NEW YORK (Reuters Health)—Lower doses of cannabidiol (CBD) failed to provide any meaningful reduction in pain when added to other analgesic therapy in patients with hand osteoarthritis (OA) or psoriatic arthritis (PsA) in a randomized, placebo-controlled study from Denmark.1
Writing in the journal, Pain, Jonathan Vela, MD, and colleagues of Aalborg University note that CBD is increasingly used as analgesic medication despite a lack of trials examining CBD for pain management.
They tested the effects of 12 weeks of CBD (20–30 mg daily) vs. placebo as add-on analgesic therapy in patients with hand OA or PsA experiencing moderate pain intensity despite other pain medication.
The primary outcome was the difference between groups after 12 weeks in the change in patient-reported pain intensity during the last 24 hours on a visual analogue scale (VAS) with scores ranging from 0 mm (no pain) to 100 mm (worst pain). A total of 136 patients were randomized, with 129 included in the primary analysis.
At 12 weeks, there were no statistically significant differences in pain intensity between the CBD group and the placebo group, with a mean difference of 0.23 mm on the VAS scale; 22% of patients using CBD and 21% using placebo experienced a reduction in pain intensity of more than 30 mm.
“We found neither clinically nor statistically significant effect of CBD for pain intensity in patients with hand OA and PsA when compared with placebo. Additionally, no statistically significant effects were found on sleep quality, depression, anxiety or pain catastrophizing scores,” the study team reports.
They caution that due to a lack of data on an optimal CBD dose for an analgesic effect, they chose a pragmatic dose of 20–30 mg daily.
“This dose could prove insufficient to produce the plasma concentrations required to activate relevant receptors involved in inflammation and nociception. CBD dosage regimes used in trials regarding neurological disease often surpass 1,000 mg daily, but with a significant number of side-effects. Future high quality double-blind, randomized and placebo-controlled trials are needed to further explore the possible analgesic properties of higher doses of CBD,” the researchers say.
The study was supported by grants from the Danish Psoriasis Foundation and the Danish Rheumatism Foundation. The authors have no relevant conflicts of interest.
- Vela J, Dreyer L, Petersen KK, et al. Cannabidiol treatment in hand osteoarthritis and psoriatic arthritis: A randomized, double-blind placebo-controlled trial. Pain. 2021 Aug 27. Online ahead of print.