Oral CBD-rich cannabis induces clinical but not endoscopic response in patients with Crohn’s disease, a randomized controlled trial
Aims: Despite reports that medical cannabis improves symptoms in Crohn’s disease (CD), controlled studies evaluating disease response are lacking. This study assessed the effect of cannabidiol (CBD)-rich cannabis oil for induction of remission in CD.
Methods: In a double-blind, randomized, placebo-controlled single center trial, patients received orally eithercannabis oil containing160/40mg/ml cannabidiol/ tetrahydrocannabinol (CBD/THC) or placebo for eight weeks. Disease parameters including CD activity index (CDAI), and simple endoscopic score for CD (SES-CD) were assessed before and after treatment. In a subgroup of patients, blood samples were collected for CBD and THC plasma levels.
Results: The study included 56 patients, age 34.5±11 years, men/women 30/26 (54/46%), 30 in cannabis and 26 in placebo groups. CDAI at recruitment and after eight weeks was282(IQR243-342) and 166 (IQR 82-226) and 264(IQR 234-320) and 237(IQR 121-271) (p<0.05) in the cannabis and placebo groups, respectively. Median QOL score improved from 74 for both groups at baseline to 91 (IQR 85-102) and 75 (IQR 69-88) after 8 weeks in the cannabis and placebo groups, respectively (p=0.004). SES-CD was 10 (7-14) and 11 (IQR7-14), and 7 (4-14) and 8 (IQR 4-12;p=0.75)before and after treatment, in the cannabis and placebo groups, respectively. Inflammatory markers (CRP, calprotectin) remained unchanged.
Conclusions: Eight weeks of CBD-rich cannabis treatment induced significant clinical and QOL improvement without significant changes in inflammatory parameters or endoscopic scores. The oral CBD-rich cannabis extract was well absorbed. Until further studies are available, cannabis treatment in Crohn’s disease should be used only in the context of clinical trials.
Keywords: Crohn’s disease; cannabidiol; cannabis.