Nicholas Frane
Zucker School of Medicine at Hofstra
Objective: The purpose of our study was to evaluate evaluating the patient-perceived effect that CBD use has on pain and use of other oral medications in patients with arthritis. We hypothesized that patients who used CBD would report improvements in pain with no difference between groups when compared by type of arthritis.
Methods: A novel anonymous questionnaire was created to evaluate patients\’ perceived efficacy of CBD use for arthritis pain. Patients were recruited through online methods including social media accounts and newsletters (The Arthritis Foundation and Savvy Cooperative). 709 patients initially participated in the survey. Participants were excluded if they didn’t have arthritis (N=75), had not tried CBD (N=133), or had incomplete surveys (N=73). Responses to use and pain questions were stratified by subtypes of arthritis. Pearson’s chi-squared and Fisher’s exact tests were used in the analysis of categorical variables. Pain and pain reduction responses were evaluated with non-parametric Kruskal Wallis Tests. Individual comparisons were evaluated with Mann-Whitney U tests. A two-tailed p-value less than 0.05 was considered statistically significant.
Results: The influence of CBD was mostly positive in effect on pain intensity (37.9% much better, 45.1% little better), physical function (28.7% much better, 37.4% little better), and sleep quality (37.6% much better and 28.5% little better). Subgroup analysis by diagnosis type (osteoarthritis, rheumatoid, or other autoimmune arthritis) found differences in among groups for physical function (P=0.013), favoring the osteoarthritis group.
The cohort reported a 44% reduction in pain after CBD use (2.58-point reduction). The osteoarthritis group had greater percentage reduction (P=0.020) and point reduction (P<0.001) in pain compared to rheumatoid arthritis and other autoimmune arthritis.
The majority of respondents reported a reduction or cessation of other medications after CBD use (N=259, 60.5%): reductions in Anti-inflammatories (N=129, 31.1%), Acetaminophen (N=78, 18.2%), Opioids (N=36, 8.6%) and discontinuation of Anti-inflammatories (N=76, 17.8%), Acetaminophen (N=76, 17.8%), and opioids (N=81, 18.9%).
Discussion: In our convenience sample, participants reported high rates of symptomatic relief. Furthermore, patients using CBD reported reduction and discontinuation of opioids, Tylenol, and anti-inflammatories. The present study suggests that there may be therapeutic benefit to CBD use in patients with arthritis.
Co-authors: Erik Stapleton1, Maximillian Ganz1, Cesar Iturriaga2, Rupa Vijayan3, Robert Duarte4
1Zucker School of Medicine at Hofstra
2Long Island Jewish Medical Center Department of Orthopaedic Surgery
3Northwell Health Orthopaedic Research Department
4Long Island Jewish Medical Center Department of Neurology and Pain Medicine