How effective are cannabis and cannabinoids for induction and maintenance of remission in people with Crohn disease?
The effects of cannabis and cannabis oil on CD are uncertain. Thus, no firm conclusions regarding the efficacy and safety of cannabis and cannabis oil in adults with active CD can be drawn. There is no evidence for cannabis or cannabinoid use for maintenance of remission in CD. One small study compared 8 weeks of treatment with cannabis cigarettes containing D9‐tetrahydrocannabinol (THC) 115mg with placebo cigarettes containing cannabis with the THC removed in participants with active CD who had failed at least one medical treatment. Although no difference in clinical remission rates was observed, more participants in the THC-cannabis group had improvement in their CD symptoms than participants in the placebo group. More side effects were observed in the THC-cannabis cigarette group compared with placebo. Another small study compared cannabis oil (CO; cannabidiol 10mg twice daily) with placebo (olive oil) in participants with active CD who had failed at least one medical treatment. No difference in clinical remission rates was observed. There was no difference in serious side effects. The third small study compared CO (composed of 15% cannabidiol and 4% THC) to placebo oil in participants with active CD. Positive differences in quality of life and the CD activity index were observed.
The studies were not pooled due to differences in the interventional drug. The review involved 3 studies with only 93 participants. The effects of cannabis and cannabis oil in people with CD in remission were not investigated.
CD is a chronic, immune‐mediated condition of transmural inflammation in the gastrointestinal tract, associated with significant morbidity and decreased quality of life. The endocannabinoid system provides a potential therapeutic target for cannabis and cannabinoids, and animal models have shown benefit in decreasing inflammation.
Cochrane Systematic Review
Cochrane Systematic Review Kafil TS et al. Cannabis for treatment of Crohn’s disease. Cochrane Reviews, 2018, Issue 11. Art. No.: CD012853.DOI: 10.1002/14651858. CD012853.pub2. This review contains 3 studies involving 93 participants.