Cannabis for the treatment of Crohn's disease.

Crohn's disease (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. However, there is also evidence to suggest transient adverse events such as weakness, dizziness and diarrhea, and an increased risk of surgery in people with CD who use cannabis. The objectives were to assess the efficacy and safety of cannabis and cannabinoids for induction and maintenance of remission in people with CD. Three studies (93 participants) that assessed cannabis in people with active CD met the inclusion criteria. One small study (N=21) compared cannabis cigarettes (115 mg THC) to placebo: 45% (5/11) vs. 10% (1/10) achieved remission (RR 4.55, 95% CI 0.63–32.56); clinical response 91% vs. 40% (RR 2.27, 95% CI 1.04–4.97); very low certainty evidence. One small study (N=22) compared 5% CBD oil to placebo: remission 40% vs. 33% (RR 1.20, 95% CI 0.36–3.97); very low certainty evidence. One study (N=50) compared cannabis oil (15% CBD+4% THC) to placebo: CDAI 118.6 vs. 212.6 (MD −94.00, 95% CI −148.86 to −39.14); quality of life (SF-36) 96.3 vs. 79.9 (MD 16.40, 95% CI 5.72–27.08); low certainty evidence. Conclusion: The effects of cannabis and cannabis oil on Crohn's disease are uncertain; no firm conclusions can be drawn.