Morbus Crohn
Studienlage · Detail RCT · Morbus Crohn · 2017

Low-Dose Cannabidiol Is Safe but Not Effective in the Treatment for Crohn’s Disease, a Randomized Controlled Trial

Kein Nutzen nachgewiesen GRADE Moderat 214 Zitate
Stichproben = 19 Pat.
Dauer8 weeks of treatment and 2…
KontrollePlacebo oral, 2x täglich über 8 Wochen
EndpunktCDAI
Verblindungdoppelblind
DesignRCT
Cannabinoidcbd
Max. Dosis20.0 mg
Applikationoral
Kernaussage

CBD zeigte keinen signifikanten Nutzen: CDAI sank in der CBD-Gruppe von 337±108 auf 220±122 und in der Placebo-Gruppe von 308±96 auf 216±121 (p=NS); beide Gruppen verbesserten sich ähnlich.

Zusammenfassung

n=19 aktiver Morbus Crohn, CBD 10 mg 2×täglich vs. Placebo über 8 Wochen; kein signifikanter Unterschied im Crohn's Disease Activity Index (CDAI: -18 vs. -30 Punkte, p=0.6), CBD gut verträglich aber bei dieser Dosis ineffektiv.

P
PopulationErwachsene mit moderat aktivem Morbus Crohn (CDAI >200), n=20 (19 completers), therapierefraktär gegenüber Steroiden, Thiopurinen oder TNF-Antagonisten
I
InterventionCannabidiol (CBD) 10 mg oral, 2x täglich über 8 Wochen
C
KontrollePlacebo oral, 2x täglich über 8 Wochen
O
OutcomePrimärer Endpunkt CDAI: Baseline CBD 337±108 vs. Placebo 308±96, nach 8 Wochen CBD 220±122 vs. Placebo 216±121 (p=n.s.) — kein signifikanter Unterschied, CBD sicher aber nicht wirksam
Vertrauen in die Evidenz
Moderat

Dritte von vier GRADE-Stufen, die Effektschätzung ist wahrscheinlich verlässlich.

Herabgestuft wegen
Ungenauigkeit
Qualitätsprofil
Größe
Verblindung Doppelblind
Effektstärke Kein Nutzen
Zitate / Jahr
Autoren
Naftali T, Mechulam R, Marii A et al.
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Abstract
Background: Cannabidiol (CBD) is an anti-inflammatory cannabinoid shown to be beneficial in a mouse model of IBD. Lacking any central effect, cannabidiol is an attractive option for treating inflammatory diseases. Aim: To assess the effects of cannabidiol on Crohn's disease in a randomized placebo-controlled trial. Patients And Methods: Twenty patients aged 18-75 years with a Crohn's disease activity index (CDAI) >200 were randomized to receive oral (10 mg) CBD or placebo twice daily. Patients did not respond to standard treatment with steroids (11 patients), thiopurines (14), or TNF antagonists (11). Disease activity and laboratory parameters were assessed during 8 weeks of treatment and 2 weeks thereafter. Other medical treatment remained unchanged. Results: Of 20 patients recruited 19 completed the study. Their mean age was 39 ± 15, and 11 were males. The average CDAI before cannabidiol consumption was 337 ± 108 and 308 ± 96 (p = NS) in the CBD and placebo groups, respectively. After 8 weeks of treatment, the index was 220 ± 122 and 216 ± 121 in the CBD and placebo groups, respectively (p = NS). Hemoglobin, albumin, and kidney and liver function tests remained unchanged. No side effects were observed. Conclusion: In this study of moderately active Crohn's disease, CBD was safe but had no beneficial effects. This could be due to lack of effect of CBD on Crohn's disease, but could also be due to the small dose of CBD, the small number of patients in the study, or the lack of the necessary synergism with other cannabinoids. Further investigation is warranted. Clinicaltrials.Gov: NCT01037322.

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