Cannabinoids in rheumatology: Friend, foe or a bystander?
cannabinoids
chronic pain
complementary medicine
drug interaction of cannabinoids
fibromyalgia
medical cannabis
Journal
Musculoskeletal care
ISSN: 1557-0681
Titre abrégé: Musculoskeletal Care
Pays: England
ID NLM: 101181344
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
revised:
14
03
2022
received:
22
02
2022
accepted:
15
03
2022
pubmed:
28
4
2022
medline:
15
6
2022
entrez:
27
4
2022
Statut:
ppublish
Résumé
Cannabinoids have gained popularity recently with special emphasis on their use for chronic pain. Although NICE guidelines advise against their usage for management of chronic pain, almost all rheumatologists encounter a few patients in their daily practice who either use them or are curious about them. We reviewed the mechanism of action of cannabinoids, current knowledge about their role in rheumatology and potential drug interactions with common drugs used in Rheumatology. We attempted to answer the question "If cannabinoids are friend, foe or just a mere bystander?" We adhered to a search strategy for writing narrative reviews as per available guidelines. We searched PubMed with the search terms "Cannabinoids", "Rheumatology" and "Chronic pain" for published articles and retrieved 613 articles. The abstracts and titles of these articles were screened to identify relevant studies focusing on mechanism of actions, adverse effects and drug interactions. We also availed the services of a musculoskeletal librarian. Despite the NHS guidelines against the usage of cannabinoids and associated significant stigma, cannabinoids are increasingly used for the management of pain in rheumatology without prescription. Cannabinoids act through two major receptors CB1 and CB2, which are important modulators of the stress response with potential analgesic effects. Their role in various rheumatological diseases including Rheumatoid arthritis, Osteoarthritis and Fibromyalgia have been explored with some benefits. However, in addition to the adverse effects, cannabinoids also have some potential interactions with common drugs used in rheumatology, which many users are unaware of. While the current studies and patient reported outcomes suggest cannabinoids to be a "friend" of rheumatology, their adverse events and drug interactions prove to be a "Foe". We were unable to arrive at a definite answer for our question posed, however on the balance of probabilities we can conclude cannabinoids to be a "foe". Under these circumstances, a disease and drug focussed research is need of the hour to answer the unresolved question.
Identifiants
pubmed: 35476898
doi: 10.1002/msc.1636
pmc: PMC9322323
doi:
Substances chimiques
Cannabinoids
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
416-428Informations de copyright
© 2022 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.
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