2025 Sep;15(9):e70823. doi: 10.1002/brb3.70823.
Complex regional pain syndrome is characterized by severe, persistent pain. Emerging evidence suggests that cannabis-based medicinal products may represent a new therapeutic option. However, to date, no clinical studies have evaluated the effects of cannabis-based medicinal products in individuals with complex regional pain syndrome. The aim of this study is to assess changes in patient-reported outcome measures and the prevalence of adverse events associated with cannabis-based medicinal products prescribed for complex regional pain syndrome.
This case series assessed changes in patient-reported outcome measures over 6 months in complex regional pain syndrome patients enrolled in the UK Medical Cannabis Registry. Adverse events were measured and graded using the Common Terminology Criteria for Adverse Events version 4.0.
A total of 64 patients were identified for inclusion. At baseline, pain severity measured by the Brief Pain Inventory Short Form was 6.69 ± 1.42. This improved at 1 (5.85 ± 1.73), 3 (5.91 ± 1.82), and 6 months (6.05 ± 1.72; p < 0.050). Participants also reported improvements in severity as measured by the Short Form-McGill Pain Questionnaire-2 and pain visual analogue scale at the same time points (p < 0.050). Participants also reported improvements in anxiety symptoms, sleep quality, and general health-related quality of life (p < 0.050), as measured by validated measures. Five patients (7.81%) reported 50 (78.13%) adverse events.
This study represents the outcomes in individuals with complex regional pain syndrome prescribed cannabis-based medicinal products. These suggest initiation of cannabis-based medicinal products is associated with improvements in patient-reported outcome measures. While these findings are consistent with the literature, they must be interpreted with caution, considering the limitations of this study.
Cannabis-based medicinal products were associated with improvements in pain severity and interference. Participants also reported improvements in important metrics of health-related quality of life. This supports further research through high-quality randomized controlled trials to ascertain the efficacy of cannabis-based medicinal products in improving complex regional pain syndrome symptoms.
复杂性区域疼痛综合征的特征是严重、持续的疼痛。新出现的证据表明，大麻类药用产品可能是一种新的治疗选择。然而，迄今为止，尚无临床研究评估过大麻类药用产品对复杂性区域疼痛综合征患者的影响。本研究的目的是评估患者报告的结局指标的变化以及为复杂性区域疼痛综合征开具的大麻类药用产品相关不良事件的发生率。
本病例系列评估了英国医用大麻登记处登记的复杂性区域疼痛综合征患者在6个月内患者报告的结局指标的变化。使用《不良事件通用术语标准》第4.0版对不良事件进行测量和分级。
共确定64例患者纳入研究。基线时，简明疼痛问卷简表测量的疼痛严重程度为6.69±1.42。在1个月（5.85±1.73）、3个月（5.91±1.82）和6个月时有所改善（6.05±1.72；p<0.050）。参与者还报告在相同时间点，简短麦吉尔疼痛问卷-2和疼痛视觉模拟量表测量的严重程度有所改善（p<0.050）。通过有效测量方法，参与者还报告焦虑症状、睡眠质量和总体健康相关生活质量有所改善（p<0.050）。5例患者（7.81%）报告了50起不良事件（78.13%）。
本研究呈现了开具大麻类药用产品的复杂性区域疼痛综合征患者的结局。这些结果表明，开始使用大麻类药用产品与患者报告的结局指标改善相关。虽然这些发现与文献一致，但考虑到本研究的局限性，必须谨慎解读。
大麻类药用产品与疼痛严重程度及干扰的改善相关。参与者还报告了健康相关生活质量重要指标的改善。这支持通过高质量随机对照试验进行进一步研究，以确定大麻类药用产品改善复杂性区域疼痛综合征症状的疗效。
