RESUMEN
Cannabis has been used in rheumatic diseases as therapy for chronic pain or inflammatory conditions. Herein, the authors systematically review the rheumatological diseases in which cannabis has been studied: systemic sclerosis, fibromyalgia, osteoarthritis, rheumatoid arthritis, osteoporosis, polymyalgia rheumatica, gout, dermatomyositis, and psoriatic arthritis. We systematically searched PubMed for articles on cannabis and rheumatic diseases between 1966 and March 2023. Twenty-eight articles have been selected for review. Most of them (n=13) were on fibromyalgia and all of them but one showed important reduction in pain; sleep and mood also improved. On rheumatoid arthritis, two papers displayed decrease in pain and in one of them a reduction in inflammatory parameters was found. In scleroderma there was a case description with good results, one study on local use for digital ulcers also with good outcomes and a third one, that disclosed good results for skin fibrosis. In dermatomyositis a single study showed improvement of skin manifestations and in osteoarthritis (3 studies) this drug has demonstrated a good analgesic effect. Several surveys (n=5) on the general use of cannabis showed that rheumatological patients (mixed diseases) do use this drug even without medical supervision. The reported side effects were mild. In conclusion, cannabis treatment is an interesting option for the treatment of rheumatological diseases that should be further explored with more studies.
RESUMEN
BACKGROUND: Homeopathy has been used in observational and controlled studies to treat patients with fibromyalgia (FM), but none has previously used the remedy Cannabis sativa. CASE HISTORY: A 51-year-old female patient presenting with diffuse pain and sleep disorder was diagnosed with FM using the relevant American College of Rheumatology criteria. She reported having 18 tender points, a pain score (visual analog scale, VAS) of 9.0, and a well-being VAS of 5.0. She was prescribed Cannabis sativa 6 cH, five drops sublingually thrice a day. RESULTS: After 2 months, she returned asymptomatic, with 0 tender points, pain VAS of 0, and well-being VAS of 9.0. The Modified Naranjo Criteria for Homeopathy score was equal to +9, suggesting the clinical outcome was causally attributable to the medicine prescribed. CONCLUSION: This case study reveals the positive role of homeopathic treatment in FM. Studies using a randomized controlled design, including pragmatic trials to determine treatment effectiveness in real-world clinical practice, are indicated in this field.