polymyalgia rheumatica cbd

The use of cannabinoids for the relief of pain associated with RA has been assessed by one study 33 which showed that, in comparison with placebo, the cannabis-based drug was associated with significant improvements in certain pain parameters and quality of sleep. With regard to drug safety, the study found no serious adverse effects in the active treatment group, with most adverse effects being mild or moderate.

In another study, Habib and Avisar employed questionnaires on social media to reach out to Israeli fibromyalgia patients using cannabis 26 and found that, of 383 responders, 323 (84%) reported consuming cannabis; 142 (44%) of these were licensed to do so. The majority of patients reported pain relief (94%) and improved sleep quality (93%). Depression and anxiety were both also reported to improve under cannabis use by the patients. Most of the reported adverse effects were mild (e.g. eye or throat irritation); 12% reported experiencing adverse effects.

Fibromyalgia is a common chronic pain syndrome causing diffuse pain, tenderness, fatigue, and sleep disturbances. Other complaints include cognitive symptoms, as well as headaches. 11 The prevalence of fibromyalgia is estimated at 2.7% globally. 12 Without a known pathophysiology and etiology, and therefore in the absence of disease-modifying or definitive treatment, analgesia is a significant part of fibromyalgia symptomatic treatment. Fibromyalgia patients may respond to certain pharmacological agents (e.g. antidepressants and anticonvulsants) or to other interventions such as aerobic exercise, physical therapy, and rehabilitation programs (non-pharmacological interventions were recommended as the first line of treatment in recent European League Against Rheumatism [EULAR] guidelines 13 ).

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FIBROMYALGIA

Management of chronic pain is difficult, and patients are often unsatisfied with the effect of treatment. 5 Drug options that are currently available may not be very safe for certain patient populations. Opioids are a problematic long-term solution for chronic pain, due to the risk they carry of significant adverse events, addiction, and overdose. 6 Opioid use was also found to be associated with more severe symptoms and unemployment in fibromyalgia. 7 Other drugs used to treat chronic pain, such as antidepressants (e.g. serotonin-norepinephrine reuptake inhibitors [SNRIs], tricyclic antidepressants [TCAs]), have been shown to be useful for this indication but have certain side effects (e.g. increased risk of cardiovascular events and falls with TCAs) that might limit their use in older patients. 8 One solution for long-term pain that has been studied in the context of pain relief in rheumatic diseases—but not thoroughly enough—is the use of cannabis or cannabinoids, which may potentially show therapeutic qualities as well. 9

Several studies have also shown that cannabinoids and cannabinoid receptors might play a role in SSc, as cannabinoid receptors have been shown to modulate SSc in murine models, 9 and were also found to be over-expressed in SSc fibroblasts. 38 A study on a murine model also found that treatment with cannabinoids prevented the development of cutaneous and pulmonary fibrosis and decreased the proliferation of fibroblasts and antibody development. 39 A clinical trial of a novel oral selective cannabinoid receptor agonist is currently in phase 3, after showing a statistically significant effect on skin fibrosis. 40

Cannabis and cannabinoids were investigated as substances that can ameliorate chronic pain and other symptoms associated with rheumatic disease. However, it had also been suggested that cannabinoids have an inflammatory-modulating quality that could exert a therapeutic effect in such conditions, as cannabinoids were shown to have an overall anti-inflammatory effect on immune cells; these results were reinforced by studies in animal models of RA and systemic sclerosis (SSc). 9

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CANNABINOIDS

It is assumed that the plant Cannabis sativa exerts its effects on human physiology through substances it contains, termed phytocannabinoids (over 100 of them have already been isolated so far). Those phytocannabinoids are thought to bind cannabinoid receptors throughout the human body, to which endocannabinoid (i.e. cannabinoids produced by human tissue) bind as well. Of the phytocannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most well-studied and are used as medications. Tetrahydrocannabinol is considered to be the more psychoactive component in cannabis, while CBD is considered to be the major non-psychoactive component. Cannabinoid receptors are found in a variety of tissues throughout the body—from neurons in the frontal cortex, to the gastrointestinal tract and immune cells as well. 9 According to the “entourage theory,” the combination of THC and CBD creates a synergistic effect in which other phytocannabinoids possibly take part as well, suggesting that there could be a benefit in using cannabis rather than synthetic cannabinoids as analgesic or therapeutic agents. 10

Data regarding the use of cannabinoids in the treatment of fibromyalgia consist of several studies investigating the use of nabilone—a synthetic analog of THC—and fewer in which cannabis was used. Two studies evaluating the use of nabilone in fibromyalgia were included in a Cochrane review that found that nabilone was not superior to placebo or amitriptyline (a TCA) in relieving fibromyalgia symptoms, 19 – 21 as neither study provided high/moderate-quality evidence for efficacy. However, one study included in this Cochrane review did show very low-quality evidence that nabilone compared with placebo led to a decrease in pain and anxiety as well as to an improvement in health-related quality of life. 21 In the other study included in this Cochrane review, very low-quality evidence that nabilone was superior to amitriptyline in improving sleep was found. 20 While cannabinoids were not suggested as treatment for fibromyalgia in the aforementioned Cochrane review, The National Academies of Science, Engineering, and Medicine suggested in their 2017 report that there was moderate evidence that cannabis or cannabinoids are effective for fibromyalgia. 22

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I wonder very much about medical marijuana and CBD for PMR, and know several people that use the plant to combat different symptoms of their illness (PMR related and non-PMR). Unfortunately it's still very stigmatised in the UK to the point that I think that it's difficult to purchase real CBD at a price that is reasonable. Definitely research it carefully!  Personally I think it's a much maligned and little researched due to fear of 'drugs'.

joan60597 pam76053

I don't even know if this subject is welcomed on this board as you don't see much discussion about it?

AlVB pam76053

Posted 4 years ago