Fibromyalgia Research – does Medicinal Cannabis help?
Are THC-rich cannabis medications effective for treating symptoms of Fibromyalgia? Find out why a new Dutch study supports further research into treating Fibromyalgia with high THC medical cannabis formulations. Reading time: 2.5 minutes.
Medical Cannabis Research | Fibromyalgia Symptoms
Fibromyalgia is a painful, debilitating condition. Sufferers report chronic physical pain as well as mental ‘cloudiness’ and fatigue that is disruptive to daily functioning, work performance and relationships.
Illness Statistics: Fibromyalgia prevalence
Fibromyalgia is reportedly under-diagnosed.
- There is no specific test for diagnosing Fibromyalgia.
- Typically, the condition remains misdiagnosed for many years once symptoms emerge in a patient.
Under-diagnosis or misdiagnosis of Fibromyalgia also stems from the commonality of symptoms with other conditions. Similar symptoms can be found in rheumatoid illnesses such as Lupus, various neurological conditions, mental illnesses and/or sleep disturbances.
Fibromyalgia is estimated to occur somewhat rarely in the population.
- There is an estimated 2% prevalence rate for Fibromyalgia in the general population
- The condition is diagnosed more often in females versus males, often in their middle years
- The condition is frequently unrecognized or misdiagnosed and reports indicate existing treatment approaches, including medications, are not effective in managing symptoms
- Many sufferers of Fibromyalgia report the condition significantly impedes their physical and cognitive functioning and health-related quality of life (HrQOL)
- New research into Fibromyalgia treatments with THC-medications shows some positive symptom relief
- Source: Cannabis Health News (we suggest you subscribe to this great new journal) https://www.cannabishealthnews.co.uk/
Common symptoms of Fibromyalgia
- Pain, aching and stiffness (worse in the morning)
- Poor sleep or fatigue
- Irritable bowel symptoms
- Concentration and memory difficulties
- Pain, lasting for at least 3 months
- Pain is felt on both sides of the body, and above and below the waist
Fibromyalgia Research | Current evidence-base for Medicinal Cannabis
The question in relation to medical marijuana treatments for Fibromyalgia and/or other intractable health conditions is this:
Can Fibromyalgia symptoms be relieved by prescribing cannabis-based pharmaceuticals containing high levels of THC (e.g., high-THC medical cannabis products)? Does cannabis medication significantly reduce the levels of pain or pain-related dysfunction? If yes, then what is the best dosing strategy and delivery method for the drug(s)?
What potential side effects could lead to discontinuation of the treatment? And are there any concerns about the potentially addictive qualities of THC-based medicines?
These questions have yet to be answered definitively in the medicinal cannabis research literature.
- Earlier trials explored synthetic cannabinoid treatments for treating symptoms of pain, sleep disturbances and fatigue.
- Preliminary studies suggest cannabis and THC-rich medicines might be of help in pain reduction.
- Study data was impeded by relatively small sample sizes and inconsistent study populations.
The current evidence base remains inconclusive.
Yet a new, albeit small, Dutch study suggested positive indications for treating Fibromyalgia symptoms with high-THC content medications.
Further research trials using THC-cannabis medications for Fibromyalgia patients appears warranted due to:
- very small study sizes
- inconclusive or inconsistent research findings in prior medicinal cannabis research and systematic reviews
- newly formulated marijuana-based medications using varying THC percentages
- pharmaceutical cannabis formulations currently in early stages of testing and development
- legalisation issues surrounding cannabinoid medicines
- product legality differences (worldwide) having prohibited past studies
Cochrane Systematic Reviews | Fibromyalgia Treatments
Medical Cannabis Research into Fibromyalgia Symptom Relief | Clinical Studies
Cochrane Systematic Reviews essentially combine and analyse data from all relevant studies to assess the significance of findings from clinical trials. These reviews are rigorously conducted. They explore all existing relevant study data at the time of publication and are required to be updated as new studies emerge. Cochrane Reviews are considered the golden standard evidence-base for illness interventions.
- Previously-published cannabis medications research studies have indicated some positive, albeit inconsistent, results for conditions such as Fibromyalgia.
- Systematic Reviews of existing studies, however, provided little support for prescribing cannabinoid medications as a first-line treatment.
But traditional treatments for Fibromyalgia symptoms have equally failed to deliver consistent treatment outcomes and neuropathic pain reductions.
- Types of treatments investigated: pharmacological, acupuncture, lifestyle and exercise changes, cannabinoid medications and most recently, high-THC content cannabis formulations
- The only current medication with strong evidence for reducing neuropathic pain (and Fibromyalgia), according to published Cochrane Reviews, is pregabalin (300 to 600 mg daily).
- Synthetic cannabinoid medications (Cochrane Systematic Review)
- Seratonin and noradrenaline reuptake inhibitors (e.g., anti-depressant medications)
- Antipsychotics and various combinations of drugs
- Physical activity and exercising
- Acupuncture (Cochrane Systematic Review)
Overall, the literature affirming the efficacy of medical cannabis for conditions such as Arthritis and Fibromyalgia remains sparse and/or inconclusive.
But with new formulations of cannabis medications containing high THC levels…new questions are emerging in medicine.
Can high THC content medical marijuana formulations relieve common symptoms in Fibromyalgia patients? Possibly yes.
There isn’t enough data to validate the efficacy and safety of these medications at the current time. Yet where existing treatments have failed patients, some cannabis clinical trials showed promise, with THC formulation variances prime for future research studies.
- Robust data is not available at the current time yet some studies suggest medicinal cannabis (medical marijuana) and THC-formulations may help relieve chronic pain by 30% to 50%.
