Cannabis for the Treatment of Crohn's Disease and Ulcerative Colitis: Evidence From Cochrane Reviews. Issue 4 (15th October 2019)

• Record Type: Journal Article
• Authors: Kafil, Tahir S; Nguyen, Tran M; MacDonald, John K; Chande, Nilesh
• Is Part Of: Inflammatory bowel diseases. Volume 26:Issue 4(2020)
• Page Start: 502
• Page End: 509
• Publication Date: 2019-10-15
• Subjects: cannabis -- cannabinoids -- Crohn's disease -- ulcerative colitis -- inflammatory bowel disease; Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1093/ibd/izz233
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract: Background: We systematically reviewed the safety and effectiveness of cannabis and cannabinoids treatment for Crohn's disease (CD) and ulcerative colitis (UC). Methods: MEDLINE, Embase, WHO ICTRP, AMED, PsychINFO, CENTRAL, ClinicalTrials.Gov, and the European Clinical Trials Register were searched for relevant studies. Main Results: Five randomized controlled trials (3 CD and 2 UC studies, 185 participants) were included. One CD study (N = 21) showed 45% (5 of 11) of the cannabis cigarette group experienced clinical remission compared with 10% (1 of 10) of the placebo group (risk ratio [RR] 4.55; 95% CI, 0.63–32.56). Another CD study (N = 19) did not show significant rates of clinical remission. Forty percent (4 of 10) of participants in the cannabis oil group experienced remission compared with 33% (3 of 9) of the placebo group (RR 1.20; 95% CI, 0.36–3.97). A UC study (N = 60) did not have significant clinical remission rates. Twenty-four percent (7 of 29) of cannabis oil participants experienced remission compared with 26% (8 of 31) of placebo participants (RR 0.94; 95% CI, 0.39–2.25). A second UC study (N = 32) showed the effects on disease activity, C-reactive protein levels, and fecal calprotectin levels were uncertain. Adverse events were more prevalent in the cannabis groups for both CD and UC studies. GRADE analysis for the UC and CD studies ranged from very low to moderate. Conclusions: In summary, no firm conclusions can be made regarding the safety and effectiveness of cannabis and cannabinoids in adults with CD and UC. Abstract : This article summarizes 2 Cochrane systematic reviews on cannabis use in IBD. The safety and effectiveness of cannabis and cannabinoids in IBD were uncertain due to generally low quality and sparse data. Larger studies with higher methodological quality are needed. Video Abstract: