CBD (칸나비디올)

Cannabidiol and Terpene Formulation Reducing SARS-CoV-2 Infectivity Tackling a Therapeutic Strategy.

1. Front Immunol. 2022 Feb 15;13:841459. doi: 10.3389/fimmu.2022.841459. eCollection 2022. Cannabidiol and Terpene Formulation Reducing SARS-CoV-2 Infectivity Tackling a Therapeutic Strategy. Santos S(1)(2), Barata P(3)(4), Charmier A(1)(2), Lehmann I(1), Rodrigues S(1), Melosini MM(1), Pais PJ

Results of an Exploratory Crossover Pharmacokinetic Study Evaluating a Natural Hemp Extract-Based Cosmetic Product: Comparison of Topical and Oral Routes of Administration.

1. Pharmaceuticals (Basel). 2026 Jan 29;19(2):231. doi: 10.3390/ph19020231. Results of an Exploratory Crossover Pharmacokinetic Study Evaluating a Natural Hemp Extract-Based Cosmetic Product: Comparison of Topical and Oral Routes of Administration. Jain M(1), Hudson R(1), Tarrell A(1), Green DJ(1), Clifford JJ(2), Watt K(1), Mihalopoulos N(1), Rower JE(1)(3), Yellepeddi V(1), Enioutina EY(1). Author information: (1)Pediatrics Department, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84108, USA. (2)Department of Pathology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84113, USA. (3)Center for Human Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA. Background: Hemp extracts are used topically as cosmetic products and may be ingested as dietary supplements. Some users report positive carboxy delta-9-tetrahydrocannabinol (COOH-THC) urinary tests following their use. This study evaluated systemic exposure to natural hemp extract-based cosmetic (NHEC) bioactive molecules following a single dose of oral or topical application and assessed urine THC positivity. Methods: Twenty healthy adults (18-50 years, males and females) of a randomized, open-label, single-dose, crossover study received the NHEC orally or topically with a 15-day washout period. Plasma samples were analyzed for cannabidiol (CBD), tetrahydrocannabinol (THC), and their metabolites using a validated liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters were calculated by non-compartmental analysis (Phoenix® WinNonlin® 8.4, Pharsight Inc., Chatham, NJ, USA). Urine samples were tested for COOH-THC using commercial test strips. Results: All analytes, except CBD and 7-hydroxy cannabidiol (7-OH-CBD), were below the limit of quantification. Oral NHEC administration resulted in a faster Tmax (3 h vs. 24 h) and a higher AUC0-24 (281 vs. 19 h·ng/mL) for CBD compared to topical administration. Urine was positive for COOH-THC in 38% of participants receiving an oral dose. Conclusions: A single oral dose resulted in detectable plasma CBD and 7-OH-CBD, whereas topical administration produced low and frequently BLQ CBD concentrations with 7-OH-CBD and THC-related analytes not quantifiable. Urine COOH-THC tests were positive only in participants after oral use of an NHEC but not with topical use. Given the absence of THC in the product and the lack of CBD-to-THC conversion in humans, the cause of urine positivity remains unclear. DOI: 10.3390/ph19020231 PMCID: PMC12943358 PMID: 41754772 Conflict of interest statement: The authors declare that this study received funding from Young Living Essential Oils. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article or the decision to submit it for publication.

Randomised Controlled Trial Evidence on Medicinal Cannabis for Treatment of Mental Health and Substance Use Disorders: A Scoping Review.

2. Clin Drug Investig. 2026 Jan;46(1):5-36. doi: 10.1007/s40261-025-01501-3. Epub 2025 Dec 4. Randomised Controlled Trial Evidence on Medicinal Cannabis for Treatment of Mental Health and Substance Use Disorders: A Scoping Review. Cooling S(1), Bonomo YA(2)(3)(4), Castle D(5), Hallinan CM(6)(7)(8)(9). Author information: (1)Department of General Practice and Primary Care, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, Medical Building, The University of Melbourne, 181 Grattan Street, Parkville, VIC, 3010, Australia. (2)Department of Addiction Medicine, St Vincent's Hospital Melbourne, Fitzroy, Australia, 3065, VIC. (3)Women's Alcohol and Drug Service, The Royal Women's Hospital, Parkville, Australia, 3050, VIC. (4)Department of Medicine, The University of Melbourne, Parkville, Australia, 3010, VIC. (5)Centre for Mental Health Service Innovation and University of Tasmania, Hobart, TAS, Australia, 7005. (6)Department of General Practice and Primary Care, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, Medical Building, The University of Melbourne, 181 Grattan Street, Parkville, VIC, 3010, Australia. hallinan@unimelb.edu.au. (7)Department of Addiction Medicine, St Vincent's Hospital Melbourne, Fitzroy, Australia, 3065, VIC. hallinan@unimelb.edu.au. (8)Melbourne Medical School, The University of Melbourne, Parkville, VIC, Australia, 3010. hallinan@unimelb.edu.au. (9)Data for Decisions, Department of General Practice and Primary Care, The University of Melbourne, Parkville, VIC, Australia, 3010. hallinan@unimelb.edu.au. BACKGROUND: With shifting perceptions about the therapeutic potential of cannabis and evolving regulatory frameworks, global prescribing of medicinal cannabis is increasing. While some emerging evidence supports its use for conditions like multiple sclerosis and epilepsy, its efficacy and safety profile for the treatment of mental health conditions remains controversial and under-explored. Previous reviews found inconclusive evidence due to heterogeneity in study design and quality. Accordingly, this review was designed as a scoping review, consistent with established methodological frameworks to map and characterise all available randomised controlled trial (RCT) evidence in this emerging and heterogeneous field. It specifically sought to synthesise the highest-quality trial evidence to date, addressing the question: How effective is medicinal cannabis in treating mental health conditions, as classified by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and how safe and tolerable is it, as assessed through adverse events and treatment withdrawals? METHODS: A scoping review was conducted comprising RCTs investigating medicinal cannabis for mental health conditions. Eligible studies were required to meet predefined inclusion criteria based on population, intervention, comparator, outcomes, and study design (PICOS framework). PubMed, Web of Science, and PsycINFO databases were searched, supplemented by citation tracking and Google Scholar, for studies published between 1980 and 2024. RESULTS: The search identified 8061 studies, with 28 RCTs meeting inclusion criteria across 12 DSM-5 mental health conditions. Indications most frequently studied were schizophrenia (n = 5), cannabis use disorder (n = 4), cocaine use disorder (n = 4), post-traumatic stress disorder (n = 3), anxiety disorders (n = 3), and opioid use disorder (n = 2); there were two trials in autism spectrum disorder and single trials in depression, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, tobacco use disorder, and Tourette syndrome. Sample sizes ranged from 6 to 150 participants (median = 42), and follow-up durations from 1 day to 13 weeks (median = 6 weeks). Interventions included purified cannabidiol (CBD; single doses of 300-800 mg and daily regimens up to 1000 mg/day), nabiximols or other tetrahydrocannabinol (THC)/CBD oromucosal sprays (up to 113 mg THC/105 mg CBD per day), and smoked or vaporised cannabis flower of varying THC/CBD content. Findings showed substantial heterogeneity and variable quality, with some short-term benefits reported (notably in cannabis use disorder, autism spectrum disorder, and schizophrenia), but no trial demonstrated long-term efficacy. CONCLUSION: Despite growing interest, substantial heterogeneity limits current evidence for medicinal cannabis in mental health. This review highlights key gaps, underscoring the need for robust, well-powered RCTs with extended follow-up to clarify its role in the management of mental ill health. © 2025. The Author(s). DOI: 10.1007/s40261-025-01501-3 PMCID: PMC12815972 PMID: 41343139 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Conflict of interest: All authors declare that they have no conflicts of interest. Ethics approval: Not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Availability of data and materials: Data are available on request. Code availability: Not applicable. Author contributions: SC, YB, and CMH designed the review and drafted the initial manuscript. SC, YB and CMH contributed to the abstract, screening, and data extraction for the included studies. SC, YB and CMH provided critical review of the included studies and interpretation of the result. All authors SC, YB, DC and CMH contributed to manuscript development. SC and CMH prepared the manuscript for submission. CMH undertook the major revision of the manuscript, with input from all authors. All authors approved manuscript.

Daily Use of a Broad-Spectrum Cannabidiol Supplement Produces Detectable Concentrations of Cannabinoids in Urine Prohibited by the World Anti-Doping Agency: An Effect Amplified by Exercise.

3. Med Sci Sports Exerc. 2026 Jan 1;58(1):121-131. doi: 10.1249/MSS.0000000000003842. Epub 2025 Sep 8. Daily Use of a Broad-Spectrum Cannabidiol Supplement Produces Detectable Concentrations of Cannabinoids in Urine Prohibited by the World Anti-Doping Agency: An Effect Amplified by Exercise. Gillham SH(1), Cole PL(1), Owens DJ(1), Chester N(1), Bampouras TM(1), McCartney D, Gordon R, McGregor IS, Close GL(1). Author information: (1)Research Institute of Sport and Exercise Sciences (RISES), Liverpool John Moores University, Byrom Street, Liverpool, UNITED KINGDOM. BACKGROUND: Cannabidiol (CBD), a non-intoxicating phytocannabinoid, is used by athletes to enhance recovery and manage other conditions (e.g., poor sleep, anxiety). Although CBD is not prohibited by the World Anti-Doping Agency (WADA), other cannabinoids found in "broad-spectrum" CBD products (e.g., cannabigerol (CBG), cannabidivarin (CBDV)), remain prohibited. OBJECTIVES: This study aimed to determine whether 10-wk use of a broad-spectrum CBD product (150 mg·day -1 (containing trace concentrations of CBG)) could lead to detectable concentrations of prohibited cannabinoids in urine and plasma. The influence of moderate-intensity exercise was also assessed. METHODS: Thirty-six healthy individuals (47% male) self-administered either a broad-spectrum CBD product ( n = 31, CBD) or a visually identical placebo ( n = 5, PLA) for 10 wk. After 10 wk, participants completed a fasted, 90-min bout of moderate-intensity exercise (55% V̇O 2peak ). Blood and urine samples were collected at baseline (presupplementation) and pre- and postexercise. RESULTS: No cannabinoids or metabolites were detected at baseline in either the PLA or CBD group. Following 10 wk of supplementation, urinary concentrations of CBD and its metabolites (6-OH-CBD, 7-COOH-CBD, 7-OH-CBD) were present. CBG and CBDV were also detected in 42% and 68% of preexercise samples, respectively. Urinary concentrations of 6-OH-CBD ( P = 0.006), 7-OH-CBD ( P = 0.009), CBD ( P = 0.043), CBG ( P = 0.0023), and CBDV ( P = 0.033) also increased from pre- to postexercise. CBG and CBDV were detected in 74% and 84% of postexercise samples, respectively. Concentrations of ∆ 9 -THC or its metabolites (11-OH-THC, 11-COOH-THC) were not present at any timepoint. CONCLUSIONS: Daily use of a broad-spectrum CBD supplement resulted in detectable urinary concentrations of WADA-prohibited cannabinoids in urine. Exercise appeared to increase concentrations of these cannabinoids. Therefore, athletes should avoid consuming broad-spectrum CBD products, given the potential associated anti-doping risks. Copyright © 2025 by the American College of Sports Medicine. DOI: 10.1249/MSS.0000000000003842 PMID: 40920736 [Indexed for MEDLINE]

Cannabidiol versus placebo in patients with fibromyalgia: a randomised, double-blind, placebo-controlled, parallel-group, single-centre trial.

4. Ann Rheum Dis. 2026 Mar;85(3):566-574. doi: 10.1016/j.ard.2025.07.008. Epub 2025 Aug 22. Cannabidiol versus placebo in patients with fibromyalgia: a randomised, double-blind, placebo-controlled, parallel-group, single-centre trial. Rasmussen MU(1), Christensen R(2), Wæhrens EE(3), Henriksen M(4), Duhn PH(4), Bliddal H(4), Amris K(4). Author information: (1)Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark. Electronic address: marianne.uggen.rasmussen@regionh.dk. (2)Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark. (3)Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark; User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark. (4)Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark. OBJECTIVES: Cannabidiol (CBD) is used to alleviate fibromyalgia pain despite limited evidence for efficacy. This study assessed the efficacy and safety of CBD vs placebo in patients with fibromyalgia, hypothesising that CBD would be superior to placebo in reducing pain. METHODS: In this single-centre, double-blind, randomised, placebo-controlled trial, patients diagnosed with fibromyalgia were recruited from a specialised outpatient clinic in Denmark. Eligible participants were randomised 1:1 and stratified by sex, defined as biological sex assigned at birth based on physical anatomy. Age (<45 vs ≥45), and pain level (<7 vs ≥7) on a 0 to 10 numeric rating scale (NRS) to receive 50 mg plant-derived CBD or placebo tablets. The primary outcome was change in pain intensity at week 24, assessed on the NRS pain subitem in the revised Fibromyalgia Impact Questionnaire in the intention-to-treat population. Adverse events were monitored throughout the study in the safety population. RESULTS: Of 273 participants screened for eligibility, 200 were included and randomised to receive CBD (n = 100) or placebo (n = 100). At week 24, mean change in pain intensity was -0.4 points (95% CI: -0.82 to 0.08) in the CBD group and -1.1 points (95% CI: -1.53 to -0.63) in the placebo group, corresponding to a between-group difference of -0.7 points (95% CI: -1.2 to -0.25; P = .0028) favouring placebo. Adverse events were generally mild and evenly distributed between groups. CONCLUSIONS: The findings do not support CBD 50 mg daily as an analgesic supplement for patients with fibromyalgia. CLINICALTRIALS: gov number: NCT04729179. Copyright © 2025 European Alliance of Associations for Rheumatology (EULAR). Published by Elsevier B.V. All rights reserved. DOI: 10.1016/j.ard.2025.07.008 PMID: 40846590 [Indexed for MEDLINE] Conflict of interest statement: Competing interests All authors declare no competing interests.

