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Oral capsules of tetra-hydro-cannabinol (THC), cannabidiol (CBD) and their combination in peripheral neuropathic pain treatment.
Zubcevic, Kanita; Petersen, Merete; Bach, Flemming Winther; Heinesen, Aksel; Enggaard, Thomas Peter; Almdal, Thomas Peter; Holbech, Jakob Vormstrup; Vase, Lene; Jensen, Troels Stahelin; Hansen, Christian Stevns; Finnerup, Nanna Brix; Sindrup, Søren H.
Afiliación
  • Zubcevic K; Department of Neurology, Odense University Hospital, Odense, Denmark.
  • Petersen M; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
  • Bach FW; Multidisciplinary Pain Center, National Hospital, Copenhagen, Denmark.
  • Heinesen A; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
  • Enggaard TP; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
  • Almdal TP; Steno Diabetes Center Copenhagen, Copenhagen, Denmark.
  • Holbech JV; Pain Center, University Hospital of Zealand, Køge, Denmark.
  • Vase L; Department of Endocrinology, National Hospital, Copenhagen, Denmark.
  • Jensen TS; Department of Neurology, Odense University Hospital, Odense, Denmark.
  • Hansen CS; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
  • Finnerup NB; Department of Psychology and Behavioral Science, Division for Psychology and Neuroscience, Aarhus University, Aarhus, Denmark.
  • Sindrup SH; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
Eur J Pain ; 27(4): 492-506, 2023 04.
Article en En | MEDLINE | ID: mdl-36571471
BACKGROUND: Cannabinoids are often prescribed for neuropathic pain, but the evidence-based recommendation is 'weak against'. OBJECTIVES: The aim was to examine the effect of two cannabinoids and their combination in peripheral neuropathic pain. METHODS: This was a randomized, double-blind, trial with treatment arms for cannabidiol (CBD), tetra-hydro-cannabinol (THC), CBD and THC combination (CBD/THC), and placebo in a 1:1:1:1 ratio and flexible drug doses (CBD 5-50 mg, THC 2.5-25 mg, and CBD/THC 5 mg/2.5 mg-50 mg/25 mg). Treatment periods of 8-week duration were proceeded by 1 week for baseline observations. Patients with painful polyneuropathy, post-herpetic neuralgia and peripheral nerve injury (traumatic or surgical) failing at least one previous evidence-based pharmacological treatment were eligible for inclusion. The primary outcome was the change in weekly average of daily pain measured with a numeric rating scale (NRS). Trail Making Test (TMT) was used as one of the tests of mental functioning. RESULTS: In all, 145 patients were included in the study of which 118 were randomized and 115 included in the intention-to-treat analysis. None of the treatments reduced pain compared to placebo (p = 0.04-0.60). Effect sizes as estimated in week 8 (positive values worse and negative better than placebo) were CBD mean 1.14 NRS points (95% CI 0.11-2.19), THC 0.38 (CI -0.65 to 1.4) and CBD/THC -0.12 (-1.13 to 0.89). CONCLUSIONS: CBD, THC and their combination did not relieve peripheral neuropathic pain in patients failing at least one previous evidence-based treatment for neuropathic pain.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cannabidiol / Neuralgia Tipo de estudio: Clinical_trials / Guideline Límite: Humans Idioma: En Revista: Eur J Pain Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cannabidiol / Neuralgia Tipo de estudio: Clinical_trials / Guideline Límite: Humans Idioma: En Revista: Eur J Pain Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido