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  • Writer's pictureDr. Dan Jin

Cannabis in the Treatment of Rheumatoid Arthritis and Osteoarthritis

Did you know the differences between rheumatoid arthritis (RA) and osteoarthritis (OA)? OA is the most common type of arthritis which happens when the joints are overused and the smooth cartilage joint surface wears out. It usually happens on joints that bear weight, including knees, hips, feet, and spine, and makes the affected joint hurt. RA is an autoimmune disease where the immune system attacks joints of the body and lead to inflammation and pain. It usually affects small joints, including hands, wrists, elbows, shoulders, knees, ankles, feet, jaw, and neck, with a symmetrical pattern.


What does the Science say?

Cannabinoids may be useful in the management of arthritis for their anti-inflammatory, and immunomodulatory, and pain reliving properties [1–3]. One randomised placebo-controlled trial of Sativex® (Cannabis extract with THC:CBD = 1:1) in 58 patients with RA has shown statistically significant improvements in pain on movement, pain at rest, and quality of sleep compared to placebo [4]. There was no effect on morning stiffness. In an animal model of OA, cannabinoid receptor CB2 regulated central sensitisation and pain responses associated with of OA in the knee joint [5]. In another animal model, treatment with a CB2 agonist reduced the severity of OA in the whole joint [6]. More clinical trials are needed to support the use of cannabis-based medicine in the treatment of RA and OA.


Reference

  1. Lowin T, Schneider M, Pongratz G (2019) Joints for joints: cannabinoids in the treatment of rheumatoid arthritis. Current Opinion in Rheumatology 31:271–278

  2. Sarzi-Puttini P, Ablin J, Trabelsi A, Fitzcharles M-A, Marotto D, Häuser W (2019) Cannabinoids in the treatment of rheumatic diseases: Pros and cons. Autoimmunity Reviews 18:102409

  3. Berg MVD, John M, Black M, Semprini A, Oldfield K, Glass M, Braithwaite I (2020) Cannabis-based medicinal products in arthritis, a painful conundrum. The New Zealand medical journal

  4. Blake DR, Robson P, Ho M, Jubb RW, Mccabe CS (2006) Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology (Oxford Print) 45:50–52

  5. Burston JJ, Sagar DR, Shao P, et al (2013) Cannabinoid CB2 receptors regulate central sensitization and pain responses associated with osteoarthritis of the knee joint. PLoS One 8:e80440

  6. Sophocleous A, Börjesson AE, Salter DM, Ralston SH (2015) The type 2 cannabinoid receptor regulates susceptibility to osteoarthritis in mice. Osteoarthritis and Cartilage 23:1586–1594

 

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