- A Cochrane review finds the evidence uncertain concerning the efficacy of cannabis or its cannabinoid derivatives for ulcerative colitis (UC).
Why this matters
- The review draws "no firm conclusions" about cannabis' benefits amidst evidence that patients with UC are using cannabis at a higher rate than that in the general population.
- Review of 2 randomized controlled trials (RCTs) (n=92) that met eligibility criteria after search including MEDLINE, EMBASE, PsychINFO, and the Cochrane IBD Group Specialized Register.
- Quality of evidence was rated by GRADE.
- Funding: Crohn's and Colitis Canada.
- 1 RCT comparing cannabidiol capsules (100-500 mg daily for 10 weeks) with placebo:
- no difference between groups in clinical remission, clinical response but evidence is of low certainty;
- no difference between groups in mean serum C-reactive protein (CRP), with moderate certainty of evidence; and
- cannabidiol group may have had higher QoL by IBD questionnaire (mean difference, 17.4; 95% CI, -3.45 to 38.25; moderate certainty evidence).
- 1 RCT comparing cannabis cigarettes (23 mg tetrahydrocannabinol [THC] per day for 8 weeks) with placebo:
- the cannabis group had lower mean disease activity (mean difference, -4.00; 95% CI, -5.98 to -2.02; low certainty evidence); and
- no difference between groups in CRP or fecal calprotectin.
- Small number of RCTs.
- Studies were too different for pooling.