In the Journals

Early data warrants human studies of cannabinoids for IBD

Many preclinical studies have shown cannabinoids have anti-inflammatory effects in the gut, which warrants further research that could lead to the development of new therapies for inflammatory bowel disease, according to a meta-analysis published in Inflammatory Bowel Diseases.

Daniel G. Couch, MB, ChB, of the school of medicine at Royal Derby Hospital in the United Kingdom, and colleagues wrote that while many treatments for Crohn’s disease and ulcerative colitis are already available, none can treat IBD without the risk for significant adverse effects. They believe their analysis shows that cannabinoids could potentially fill this void.

“Corticosteroids, [5-aminosaliciclic-acid [5-ASA]) agents, anti-TNFalpha antibodies and other immunomodulatory drugs have all been shown to induce significant remission in IBD, but are associated with bone marrow suppression, opportunistic infection, infusion reaction and malignancy secondary to immunosuppression,” the researchers wrote. “There is a significant amount of promising preclinical evidence for the use of cannabinoid agents in the treatment of colitis.”

The investigators reviewed research from March 1980 to March 2017 that studied the benefit of drugs targeting the endo-cannabinoid system in intestinal inflammation. Using the EMBASE, MEDLINE and PubMed databases, they identified 51 publications and two clinical trials that examined the effects of 24 different cannabinoid compounds on murine colitis assessed across 71 endpoints.

Couch and colleagues analyzed macroscopic colitis severity disease activity index (DAI) and myeloperoxidase activity (MPO) across the publications using random effect models.

They found that cannabinoids reduced DAI compared with the vehicle (standard mean difference [SMD] –1.36; 95% CI, –1.62 to –1.09; I² = 61%). Cannabinoids also reduced MPO in rodents compared with the vehicle (SMD –1.26; 95% CI, –1.54 to –0.97; I² = 48.1%).

Couch and colleagues wrote that these findings justify future research in human patients.

“We have shown in this systematic review and meta-analysis that cannabinoid drugs are beneficial in treating experimentally induced murine models of colitis,” they wrote. “These positive findings support the development of further human clinical trials.” – by Alex Young

Disclosures : The authors report no relevant financial disclosures.

Many preclinical studies have shown cannabinoids have anti-inflammatory effects in the gut, which warrants further research that could lead to the development of new therapies for inflammatory bowel disease, according to a meta-analysis published in Inflammatory Bowel Diseases.

Daniel G. Couch, MB, ChB, of the school of medicine at Royal Derby Hospital in the United Kingdom, and colleagues wrote that while many treatments for Crohn’s disease and ulcerative colitis are already available, none can treat IBD without the risk for significant adverse effects. They believe their analysis shows that cannabinoids could potentially fill this void.

“Corticosteroids, [5-aminosaliciclic-acid [5-ASA]) agents, anti-TNFalpha antibodies and other immunomodulatory drugs have all been shown to induce significant remission in IBD, but are associated with bone marrow suppression, opportunistic infection, infusion reaction and malignancy secondary to immunosuppression,” the researchers wrote. “There is a significant amount of promising preclinical evidence for the use of cannabinoid agents in the treatment of colitis.”

The investigators reviewed research from March 1980 to March 2017 that studied the benefit of drugs targeting the endo-cannabinoid system in intestinal inflammation. Using the EMBASE, MEDLINE and PubMed databases, they identified 51 publications and two clinical trials that examined the effects of 24 different cannabinoid compounds on murine colitis assessed across 71 endpoints.

Couch and colleagues analyzed macroscopic colitis severity disease activity index (DAI) and myeloperoxidase activity (MPO) across the publications using random effect models.

They found that cannabinoids reduced DAI compared with the vehicle (standard mean difference [SMD] –1.36; 95% CI, –1.62 to –1.09; I² = 61%). Cannabinoids also reduced MPO in rodents compared with the vehicle (SMD –1.26; 95% CI, –1.54 to –0.97; I² = 48.1%).

Couch and colleagues wrote that these findings justify future research in human patients.

“We have shown in this systematic review and meta-analysis that cannabinoid drugs are beneficial in treating experimentally induced murine models of colitis,” they wrote. “These positive findings support the development of further human clinical trials.” – by Alex Young

Disclosures : The authors report no relevant financial disclosures.

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