Evaluation of the Effectiveness of a Mouthwash Containing Spilanthol and Cannabidiol on Improving Oral Health in Patients with Gingivitis-Clinical Trial.

5. J Clin Med. 2025 Feb 28;14(5):1641. doi: 10.3390/jcm14051641. Evaluation of the Effectiveness of a Mouthwash Containing Spilanthol and Cannabidiol on Improving Oral Health in Patients with Gingivitis-Clinical Trial. Kiełbratowski M(1), Kuśka-Kiełbratowska A(2), Mertas A(3), Bobela E(3), Wiench R(2), Kępa M(4), Trzcionka A(1), Korkosz R(1), Tanasiewicz M(1). Author information: (1)Department of Conservative Dentistry with Endodontics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland. (2)Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland. (3)Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland. (4)Department of Microbiology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland. Background/Objectives: Plaque-associated gingivitis is widely regarded as a local inflammatory condition initiated by the accumulation of a non-specific dental biofilm in the interaction with the host immune system. The initial symptom noticed by the patient is bleeding gums. The use of mouthwash can serve to supplement mechanotherapy. However, there is an increasing interest in mouthwashes comprising natural ingredients, including cannabidiol (CBD) and spilanthol. The objective of this study was to evaluate the effect of an oral rinse containing spilanthol and CBD oil compared to a rinse containing tea tree oil on the oral microbiota and the values of selected oral status indicators in patients with gingivitis. Methods: The study included 40 patients treated with a rinse containing tea tree oil (TTO)/TTO + spilanthol + CBD for a period of 42 days. Patients rinsed their mouth twice daily for 30 s. The patients' oral microbiome was assessed before and after treatment, and bleeding on probing (BOP) and approximal plaque index (API) were assessed. The study was double-blind. Results: API and BOP were reduced in all groups, both the test and control. The most significant decrease in baseline BOP-1 scores was observed in test groups A and D (p = 0.005062 and p = 0.005062, respectively). A significant difference in API improvement was observed between the initial and final visits in the test (A, D) and control (B, C) groups (p = 0.012516, p = 0.005062, p = 0.004028, p = 0.003172, respectively). Conclusions: Firstly, the use of a mouthwash containing cannabidiol (CBD) and spilanthol was demonstrated to be efficacious in the maintenance of oral microbiota homeostasis. Secondly, the combination of TTO with spilanthol and CBD in the rinse was shown to result in a more significant reduction in selected oral health parameters (BOP and API) and anti-inflammatory effects when compared to a rinse with TTO alone. It should be noted that this is a pilot study and will continue. DOI: 10.3390/jcm14051641 PMCID: PMC11899771 PMID: 40095592 Conflict of interest statement: The authors declare no conflicts of interest.

Case reports of identical twins with developmental and epileptic encephalopathy with STXBP1 gene mutations for whom different CBD supplementations were markedly effective.

6. Epilepsy Behav Rep. 2024 Oct 24;28:100720. doi: 10.1016/j.ebr.2024.100720. eCollection 2024. Case reports of identical twins with developmental and epileptic encephalopathy with STXBP1 gene mutations for whom different CBD supplementations were markedly effective. Masataka Y(1)(2)(3), Miki N(2), Akino K(4), Yamamoto H(5), Takumi I(3)(6). Author information: (1)Department of Neurology, Kumamoto Seijo Hospital, Kumamoto, Japan. (2)General Incorporated Association Green Zone Japan, Saitama, Japan. (3)General Incorporated Association Japan Clinical Association of Cannabinoids, Kanagawa, Japan. (4)Member of the House of Councillors (District of Fukuoka Prefecture), Tokyo, Japan. (5)Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan. (6)Department of Neurosurgery, St.Marianna University School of Medicine, Kanagawa, Japan. Cannabidiol (CBD) is a compound found specifically in the cannabis plant. Although a clinical trial for intractable epilepsy started in Japan in 2023, it is also available in the market as a dietary supplement. Herein, we report two cases of identical twins with developmental and epileptic encephalopathy with STXBP1 gene mutation who achieved seizure suppression through different regimens of CBD supplementation. The observation that different trace ingredients produced different effects in patients with identical genetic backgrounds is a crucial finding that has implications for the future regulation and clinical application of cannabinoid products. © 2024 The Author(s). DOI: 10.1016/j.ebr.2024.100720 PMCID: PMC11555409 PMID: 39534466 Conflict of interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Effects of a cannabidiol/terpene formulation on sleep in individuals with insomnia: a double-blind, placebo-controlled, randomized, crossover study.

7. J Clin Sleep Med. 2025 Jan 1;21(1):69-80. doi: 10.5664/jcsm.11324. Effects of a cannabidiol/terpene formulation on sleep in individuals with insomnia: a double-blind, placebo-controlled, randomized, crossover study. Wang M(1), Faust M(1), Abbott S(1), Patel V(1), Chang E(1), Clark JI(2), Stella N(3), Muchowski PJ(1). Author information: (1)Defined Research Institute, San Francisco, California. (2)Department of Biological Structure, University of Washington, Seattle, Washington. (3)Stella Consulting, LLC, Seattle, Washington. STUDY OBJECTIVES: Cannabidiol (CBD) is increasingly used as a health supplement, though few clinical studies have demonstrated benefits. The primary objective of this study was to evaluate the effects of an oral CBD-terpene formulation on sleep physiology in individuals with insomnia. METHODS: In this double-blind, placebo-controlled, randomized clinical trial, 125 individuals with insomnia received an oral administration of CBD (300 mg) and terpenes (1 mg each of linalool, myrcene, phytol, limonene, α-terpinene, α-terpineol, α-pinene, and β-caryophyllene) for ≥ 4 days/wk over 4 weeks using a crossover design. The study medication was devoid of Δ9-tetrahydrocannabinol. The primary outcome measure was the percentage of time participants spent in the combination of slow-wave sleep (SWS) and rapid eye movement (REM) sleep stages, as measured by a wrist-worn sleep-tracking device. RESULTS: This CBD-terpene regimen marginally increased the mean nightly percentage of time participants spent in SWS + REM sleep compared to the placebo (mean [standard error], 1.3% [0.60%]; 95% confidence interval, 0.1-2.5%; P = .03). More robust increases were observed in participants with low baseline SWS + REM sleep, as well as in day sleepers. For select participants, the increase in SWS + REM sleep averaged as much as 48 minutes/night over a 4-week treatment period. This treatment had no effect on total sleep time, resting heart rate, or heart rate variability, and no adverse events were reported. CONCLUSIONS: Select CBD-terpene ratios may increase SWS + REM sleep in some individuals with insomnia and may have the potential to provide a safe and efficacious alternative to over-the-counter sleep aids and commonly prescribed sleep medications. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Evaluation of an Oral Cannabidiol (CBD)-Terpene Formulation on Sleep Physiology in Participants With Insomnia; URL: https://clinicaltrials.gov/study/NCT05233761; Identifier: NCT05233761. CITATION: Wang M, Faust M, Abbott S, et al. Effects of a cannabidiol/terpene formulation on sleep in individuals with insomnia: a double-blind, placebo-controlled, randomized, crossover study. J Clin Sleep Med. 2025;21(1):69-80. © 2025 American Academy of Sleep Medicine. DOI: 10.5664/jcsm.11324 PMCID: PMC11701282 PMID: 39167421 [Indexed for MEDLINE] Conflict of interest statement: All authors have seen and approved this manuscript. Funding for this study was provided by Defined Research, Inc. M.W., M.F., S.A., V.P., E.C., and P.J.M. hold equity in Defined Research Inc., a for-profit company. J.I.C. and N.S. are unpaid consultants who hold stock option grants for equity in Defined Research Inc.

