Cannabis und Dronabinol steigern die Kalorienaufnahme signifikant bei HIV-Patienten mit Muskelmasseverlust.
Zusammenfassung
n=30 HIV-positive Cannabiskonsumenten (n=15 mit klinisch signifikantem Muskelmasseverlust <90 % BCM/Körpergröße, n=15 ohne), randomisierter Vergleich Dronabinol (10/20/30 mg) vs. inhaliertes Cannabis (1,8/2,8/3,9 % THC) vs. Placebo; bei Probanden mit Wasting signifikante Kalorienaufnahme-Steigerung unter Cannabis (alle 3 Dosierungen) und Dronabinol (10, 20 mg) vs. Placebo (p<0.05); 30 mg Dronabinol schlecht verträglich in einer Teilgruppe; kognitive Effekte gering.
P
PopulationHIV-positive Cannabisraucher mit (n=15) und ohne (n=15) klinisch signifikanten Muskelmasseverlust (<90% Körperzellmasse/Körpergröße), Gesamt-n=30
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InterventionOrales Dronabinol (0, 10, 20, 30 mg p.o.) und gerauchtes Cannabis (0,0; 1,8; 2,8; 3,9% THC) in 8 Sitzungen à 7 Stunden
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KontrollePlacebo (0 mg Dronabinol / 0,0% THC Cannabis) im Double-Dummy-Design
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OutcomeKalorienaufnahme signifikant erhöht unter Cannabis und Dronabinol in der Gruppe mit niedrigem BIA (Muskelmasseverlust), nicht in der Gruppe mit normalem BIA; 30 mg Dronabinol schlecht verträglich bei einer Teilgruppe
Vertrauen in die Evidenz
Sehr niedrigNiedrigModeratHoch
Moderat
Dritte von vier GRADE-Stufen, die Effektschätzung ist wahrscheinlich verlässlich.
<h4>Rationale</h4>No studies to date have directly compared the tolerability and efficacy of smoked Cannabis and oral dronabinol in HIV(+) Cannabis smokers.<h4>Objectives</h4>The aim of this study was to compare dronabinol (0, 10, 20, 30 mg p.o.) and Cannabis [0.0, 1.8, 2.8, 3.9% Delta(9)-tetrahydrocannabinol (THC)] in two samples of HIV(+) Cannabis smokers: those with (n=15) and those without (n=15) a clinically significant loss of muscle mass (<90% body cell mass/height), which is one component of AIDS wasting.<h4>Methods</h4>Mood, physical symptoms, self-selected food intake, cardiovascular data, and cognitive task performance were measured before and repeatedly after dronabinol and Cannabis administration in eight 7-h sessions. Cannabis and dronabinol were administered in randomized order using a within-subject, staggered, double-dummy design.<h4>Results</h4>As compared to placebo, (1) Cannabis (1.8, 2.8, 3.9% THC) and the lower dronabinol doses (10, 20 mg) were well tolerated (e.g., few physical symptoms, significant increases in ratings of "good drug effect") in both groups of participants; the highest dose of dronabinol (30 mg) was poorly tolerated in a subset of participants; (2) Cannabis and dronabinol significantly increased caloric intake in the low bioelectrical impedance analysis (BIA) group but not in the normal BIA group; and (3) drug effects on cognitive performance were minor.<h4>Conclusions</h4>These data suggest that for experienced Cannabis smokers with clinically significant muscle mass loss, both dronabinol (at acute doses at least four to eight times the current recommendation) and Cannabis produce substantial and comparable increases in food intake without producing adverse effects.