Assessment of Clinical Outcomes in Patients With Osteoarthritis: Analysis From the UK Medical Cannabis Registry

Abstract

Osteoarthritis accounts for 0.6% of disability-adjusted life years globally. There is a paucity of research focused on cannabis-based medicinal products (CBMPs) for osteoarthritic chronic pain management. This study aims to assess changes in validated patient-reported outcome measures (PROMs) and CBMP clinical safety in patients with osteoarthritis. A prospective case series from the UK Medical Cannabis Registry was analyzed. Primary outcomes were changes in the Brief Pain Inventory (BPI), McGill Pain Questionnaire (MPQ2), EQ-5D-5L, Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and Single-Item Sleep Quality Scale (SQS) at 1-, 3-, 6-, and 12-month follow-ups from baseline. Common Terminology Criteria for Adverse Events v.4.0 was used for adverse event (AE) analysis. Statistical significance was defined as p < 0.050. Seventy-seven patients met inclusion criteria. CBMP initiation correlated with BPI pain severity (p = 0.004), pain interference (p = 0.005), and MPQ2 (p = 0.017) improvements at all follow-ups compared to baseline. There were improvements in the EQ-5D-5L index (p = 0.026), SQS (p < 0.001), and GAD-7 (p = 0.038) up to 6 and 3 months, respectively. Seventeen participants (22.08%) recorded 76 mild AEs (34.86%), 104 moderate AEs (47.71%), and 38 severe AEs (17.43%). Though causality cannot be assumed in this observational study, results support development of randomized control trials for osteoarthritis pain management with CBMPs.

Keywords:

• Arthritis
• cannabidiol
• chronic pain
• medical cannabis
• tetrahydrocannabinol

Disclosure statement

Ann Francis is a medical student at Imperial College London. Ann Francis has no shareholdings in pharmaceutical companies. Simon Erridge is a junior doctor and head of research at Curaleaf Clinic. Simon Erridge is a research fellow at Imperial College London. Simon Erridge has no shareholdings in pharmaceutical companies. Carl Holvey is chief clinical pharmacist at Curaleaf Clinic. Carl Holvey has no shareholdings in pharmaceutical companies. Ross Coomber is a consultant orthopedic surgeon at St George’s Hospital, London, and operations director at Curaleaf Clinic. Ross Coomber has no shareholdings in pharmaceutical companies. Wendy Holden is a consultant rheumatologist and pain specialist at Curaleaf Clinic (London). Wendy Holden is a medical advisor to the Arthritis Action charity. Wendy Holden has no shareholdings in pharmaceutical companies. James Rucker is a consultant psychiatrist at Curaleaf Clinic (London), an honorary consultant psychiatrist at The South London & Maudsley NHS Foundation Trust, and an NIHR clinician scientist fellow at the Center for Affective Disorders at King’s College London. James Rucker is funded by a fellowship (CS-2017-17-007) from the National Institute for Health Research (NIHR). James Rucker leads the Psychedelic Trials Group at King’s College London. King’s College London receives grant funding from COMPASS Pathways PLC to undertake phase 1 and phase 2 trials with psilocybin. COMPASS Pathways PLC has paid for James Rucker to attend trial related meetings and conferences to present the results of research using psilocybin. James Rucker has undertaken paid consultancy work for Beckley PsyTech and Clerkenwell Health. Payments for consultancy work are received and managed by King’s College London and James Rucker does not benefit personally. James Rucker has no shareholdings in pharmaceutical companies. Michael Platt is a consultant in pain services at Curaleaf Clinic (London). Michael Platt has no shareholdings in pharmaceutical companies. Mikael Sodergren is a consultant hepatopancreatobiliary surgeon at Imperial College NHS Trust, London, a senior clinical lecturer at Imperial College London, and the chief medical officer of Curaleaf International. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

Ethics approval

Ethics approval provided by South West–Central Bristol Research Ethics Committee (Reference: 22/SW/0145).

Patient consent statement

All participants completed written, informed consent prior to enrollment in the registry.

Data availability statement

Data that support the findings of this study are available from the UK Medical Cannabis Registry. Restrictions apply to the availability of these data. Data specifications and applications are available from the corresponding author.

All authors contributed to and approved the final article.

All work was conducted at Curaleaf Clinic, London, UK.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.