Does a broad-spectrum cannabidiol supplement improve performance in a 10-min cycle ergometer performance-test?

8. Eur J Sport Sci. 2024 Jul;24(7):870-877. doi: 10.1002/ejsc.12116. Epub 2024 May 3. Does a broad-spectrum cannabidiol supplement improve performance in a 10-min cycle ergometer performance-test? Gillham SH(1), Starke L(1), Welch L(1), Mather E(1), Whitelegg T(1), Chester N(1), Owens DJ(1), Bampouras T(1), Close GL(1). Author information: (1)Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK. Cannabidiol (CBD) is a non-intoxicating phytocannabinoid which has been proposed to possess anti-inflammatory and analgesic properties. Given the potential for perceptions of pain to limit exercise performance, the aim of the present study was to investigate if 3 weeks of daily CBD supplementation (150 mg day-1) improved performance in a 10-min performance-trial on a cycle ergometer. In a randomized, double-blind and placebo-controlled study, 22 healthy participants (n = 11 male and n = 11 female) completed two 10-min performance trials on a WattBike cycle ergometer interspersed with a 3-week supplementation period. Supplementation involved either 150 mg day-1 oral CBD or 150 mg day-1 of a visually identical placebo (PLA). During trials, ratings of perceived exertion (RPE [6-20]), heart rate (HR) and blood lactate (BLa) were collected every 2 min. Mean power (W) was also taken throughout the exercise at each time point. All data were analyzed using two-way ANOVAs. There were no significant differences (P > 0.05) between CBD or PLA groups for mean power (W) during the 10-min performance trial. There were also no significant differences (P > 0.05) in any of the physiological or perceptual parameters (HR, BLa and RPE) between conditions. Three weeks supplementation of a broad-spectrum CBD supplement did not improve performance via any change in RPE during a 10-min time trial on a cycle ergometer, and as such, this evidence does not support the claim that broad-spectrum CBD supplements could be performance-enhancing in this exercise modality. © 2024 The Authors. European Journal of Sport Science published by Wiley‐VCH GmbH on behalf of European College of Sport Science. DOI: 10.1002/ejsc.12116 PMCID: PMC11236031 PMID: 38956805 [Indexed for MEDLINE] Conflict of interest statement: No conflicts of interest to disclose.

Influence of short-term chronic oral cannabidiol application on muscle recovery and performance after an intensive training protocol - a randomized double-blind crossover study.

9. J Int Soc Sports Nutr. 2024 Dec;21(1):2337252. doi: 10.1080/15502783.2024.2337252. Epub 2024 Apr 4. Influence of short-term chronic oral cannabidiol application on muscle recovery and performance after an intensive training protocol - a randomized double-blind crossover study. Isenmann E(1)(2), Veit S(1), Flenker U(1), Lesch A(1), Lachenmeier DW(3), Diel P(1). Author information: (1)German Sport University Cologne, Department of Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, Cologne, Germany. (2)IST Hochschule of Applied Sciences, Department of Fitness and Health, Dusseldorf, Germany. (3)Chemical and Veterinary Investigation Agency (CVUA), Karlsruhe, Germany. BACKGROUND: Rapid regeneration after intense exercise is essential for competitive athletes. Based on this assumption, supplementation strategies, focusing on food supplements, are increasing to improve the recovery processes. One such supplement is cannabidiol (CBD) which is gaining more attention in competitive sports. However, the evidence is still lacking and there are no data available about the effect of a short-term chronic application. METHODS: A three-arm double-blind cross-over study was conducted to determine the effects of two different CBD products on performance, muscle damage and inflammatory processes in well-trained athletes. In total 17 subjects took successfully part in this study. Each subject underwent the six-day, high-intensity training protocol three times. After each training session, each subject took either a placebo or a CBD product (60 mg of oil or solubilisate). Between the intervention phases, at least four weeks of washout period was conducted. Before and after the training protocols the performance capacity in countermovement jump (CMJ), back squat (BS), bench press (BP) and 1-mile run were measured and biomarkers for muscle damage (creatine kinase, myoglobin), inflammatory processes (interleukin 6 and 10) and immune cell activity (ratios of neutrophil granulocytes, lymphocytes and, platelets) were analyzed. For statistical analyses, the current version of R and a linear mixed model was used. RESULTS: It could identify different effects of the training protocol depending on performance level (advanced or highly advanced athletes) (p < .05). Regardless of the performance level, muscle damage and a reduction in performance could be induced by the training protocol. Only CBD oil was associated with a reduction in myoglobin concentration (p < .05) in advanced athletes. Concerning immune activity, a significant decrease in platelets lymphocyte ratios was observed in advanced athletes after placebo treatment (p < .05). CBD oil application showed a slight inhibitory effect (p < .10). Moreover, the reduction in performance differs between the performance levels. A significant decrease in CMJ was observed in advanced athletes and a decreasing trend in BS was observed in highly advanced athletes after placebo treatment (p < 0.10). Both CBD products do not affect performance parameters. For inflammatory parameters, no effects were observed. CONCLUSION: It was found that the performance level of the subjects was a decisive factor and that they responded differently to the training protocol and the CBD application. However, no clear effects of either CBD product were found and further research is needed to identify the long-term effects of CBD application. DOI: 10.1080/15502783.2024.2337252 PMCID: PMC10997358 PMID: 38572744 [Indexed for MEDLINE] Conflict of interest statement: No potential conflict of interest was reported by the author(s).

