A cautious hope for cannabidiol (CBD) in rheumatology care

Arthritis Care & Research
Mary-Ann FitzcharlesWinfried Hauser

Abstract

Cannabidiol (CBD), a major metabolite of Cannabis sativa, is popularized as a medicinal product, with potential for analgesic, anti-inflammatory and antioxidant effects. CBD may hold promise as a treatment in rheumatic diseases, but evidence to date remains preclinical. Preclinical effects on pain and inflammation is encouraging, but clinical study is lacking with only a single study in knee osteoarthritis reporting promising effect on symptoms. CBD products are freely available over the counter and marketed as food supplements or wellness products. The World Health Organization has identified pure CBD as safe and without abuse potential, but products are not subject to drug regulatory standards leading to inconsistency in manufacturing practices and quality of products. Not only have molecular concentrations of CBD been identified as inaccurate, but there are concerns for contaminants including heavy metals, pesticides, microbes and mycotoxins, as well as added THC. Drug-drug interactions pose a potential risk due to metabolism via the CYP P450 enzyme pathway. Patients wishing to use CBD should obtain a product with certification of Good Manufacturing Practices, initiate treatment with a nighttime low dose and have defined out...Continue Reading

Citations

Feb 2, 2021·Frontiers in Psychiatry·Joseph R VilchesFrancesca M Filbey
Nov 23, 2020·Psychopharmacology·Stevie C BritchSharon L Walsh
May 15, 2021·Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews·David G DeckeyJoshua S Bingham
Sep 2, 2021·Journal of Neuroimmune Pharmacology : the Official Journal of the Society on NeuroImmune Pharmacology·Markus KöstenbergerRudolf Likar

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