& Aims: The marijuana plant Cannabis sativa has been reported to produce beneficial effects for patients with inflammatory bowel diseases, but these have not been investigated in controlled trials. We performed a prospective trial to determine whether cannabis can induce remission in patients with Crohn’s disease.
We studied 21 patients (mean age 40±14 years, 13 male) with Crohn’s Disease and activity index (CDAI) scores >200 who did not respond to therapy with steroids, immunomodulators, or anti-tumor necrosis factor-α agents. Patients were randomly assigned to groups given cannabis, twice daily, in the form of cigarettes containing 11.5 mg of tetrahydrocannabinol (THC) or placebo containing cannabis flowers from which the THC had been extracted. Disease activity and laboratory tests were assessed during 8 weeks of treatment and 2 weeks thereafter.
Complete remission (a CDAI score <150) was achieved by 5/11 subjects in the cannabis group (45%) and 1/10 in the placebo group (10%; P=.43). A clinical response (a decrease in CDAI score of >100) was observed in 10/11 subjects in the cannabis group (90%; from 330±105 to 152±109) and 4/10 in the placebo group (40%; from 373±94 to 306±143; P=.028). Three patients in the cannabis group were weaned from steroid dependency. Subjects receiving cannabis reported improved appetite and sleep, with no significant side effects.
Although the primary endpoint of the study (induction of remission) was not achieved, a short course (8 week) of THC-rich cannabis produced significant clinical, steroid-free benefits to 11 patients with active CD, compared to placebo, without side effects. Further studies, with larger patient groups and a non-smoking mode of intake, are warranted. ClinicalTrials.gov NCT01040910.
Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.