Oral cannabidiol (CBD) as add-on to paracetamol for painful chronic osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial.

10. Lancet Reg Health Eur. 2023 Nov 10;35:100777. doi: 10.1016/j.lanepe.2023.100777. eCollection 2023 Dec. Oral cannabidiol (CBD) as add-on to paracetamol for painful chronic osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial. Pramhas S(1), Thalhammer T(1), Terner S(1), Pickelsberger D(1), Gleiss A(2), Sator S(1), Kress HG(1). Author information: (1)Department of Special Anaesthesia and Pain Therapy, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria. (2)Center for Medical Data Science, Medical University of Vienna, Spitalgasse 23, Vienna 1090, Austria. BACKGROUND: Painful knee osteoarthritis (KOA) is common, pharmacological treatment, however, is often hampered by limited tolerability. Cannabidiol, which preclinically showed anti-inflammatory, analgesic activity, could supplement established analgesics, but robust clinical trials are lacking. The aim of our study was to investigate the effects of oral high-dose CBD administered over 8 weeks on pain, function and patient global assessment as an add-on to continued paracetamol in chronic symptomatic KOA. METHODS: Prospective, randomized, placebo-controlled, double-blind, parallel-group study. Single center, Outpatient Clinic, Department of Special Anaesthesia and Pain Therapy at Medical University of Vienna, Austria. Eligibility criteria included: age: 18-98 years; painful KOA; score ≥5 on the pain subscale of the Western Ontario and McMasters Universities Osteoarthritis (WOMAC) Index; KOA confirmed by imaging. Participants were on continued dosage of paracetamol 3 g/d and randomly assigned by web-based software 1:1 to oral cannabidiol 600 mg/d (n = 43) or placebo (n = 43). Study period: 8 weeks. Primary outcome: Change in WOMAC pain subscale scores (0 = no pain, 10 = worst possible pain) from baseline to week 8 of treatment. Trial Registration: ClinicalTrials.gov Identifier: NCT04607603. Trial is completed. FINDINGS: The trial was conducted from October 1, 2020 to March 29, 2022. 159 patients screened, 86 randomized. Among 86 participants (mean age, 62.8 [SD 20.3] years; 60 females [69.8%]), 58 (67.4%) completed the trial. Mean baseline WOMAC pain subscale was 6.0 ± 1.1. Analysis: Intention-to-treat principal. Mean reduction in WOMAC pain subscale was 2.5 (95% CI: 1.8-3.3) in the cannabidiol group and 2.4 (95% CI: 1.7-3.2) in the placebo group with no significant group difference (p = 0.80). Adverse events were significantly more frequent with cannabidiol (cannabidiol: 135 [56%]; placebo: 105 [44%]) (p = 0.008). Rise above baseline of liver aminotransferases and gamma-glutamyltransferase was significantly more common in the cannabidiol (n = 15) than the placebo group (n = 5) (p = 0.02). INTERPRETATION: In KOA patients, oral high-dose add-on cannabidiol had no additional analgesic effect compared to adding placebo to continued paracetamol. Our results do not support the use of cannabidiol as an analgesic supplement in KOA. FUNDING: Trigal Pharma GmbH. © 2023 The Author(s). DOI: 10.1016/j.lanepe.2023.100777 PMCID: PMC10682664 PMID: 38033459 Conflict of interest statement: We declare no competing interests.

Eight Weeks of Daily Cannabidiol Supplementation Improves Sleep Quality and Immune Cell Cytotoxicity.

11. Nutrients. 2023 Sep 27;15(19):4173. doi: 10.3390/nu15194173. Eight Weeks of Daily Cannabidiol Supplementation Improves Sleep Quality and Immune Cell Cytotoxicity. Kisiolek JN(1)(2), Flores VA(1)(3), Ramani A(1), Butler B(1), Haughian JM(4), Stewart LK(1). Author information: (1)Department of Kinesiology, Nutrition, and Dietetics, University of Northern Colorado, Greeley, CO 80639, USA. (2)Department of Pathology, Division of Microbiology and Immunology, University of Utah, Salt Lake City, UT 84112, USA. (3)Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL 60612, USA. (4)Department of Biological Sciences, College of Natural and Health Sciences, University of Northern Colorado, Greeley, CO 80639, USA. BACKGROUND: The endocannabinoid system is active in nervous and immune cells and involves the expression of two cannabinoid receptor genes (CB1 and CB2), along with endogenous endocannabinoid ligands, 2-arachidonoyl glycerol (2-AG) and arachidonoyl ethanolamide (anandamide), and their synthetic enzymes. Cannabidiol (CBD) is a non-intoxicating exogenous cannabinoid agonist derived from plants that, at high doses, has received FDA approval as an anticonvulsant for epileptic seizures, and at low doses is marketed as a food-grade supplement for improved mental health, sleep quality, and immunological function. At present, the predominance of published CBD clinical research has focused on ameliorative or disease-specific intervention, with few trials investigating CBD effects in healthy populations. METHODS: This clinical study aimed to investigate the effects of 8 weeks of 50 mg oral CBD on mental health, sleep quantity and quality, and immune cell function in healthy, college-aged individuals. Twenty-eight participants (average age 25.9 ± 6.1 y) were randomized to receive either daily oral capsules of 50 mg of CBD (CB, n = 14) or a calorie-matched placebo (CN, n = 14). Participants completed pre- and post-intervention assessments, including anthropometric measurements, mental health surveys, sleep analysis, and immunological function assessments. RESULTS: After completing the 8-week intervention, there were no significant changes in body weight and BMI (CN: 1.09 ± 0.89%: CB: 1.41 ± 1.07%), or body fat percentage (CN: 9.01 ± 7.51%: CB: 8.57 ± 7.81%), respectively (values are % change pre to post, p > 0.05). There were also no significant differences between CB and CN groups with respect to mental health measures, sleep quantity, or circulating immunophenotype as a result of the intervention. However, the CB group experienced significant improvements in sleep quality measured objectively using a sleep questionnaire (p = 0.0023) and enhanced Natural Killer (NK) immune cell function assessed in situ (p = 0.0125). CONCLUSIONS: Eight weeks of daily 50 mg CBD may improve sleep quality, and NK immunosurveillance in healthy, younger adults. DOI: 10.3390/nu15194173 PMCID: PMC10574483 PMID: 37836465 [Indexed for MEDLINE] Conflict of interest statement: The authors declare no conflict of interest.

Effects of CBD supplementation on ambulatory blood pressure and serum urotensin-II concentrations in Caucasian patients with essential hypertension: A sub-analysis of the HYPER-H21-4 trial.