- These are significant pain reductions that could change lives; but commonly reported side effects may limit drug tolerance or temporarily impede daily functioning
- Common side effects reported by trial patients included dizziness, nausea, dry mouth and drowsiness
FUTURE Fibromyalgia Treatment considerations
Systematic reviews indicate research results are either inconclusive or of limited due to very small sample sizes.
That noted, as cannabis becomes legalised in more countries, more Universities and Hospitals can lead, or participate in, multi-site clinical research studies.
- High-THC formulations appear worthy of further clinical research trials involving larger populations
- Commonly reported side effects that may limit drug tolerance should be explored
- It is feasible that adjusting THC formulations will alter side effect complaints
A new Dutch study explored high THC content medications in 20 study participants. Findings indicated significant reductions in self-reported pain and an improvement in pain-associated symptoms.
- Different formulations of medical cannabis, including formulas with high THC content, are targeted for further clinical investigations.
- Read about the recent Fibromyalgia study conducted at the Dutch Leiden University Medical Centre (and it is recommended to stay updated by subscribing to Cannabis Health News (UK).
Expect more robust efficacy and safety data to emerge in the next few years.
Future Fibromyalgia treatment research is necessary to explore the effectiveness of high-THC-cannabis medications, as reported by Cannabis Health News (UK).
Due to drug-legality issues, however, studies into medicinal marijuana treatments for specific illnesses, such as Fibromyalgia, are predomantly lacking in size and scope. Researchers have only recently begun studies with adequate participant sizes and sufficiently long follow-up periods. These upcoming cannabis studies will create a more robust evidence base for cannabis-related medical decision-making, including dosing requirements and potential side effects.
Golden Standard Clinical Research designs for medicinal cannabis
Good study designs will feature:
- larger study populations (higher participant numbers, over 2,000 per study versus a few hundred)
- double-blind, randomised control trials (RCTs)
- standardised formulas, medication delivery methods and medication sources
- consistency of baseline dosing
Future medical cannabis research will also benefit from:
- higher participation rates and multi-site, cross-country designs
- longer follow-up periods and 5-year data-analyses
- varying formulations with evidence-based dosing standards, followed by larger studies
- consistent data collection protocols and time frames across participating study sites
- more detailed reporting of symptoms, medication tolerance, pharmaceutical prescription compliance and side effects
- compatible study designs including data analyses and reporting methodologies
- Read more at Designing a Medicinal Cannabis Clinical Trial
Medicinal Cannabis trials should be designed as double-blind, randomised control trials (RCTs), with larger study sizes and consistent data point collection time points, measurement tools and time frames. Longer-term follow-up assessments should also be included in the study designs.
Here’s what to look for in future clinical trials into medicinal cannabis efficacy, side effects and safety
- Look for double-blind clinical studies comparing cannabis-derived medications and CBD to traditional medications, exploring efficacy, dosing levels, patient safety and adverse effects (SAEs).
- Large study sizes and multi-site studies will be of benefit.
- Open disclosure of the pharmaceutical formulations could assist with study design consistencies.
- However, most pharmaceutical manufacturing companies are rushing to secure drug patents as research continues, which means studies involving the same formulations will be limited in certain cases.
Article Summary: Existing medicinal cannabis research reporting is largely based on case studies, anecdotal reports or smaller-sized studies. Multi-site studies are less common due to former legality constraints.
Symptom relief from using medicinal cannabis or THC-rich products are often reported. But studies show inconsistency and drug tolerance differences. The result is that robust data is yet to be found.
A new Dutch study, however, supports further investigations into high-TCH medicinal cannabis medications for people with chronic pain from Fibromyalgia. The trial was small, but promising for patients where current treatment approaches have had limited effects. Read more at Cannabis Health (UK).
Journals and Publications | References and Suggested Reading
Existing Research | Medicinal cannabis treatments | neuropathic pain
Systematic reviews (Cochrane) for treating chronic neuropathic pain suggests insufficient evidence of benefits so far. Self-reported pain measurements indicated reduction in perceived pain of up to 30% (NNT = 11).
Example of Cochrane Reviews: A meta-analysis of 15 randomised control trials (RCTs) found patients taking cannabinoids attained at least a 30% pain reduction: risk ratio (RR) of 1.37 (95% CI 1.14 to 1.64), number needed to treat (NNT) of 11.” Source: https://www.cochrane.org/CD012182/SYMPT_cannabis-products-adults-chronic-neuropathic-pain
Best-practice clinical trials for medicinal cannabis are currently being designed and/or are in progress, as more top Universities gain funding to explore this new pharmaceutical domain.
Findings from new studies, once published, will help medical practitioners better understand dosing guidelines, efficacy, safety and tolerability of marijuana-based medicines for Fibromyalgia, arthritis and other neurological pain conditions.
Results from larger RCT studies remain a few years away, however, so carry a certain degree of unpredictability. Expect to see a growing number of clinical research studies and publications in the coming years.
Recent and Future Research | THC Medicinal Cannabis Formulations |Fibromyalgia |
- Presently, research suggests potentially significant reductions in pain symptoms when treating Fibromyalgia patients with high-THC content cannabis formulations.
- The good news is that preliminary investigatory research studies and new anecdotal reports show high-THC medications derived from cannabis may help relieve symptoms of Fibromyalgia in some patients.
- The review indicated no high-quality study data existed.
- Studies were relatively short in duration and lacked consistency in medications and delivery methods (e.g., oral sprays vs other inhalants).
A Cochrane review of 17 studies of cannabis-based medications for Fibromyalgia symptoms also indicated that no high-quality study data existed.
- Suggested a lack of robust studies.
- Prior research was also hampered due to legality issues of the medications.