Medical cannabis for inflammatory bowel disease: real-life experience of mode of consumption and assessment of side-effects

Eur J Gastroenterol Hepatol. 2019 Nov;31(11):1376-1381. doi: 10.1097/MEG.0000000000001565.

Abstract

Objective: Use of medical cannabis for improving symptoms of inflammatory bowel disease is increasing. However, reports on long-term outcomes are lacking. This prospective, observational study assessed the effects of licensed cannabis use among patients with inflammatory bowel disease.

Methods: Dose and mode of consumption, adverse events, use of other medications, and long-term effects were evaluated among 127 patients with inflammatory bowel disease using legalized medical cannabis. Blood count, albumin, and C-reactive protein were assessed before, 1 month, and at least 1 year after medical cannabis therapy was initiated. Questionnaires on disease activity, patient function, and signs of addiction were completed by patients and by a significant family member to assess its effects.

Results: The average dose used was 31 ± 15 g/month. The average Harvey-Bradshaw index improved from 14 ± 6.7 to 7 ± 4.7 (P < 0.001) during a median follow-up of 44 months (interquartile range, 24-56 months). There was a slight, but statistically significant, average weight gain of 2 kg within 1 year of cannabis use. The need for other medications was significantly reduced. Employment among patients increased from 65 to 74% (P < 0.05). We conclude that the majority of inflammatory bowel disease patients using cannabis are satisfied with a dose of 30 g/month. We did not observe negative effects of cannabis use on the patients' social or occupational status.

Conclusions: Cannabis use by inflammatory bowel disease patients can induce clinical improvement and is associated with reduced use of medication and slight weight gain. Most patients respond well to a dose of 30 g/month, or 21 mg Δ9-tetra- hydrocannabinol (THC) and 170 mg Cannabidiol (CBD) per day.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Biological Products / therapeutic use
  • C-Reactive Protein / metabolism
  • Cannabidiol / administration & dosage*
  • Dronabinol / administration & dosage*
  • Drug Administration Routes
  • Employment
  • Female
  • Humans
  • Immunologic Factors / therapeutic use
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / metabolism
  • Inflammatory Bowel Diseases / physiopathology
  • Israel
  • Male
  • Medical Marijuana / therapeutic use*
  • Mesalamine / therapeutic use
  • Middle Aged
  • Patient Reported Outcome Measures
  • Patient Satisfaction
  • Prospective Studies
  • Serum Albumin / metabolism
  • Treatment Outcome
  • Tumor Necrosis Factor Inhibitors / therapeutic use
  • Weight Gain
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Biological Products
  • Immunologic Factors
  • Medical Marijuana
  • Serum Albumin
  • Tumor Necrosis Factor Inhibitors
  • Cannabidiol
  • Mesalamine
  • Dronabinol
  • C-Reactive Protein