12. Biomed Pharmacother. 2023 Aug;164:115016. doi: 10.1016/j.biopha.2023.115016. Epub 2023 Jun 13. Effects of CBD supplementation on ambulatory blood pressure and serum urotensin-II concentrations in Caucasian patients with essential hypertension: A sub-analysis of the HYPER-H21-4 trial. Kumric M(1), Dujic G(2), Vrdoljak J(3), Supe-Domic D(4), Bilopavlovic N(5), Dolic K(6), Dujic Z(7), Bozic J(8). Author information: (1)Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: marko.kumric@mefst.hr. (2)Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia. Electronic address: gdujic@kbsplit.hr. (3)Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: josip.vrdoljak@mefst.hr. (4)Department of Health Studies, University of Split, 21000 Split, Croatia; Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia. Electronic address: daniela.supe.domic@ozs.unist.hr. (5)Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia. (6)Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia. Electronic address: kdolic@kbsplit.hr. (7)Department of Integrative Physiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: zeljko.dujic@mefst.hr. (8)Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: josko.bozic@mefst.hr. HYPER-H21-4 was a randomized crossover trial that aimed to determine if cannabidiol (CBD), a non-intoxicating constituent of cannabis, has relevant effects on blood pressure and vascular health in patients with essential hypertension. In the present sub-analysis, we aimed to elucidate whether serum urotensin-II concentrations may reflect hemodynamic changes caused by oral supplementation with CBD. The sub-analysis of this randomized crossover study included 51 patients with mild to moderate hypertension that received CBD for five weeks, and placebo for five weeks. After five weeks of oral CBD supplementation, but not placebo, serum urotensin concentrations reduced significantly in comparison to baseline (3.31 ± 1.46 ng/mL vs. 2.08 ± 0.91 ng/mL, P < 0.001). Following the five weeks of CBD supplementation, the magnitude of reduction in 24 h mean arterial pressure (MAP) positively correlated with the extent of change in serum urotensin levels (r = 0.412, P = 0.003); this association was independent of age, sex, BMI and previous antihypertensive treatment (β ± standard error, 0.023 ± 0.009, P = 0.009). No correlation was present in the placebo condition (r = -0.132, P = 0.357). In summary, potent vasoconstrictor urotensin seems to be implicated in CBD-mediated reduction in blood pressure, although further research is needed to confirm these notions. Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved. DOI: 10.1016/j.biopha.2023.115016 PMID: 37321059 [Indexed for MEDLINE] Conflict of interest statement: Declaration of Competing Interest The authors declare that there are no conflicts of interest.

Cannabis-based medicines and medical cannabis for adults with cancer pain.

