Höheres THC:CBD-Verhältnis verbessert neuropathischen Schmerz, Insomnie und Depressionen signifikant, nicht jedoch Anorexie und PTSD-Flashbacks; Angst profitiert am meisten von einem 1:1-Verhältnis.
Zusammenfassung
Retrospektive Real-World-Studie (n=2.431, 26.150 Beobachtungen): Höheres THC:CBD-Verhältnis nicht signifikant assoziiert mit Besserung von PTBS-Flashbacks OR=1,43 (95%-KI 0,60–3,41; p=0,415). Negativbefund: THC:CBD-Ratio ohne signifikanten Vorteil bei PTBS-Flashbacks gegenüber niedrigerem Verhältnis.
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PopulationPalliativpatienten mit neuropathischen Schmerzen, Anorexie, Angst, Depressionen, Insomnie oder PTSD-Flashbacks; n=2.431 (26.150 Beobachtungen)
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InterventionMedizinisches Cannabis mit variablem THC:CBD-Verhältnis (verschiedene Produkte, Eigenangaben)
<b><i>Objectives:</i></b> To determine the relative contributions of tetrahydrocannabinol (THC) and cannabidiol (CBD) to patients' self-ratings of efficacy for common palliative care symptoms. <b><i>Design:</i></b> This is an electronic record-based retrospective cohort study. Model development used logistic regression with bootstrapped confidence intervals (CIs), with standard errors clustered to account for multiple observations by each patient. <b><i>Setting:</i></b> This is a national Canadian patient portal. <b><i>Participants:</i></b> A total of 2,431 patients participated. <b><i>Main Outcome Measures:</i></b> Self-ratings of efficacy of cannabis, defined as a three-point reduction in neuropathic pain, anorexia, anxiety symptoms, depressive symptoms, insomnia, and post-traumatic flashbacks. <b><i>Results:</i></b> We included 26,150 observations between October 1, 2017 and November 28, 2018. Of the six symptoms, response was associated with increased THC:CBD ratio for neuropathic pain (odds ratio [OR]: 3.58; 95% CI: 1.32-9.68; <i>p</i> = 0.012), insomnia (OR: 2.93; 95% CI: 1.75-4.91; <i>p</i> < 0.001), and depressive symptoms (OR: 1.63; 95% CI: 1.07-2.49; <i>p</i> = 0.022). Increased THC:CBD ratio was not associated with a greater response of post-traumatic stress disorder (PTSD)-related flashbacks (OR: 1.43; 95% CI: 0.60-3.41; <i>p</i> = 0.415) or anorexia (OR: 1.61; 95% CI: 0.70-3.73; <i>p</i> = 0.265). The response for anxiety symptoms was not significant (OR: 1.13; 95% CI: 0.77-1.64; <i>p</i> = 0.53), but showed an inverted U-shaped curve, with maximal benefit at a 1:1 ratio (50% THC). <b><i>Conclusions:</i></b> These preliminary results offer a unique view of real-world medical cannabis use and identify several areas for future research.