Cochrane: pot yields uncertain benefit in ulcerative colitis

  • Cochrane Database of Systematic Reviews

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.

Limitations

  • Small number of RCTs.
  • Studies were too different for pooling.

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