13. Cochrane Database Syst Rev. 2023 Jun 5;6(6):CD014915. doi: 10.1002/14651858.CD014915.pub2. Cannabis-based medicines and medical cannabis for adults with cancer pain. Häuser W(1), Welsch P(2), Radbruch L(3), Fisher E(4)(5), Bell RF(6), Moore RA(7). Author information: (1)Department of Psychosomatic Medicine and Psychotherapy, Technische Universität München, München, Germany. (2)Health Care Center for Pain Medicine and Mental Health, Saarbrücken, Germany. (3)Department of Palliative Medicine, University Hospital of Bonn, Bonn, Germany. (4)Cochrane Pain, Palliative and Supportive Care Group, Pain Research Unit, Churchill Hospital, Oxford, UK. (5)Centre for Pain Research, University of Bath, Bath, UK. (6)Emerita, Regional Centre of Excellence in Palliative Care, Haukeland University Hospital, Bergen, Norway. (7)Plymouth, UK. Comment in Am Fam Physician. 2024 Feb;109(2):117-118. BACKGROUND: Pain is a common symptom in people with cancer; 30% to 50% of people with cancer will experience moderate-to-severe pain. This can have a major negative impact on their quality of life. Opioid (morphine-like) medications are commonly used to treat moderate or severe cancer pain, and are recommended for this purpose in the World Health Organization (WHO) pain treatment ladder. Pain is not sufficiently relieved by opioid medications in 10% to 15% of people with cancer. In people with insufficient relief of cancer pain, new analgesics are needed to effectively and safely supplement or replace opioids. OBJECTIVES: To evaluate the benefits and harms of cannabis-based medicines, including medical cannabis, for treating pain and other symptoms in adults with cancer compared to placebo or any other established analgesic for cancer pain. SEARCH METHODS: We used standard, extensive Cochrane search methods. The latest search date was 26 January 2023. SELECTION CRITERIA: We selected double-blind randomised, controlled trials (RCT) of medical cannabis, plant-derived and synthetic cannabis-based medicines against placebo or any other active treatment for cancer pain in adults, with any treatment duration and at least 10 participants per treatment arm. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. The primary outcomes were 1. proportions of participants reporting no worse than mild pain; 2. Patient Global Impression of Change (PGIC) of much improved or very much improved and 3. withdrawals due to adverse events. Secondary outcomes were 4. number of participants who reported pain relief of 30% or greater and overall opioid use reduced or stable; 5. number of participants who reported pain relief of 30% or greater, or 50% or greater; 6. pain intensity; 7. sleep problems; 8. depression and anxiety; 9. daily maintenance and breakthrough opioid dosage; 10. dropouts due to lack of efficacy; 11. all central nervous system adverse events. We used GRADE to assess certainty of evidence for each outcome. MAIN RESULTS: We identified 14 studies involving 1823 participants. No study assessed the proportions of participants reporting no worse than mild pain on treatment by 14 days after start of treatment. We found five RCTs assessing oromucosal nabiximols (tetrahydrocannabinol (THC) and cannabidiol (CBD)) or THC alone involving 1539 participants with moderate or severe pain despite opioid therapy. The double-blind periods of the RCTs ranged between two and five weeks. Four studies with a parallel design and 1333 participants were available for meta-analysis. There was moderate-certainty evidence that there was no clinically relevant benefit for proportions of PGIC much or very much improved (risk difference (RD) 0.06, 95% confidence interval (CI) 0.01 to 0.12; number needed to treat for an additional beneficial outcome (NNTB) 16, 95% CI 8 to 100). There was moderate-certainty evidence for no clinically relevant difference in the proportion of withdrawals due to adverse events (RD 0.04, 95% CI 0 to 0.08; number needed to treat for an additional harmful outcome (NNTH) 25, 95% CI 16 to endless). There was moderate-certainty evidence for no difference between nabiximols or THC and placebo in the frequency of serious adverse events (RD 0.02, 95% CI -0.03 to 0.07). There was moderate-certainty evidence that nabiximols and THC used as add-on treatment for opioid-refractory cancer pain did not differ from placebo in reducing mean pain intensity (standardised mean difference (SMD) -0.19, 95% CI -0.40 to 0.02). There was low-certainty evidence that a synthetic THC analogue (nabilone) delivered over eight weeks was not superior to placebo in reducing pain associated with chemotherapy or radiochemotherapy in people with head and neck cancer and non-small cell lung cancer (2 studies, 89 participants, qualitative analysis). Analyses of tolerability and safety were not possible for these studies. There was low-certainty evidence that synthetic THC analogues were superior to placebo (SMD -0.98, 95% CI -1.36 to -0.60), but not superior to low-dose codeine (SMD 0.03, 95% CI -0.25 to 0.32; 5 single-dose trials; 126 participants) in reducing moderate-to-severe cancer pain after cessation of previous analgesic treatment for three to four and a half hours (2 single-dose trials; 66 participants). Analyses of tolerability and safety were not possible for these studies. There was low-certainty evidence that CBD oil did not add value to specialist palliative care alone in the reduction of pain intensity in people with advanced cancer. There was no difference in the number of dropouts due to adverse events and serious adverse events (1 study, 144 participants, qualitative analysis). We found no studies using herbal cannabis. AUTHORS' CONCLUSIONS: There is moderate-certainty evidence that oromucosal nabiximols and THC are ineffective in relieving moderate-to-severe opioid-refractory cancer pain. There is low-certainty evidence that nabilone is ineffective in reducing pain associated with (radio-) chemotherapy in people with head and neck cancer and non-small cell lung cancer. There is low-certainty evidence that a single dose of synthetic THC analogues is not superior to a single low-dose morphine equivalent in reducing moderate-to-severe cancer pain. There is low-certainty evidence that CBD does not add value to specialist palliative care alone in the reduction of pain in people with advanced cancer. Publisher: ANTECEDENTES: El dolor es un síntoma común en las personas con cáncer; entre el 30% y el 50% de las personas con cáncer experimentarán dolor de moderado a intenso. Esto puede tener un gran impacto negativo en su calidad de vida. Los fármacos opiáceos (similares a la morfina) se utilizan habitualmente para tratar el dolor por cáncer moderado o intenso, y se recomiendan para este propósito en la escala de tratamiento del dolor de la Organización Mundial de la Salud (OMS). El dolor no se alivia lo suficiente con los medicamentos opiáceos en el 10% al 15% de las personas con cáncer. En las personas con un alivio insuficiente del dolor por cáncer, se necesitan nuevos analgésicos que complementen o sustituyan de forma eficaz y segura a los opiáceos. OBJETIVOS: Evaluar los efectos beneficiosos y perjudiciales de los medicamentos con cannabis, incluido el cannabis medicinal, para tratar el dolor y otros síntomas en adultos con cáncer en comparación con placebo o cualquier otro analgésico establecido para el dolor por cáncer. MÉTODOS DE BÚSQUEDA: Se utilizaron los métodos exhaustivos estándar de búsqueda de Cochrane. La última fecha de búsqueda fue el 26 de enero de 2023. CRITERIOS DE SELECCIÓN: Se seleccionaron los ensayos controlados aleatorizados (ECA) doble ciego de cannabis medicinal, medicamentos derivados de plantas y sintéticos con cannabis versus placebo o cualquier otro tratamiento activo para el dolor por cáncer en adultos, con cualquier duración del tratamiento y al menos 10 participantes por grupo de tratamiento. OBTENCIÓN Y ANÁLISIS DE LOS DATOS: Se utilizaron los métodos estándar de Cochrane. Los desenlaces principales fueron los siguientes: 1. proporción de participantes que declararon dolor leve; 2. Patient Global Impression of Change (PGIC) de mucha o muchísima mejoría y 3. retiros debido a eventos adversos. Los desenlaces secundarios fueron 4. número de participantes que declararon un alivio del dolor del 30% o superior y un consumo general de opiáceos reducido o estable; 5. número de participantes que declararon un alivio del dolor del 30% o superior, o del 50% o superior; 6. intensidad del dolor; 7. problemas de sueño; 8. depresión y ansiedad; 9. dosis diaria de opiáceos de mantenimiento y de inicio; 10. abandonos por falta de eficacia; 11. todos los eventos adversos del sistema nervioso central. Se utilizó el método GRADE para evaluar la calidad de la evidencia de cada desenlace. RESULTADOS PRINCIPALES: Se identificaron 14 estudios con 1823 participantes. Ningún estudio evaluó las proporciones de participantes que declararon un dolor no peor que leve a los 14 días de inicio del tratamiento. Se encontraron cinco ECA que evaluaron nabiximoles oromucosos (tetrahidrocannabinol [THC] y cannabidiol [CBD]) o THC solo, con 1539 participantes con dolor moderado o intenso a pesar del tratamiento con opiáceos. Los periodos doble ciego de los ECA variaron entre dos y cinco semanas. Para el metanálisis se dispuso de cuatro estudios con un diseño paralelo y 1333 participantes. Hubo evidencia de certeza moderada de que no hubo efectos beneficiosos clínicamente relevantes en las proporciones de PGIC de mucha o muchísima mejoría (diferencia de riesgos [DR] 0,06; intervalo de confianza [IC] del 95%: 0,01 a 0,12; número necesario a tratar para lograr un resultado beneficioso adicional [NNTB] 16; IC del 95%: 8 a 100). Hubo evidencia de certeza moderada de que no hubo diferencias clínicamente relevantes en la proporción de retiros debido a eventos adversos (DR 0,04; IC del 95%: 0 a 0,08; número necesario a tratar para lograr un desenlace perjudicial adicional [NNTD] 25; IC del 95%: 16 a infinito). Hubo evidencia de certeza moderada de que no hubo diferencias entre nabiximols o THC y placebo en la frecuencia de eventos adversos graves (DR 0,02; IC del 95%: ‐0,03 a 0,07). Hubo evidencia de certeza moderada de que los nabiximoles y el THC utilizados como tratamiento complementario para el dolor por cáncer refractario a los opiáceos no difirieron del placebo en cuanto a la reducción de la intensidad media del dolor (diferencia de medias estandarizada [DME] ‐0,19; IC del 95%: ‐0,40 a 0,02). Hubo evidencia de certeza baja de que un análogo sintético del THC (nabilona) administrado durante ocho semanas no fue superior a placebo para reducir el dolor asociado con la quimioterapia o la radioquimioterapia en personas con cáncer de cabeza y cuello y cáncer de pulmón de células no pequeñas (dos estudios, 89 participantes, análisis cualitativo). En estos estudios no fue posible realizar análisis de tolerabilidad y seguridad. Hubo evidencia de certeza baja de que los análogos sintéticos del THC fueron superiores a placebo (DME ‐0,98; IC del 95%: ‐1,36 a ‐0,60), pero no superiores a la codeína en dosis bajas (DME 0,03; IC del 95%: ‐0,25 a 0,32; cinco ensayos de dosis única; 126 participantes) en cuanto a la reducción del dolor moderado a intenso por cáncer después de la interrupción del tratamiento analgésico previo durante tres a cuatro horas y media (dos ensayos de dosis única; 66 participantes). En estos estudios no fue posible realizar análisis de tolerabilidad y seguridad. Hubo evidencia de certeza baja de que el aceite de CBD no agregó valor a los cuidados paliativos especializados solos en la reducción de la intensidad del dolor en personas con cáncer avanzado. No hubo diferencias en el número de abandonos debido a eventos adversos ni eventos adversos graves (un estudio, 144 participantes, análisis cualitativo). No se encontraron estudios que utilizaran la planta de cannabis. CONCLUSIONES DE LOS AUTORES: Existe evidencia de certeza moderada de que los nabiximoles y el THC por vía oromucosa no son efectivos para aliviar el dolor de moderado a intenso por cáncer refractario a los opiáceos. Hay evidencia de certeza baja de que la nabilona no es efectiva para reducir el dolor asociado con la radio‐quimioterapia en personas con cáncer de cabeza y cuello y cáncer de pulmón de células no pequeñas. Hay evidencia de certeza baja de que una dosis única de análogos sintéticos del THC no es superior a una dosis única baja equivalente de morfina para reducir el dolor moderado a intenso por cáncer. Hay evidencia de certeza baja de que el CBD no aporta valor a los cuidados paliativos especializados solos en la reducción del dolor en personas con cáncer avanzado. Copyright © 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. DOI: 10.1002/14651858.CD014915.pub2 PMCID: PMC10241005 PMID: 37283486 [Indexed for MEDLINE] Conflict of interest statement: WH was a member of the PaPaS Editorial Board and had no input into the editorial decisions or processes for this review. WH is treating people with cannabis‐based medicines. PW is treating people with cannabis‐based medicines. EF was a member of the PaPaS Editorial Board and had no input into the editorial decisions or processes for this review. LR is treating people with cannabis‐based medicines. RFB: none. RAM was a member of the PaPaS Editorial Board and had no input into the editorial decisions or processes for this review.

