Medical Cannabis Use Lowers Symptom Burden for Rheumatologic Disease Patients

Kevin Boehnke, PhD

Medical cannabis is associated with a number of favorable outcomes for patients with rheumatic diseases, including a lessened symptom burden and discontinuation of opioids or sleeping pills.

A team, led by Kevin Boehnke, PhD, University of Michigan, characterized medical cannabis use among patients with rheumatologic disease in the US and Canada, looking at demographic and clinical differences between those with inflammatory compared to non-inflammatory rheumatic conditions.

The data was presented during the American College of Rheumatology (ACR) Convergence 2022.

Patients with rheumatic diseases also suffer from persistent pain and poor sleep.

“Medical cannabis may offer symptomatic relief and is increasingly accessible to patients,” the authors wrote. “Recent recreational cannabis legalization in many United State (US) states and Canada has opened this access gateway for patients who may be using MC with physician oversight or by self-administration.”

An improved understanding on how medical cannabis culture can facilitate empathetic patient centered care.

The investigators partnered with the Arthritis Foundation in the US and the Arthritis Society in Canada and presented the data during the 2022 American College of Rheumatology (ACR) Convergence Meeting in Philadelphia.

Online Respondents

In the study, 797 participants self-reported a rheumatic condition through an online anonymous survey.

Of the responders, 441 had an inflammatory rheumatic disease and 356 had a non-inflammatory rheumatic condition.

The investigators assessed symptom burden using the 2011 Fibromyalgia diagnostic criteria and the PROMIS Global Health instrument with physical and mental health scores converted to respective t-scores for analysis.

They also assessed symptom change using a 7-point Likert scale ranging from very much to very much better.

Demographics

The majority of respondents were white females with some education beyond high school. In addition, about 33% of responders were employed.

The result show a high symptom burden with the inflammatory group showing higher FM scores (P <0.0001) and lower PROMIS physical (P <0.0001) and mental health (P = 0.0011) scores despite being younger on average (P <0.0001).

Both groups said there were moderate symptom relief across all domains, with greater improvements found in joint stiffness and global health in the inflammatory group.

The results also show substantial medication substitution across prescription drug classes related to medical cannabis use, with 51.9% discontinuing opioids, 64% discontinuing SNRIs, 68% discontinuing SSRIs, 67.3% discontinuing gabapentinoids, and 69.4% discontinuing sleeping pills.

There were no significant differences found between the 2 groups within any of the prescription medication classes.

“High symptom burden is likely a driver for MC use by persons with both inflammatory and non-inflammatory rheumatic conditions,” the authors wrote. “The substantial symptom relief and reported reduction or discontinuation of prescribed symptomatic treatments warrants formal study.”

The study, “Medical Cannabis Use by Rheumatology Patients According to Inflammatory versus Non-Inflammatory Condition,” was published online by ACR Convergence.