Background/Purpose: Medical cannabis is increasing in popularity yet the recent International Association for the Study of Pain presidential task force on cannabis and cannabinoid analgesia found a lack of trials examining cannabidiol (CBD) for pain management. We examined CBD as add on analgesic therapy in patients with hand osteoarthritis or psoriatic arthritis.

Methods: Our trial was randomized double-blind and placebo-controlled. Patients received synthetic CBD 20-30mg or placebo daily for 12 weeks. Primary outcome was pain intensity during the last 24 hours (0-100mm); safety outcomes were percentage of patients experiencing adverse events and a characterization of serious adverse events. Exploratory outcomes included change in Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale (PCS) and Health Assessment Questionnaire (HAQ-DI)

Results: We recruited and randomized one hundred and thirty-six patients and 129 were included in the primary analysis. Between group difference in pain intensity at 12 weeks was 0.23mm (95%CI -9.41 to 9.90; p = 0.96). 22% patients receiving CBD and 21% receiving placebo experienced a reduction in pain intensity ≥ 30mm p=1. Between group difference for exploratory outcomes: HAQ-DI 0.03 (95%CI-0.11 to 0.18), PSQI -0.71 (95%CI -1.99 to 0.55), HADS depression -0.04 (95%CI -0.79 to 0.70), HADS anxiety -0.69 (95%CI -0.41 to 2.75) and PCS 1.07 (95%CI -1.73 to 3.88)

Conclusion: We found no statistically significant effect of CBD for clinical pain intensity in patients with hand osteoarthritis and psoriatic arthritis compared to placebo and no statistically significant effects regarding sleep quality, scores of depression, anxiety or pain catastrophizing.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cannabidiol-treatment-in-hand-osteoarthritis-and-psoriatic-arthritis-a-randomized-double-blind-placebo-controlled-trial/