CBD supplementation reduces arterial blood pressure via modulation of the sympatho-chromaffin system: A substudy from the HYPER-H21-4 trial.

14. Biomed Pharmacother. 2023 Apr;160:114387. doi: 10.1016/j.biopha.2023.114387. Epub 2023 Feb 11. CBD supplementation reduces arterial blood pressure via modulation of the sympatho-chromaffin system: A substudy from the HYPER-H21-4 trial. Kumric M(1), Dujic G(2), Vrdoljak J(3), Svagusa K(4), Kurir TT(5), Supe-Domic D(6), Dujic Z(7), Bozic J(8). Author information: (1)Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: marko.kumric@mefst.hr. (2)Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia. Electronic address: gdujic@kbsplit.hr. (3)Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: josip.vrdoljak@mefst.hr. (4)Department of Integrative Physiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: karla.svagusa@mefst.hr. (5)Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; Department of Endocrinology, University Hospital of Split, Split 21000, Croatia. (6)Department of Health Studies, University of Split, 21000 Split, Croatia; Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia. Electronic address: daniela.supe.domic@ozs.unist.hr. (7)Department of Integrative Physiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: zeljko.dujic@mefst.hr. (8)Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia. Electronic address: josko.bozic@mefst.hr. Data concerning the effects of cannabidiol (CBD) on blood pressure (BP) is controversial. HYPER-H21-4 was a randomized, placebo-controlled, crossover trial which sought to elucidate if 5-week administration of CBD will reduce BP in hypertensive patients. In the substudy of this trial, we aimed to establish the mechanistic background of CBD-induced BP reduction. Specifically, we explored the dynamic of catestatin, a sympathoinhibitory peptide implicated in the pathophysiology of hypertension. In the present analysis, 54 patients with Grade 1 hypertension were included. 5-week administration of CBD but not placebo reduced serum catestatin concentration in comparison to baseline (13.50 [10.85-19.05] vs. 9.65 [6.37-12.26] ng/mL, p < 0.001). Serum catestatin levels at the start of the treatment period demonstrated a negative correlation with the extent of reduction in mean arterial pressure (r = -0.474, p < 0.001). Moreover, the extent of change in catestatin serum levels showed a strong correlation with the extent of mean arterial pressure reduction (r = 0.712, p < 0.001). Overall, the results of the present study imply that the antihypertensive effects of CBD may be explained by its interaction with the sympatho-chromaffin system, although further research is warranted. Copyright © 2023 The Authors. Published by Elsevier Masson SAS.. All rights reserved. DOI: 10.1016/j.biopha.2023.114387 PMID: 36780785 [Indexed for MEDLINE] Conflict of interest statement: Conflict of interest statement The authors declare that there are no conflicts of interest.

Topical Cannabidiol (CBD) After Total Knee Arthroplasty Does Not Decrease Pain or Opioid Use: A Prospective Randomized Double-Blinded Placebo-Controlled Trial.

15. J Arthroplasty. 2022 Sep;37(9):1763-1770. doi: 10.1016/j.arth.2022.03.081. Epub 2022 Apr 4. Topical Cannabidiol (CBD) After Total Knee Arthroplasty Does Not Decrease Pain or Opioid Use: A Prospective Randomized Double-Blinded Placebo-Controlled Trial. Haffar A(1), Khan IA(1), Abdelaal MS(1), Banerjee S(1), Sharkey PF(1), Lonner JH(1). Author information: (1)Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA. BACKGROUND: Multimodal analgesia has become the standard of care for pain management following total knee arthroplasty (TKA). Cannabidiol (CBD) is increasingly utilized in the postoperative period. The purpose of this study was to analyze the analgesic benefits of topical CBD following primary TKA. METHODS: In this randomized double-blinded placebo-controlled trial, 80 patients undergoing primary unilateral TKA applied topical CBD (CBD; n = 19), essential oil (EO; n = 21), CBD and essential oil (CBD + EO; n = 21), or placebo (PLA; n = 19) thrice daily around the knee for two weeks postoperatively. This supplemented a standardized multimodal analgesic protocol. Outcomes included visual analog scale (VAS) pain and numeric rating scale (NRS) sleep scores (collected on postoperative day [POD] 0, 1, 2, 7, 14, 42), and cumulative postoperative opioid use (42 days). RESULTS: Demographic characteristics were similar among the four cohorts. Preoperative VAS and NRS scores were similar among groups. The CBD cohort had a higher mean VAS pain score on POD 2 compared to the EO cohort (CBD: 69.9 ± 19.3 versus. EO: 51.0 ± 18.2; P = .013). No statistically significant differences existed for VAS scores at other times, and no statistically significant differences were observed for postoperative NRS sleep scores or postoperative opioid use at any time point. CONCLUSION: Utilization of topical CBD in supplement to multimodal analgesia did not reduce pain or opioid consumption, or improve sleep scores following TKA. These results suggest that the local effects of topical CBD are not beneficial for providing additional pain relief after TKA. Copyright © 2022 Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2022.03.081 PMID: 35390457 [Indexed for MEDLINE]