Effects of Cannabidiol (CBD) on the inflammatory response of patients with rheumatoid arthritis.

Abstract

Abstract – With an increase in the understanding of rheumatoid arthritis (RA) in terms of genetic and environmental risk factors, the pathogenesis of the disease is still not entirely understood. Treatments focus on maintaining joint function, analgesia and immunosuppression, however, in some cases there is little to no response to therapeutic drugs, highlighting the need to explore further therapeutic treatments. Cannabidiol (CBD) has been studied for its potential anti-inflammatory properties with regards to inflammatory conditions, but with conflicting and limited research surrounding RA. The aim of this systematic review was to determine the effects of cannabidiol on the inflammatory response of patients with RA. Most recent findings, relevance and quality of available research has been analyzed following the principles of the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. An electronic literature search was conducted through PubMed, Google Scholar, ScienceDirect. The PICO framework, FINER, inclusion and exclusion criteria were considered to identify specific components within the studies. Four studies were identified as relevant after being assessed through the critical appraisal tool CASP. Two qualitative in vivo experiments on 58 humans and 54 rats. One in vivo study analyzed qualitative and quantitative data from 133 mice and a final study giving quantitative data from an in vitro experiment on macrophages. All participants were diagnosed with either acute or chronic rheumatoid arthritis, whilst receiving a variation of dosages and routes of administration, with a collation of data and observations from both before and after administration of the CBD treatment. The reviewed studies highlighted no significant adverse reactions from the use of the CBD therapeutics in the varying dosages and routes of administration. From these four studies there is evidence to suggest that there are benefits of CBD as a therapeutic in terms of inflammation, three of the studies specifically found a reduction in the inflammatory marker TNF-α caused by RA after administration of the various therapeutic interventions and dosages. There is a requirement for more human clinical trials to determine the anti- inflammatory properties, the safety, dosage, route of administration and efficacy of CBD in humans with RA.