What is Osteoarthritis?
Osteoarthritis is the most common type of arthritis. It is characterised by localised inflammation, pain, and loss of cartilage in a joint. It typically affects one joint in isolation, such as the knee or hip joint. However, some people may be affected by osteoarthritis in more than one joint. For many osteoarthritis sufferers, managing pain is a daily struggle. It can have a significant impact on sleep, mood, and relationships.
The number of people affected by osteoarthritis is expected to rise in the future. Therefore there is likely to be a growing number of patents requiring management of osteoarthritis-related pain.
What Treatments Are Available for Osteoarthritis?
Treatment of osteoarthritis requires a holistic approach. An important aspect of treatment is appropriate physical therapy to ensure the affected joint is appropriately strengthened to help reduce progression of the condition. In addition, talking therapies can be helpful in improving self-management of pain symptoms.
Many people require or are reliant upon medications as a component of treatment to help manage pain. There are no medications that have been proven to delay or prevent disease progression. In the UK, if people have tried two or more licensed pain medications they may be eligible for a medical cannabis prescription if deemed suitable by a specialist consultant.
In appropriate cases, joint replacement may be the best option for long-term management of osteoarthritis. However, in the UK, some joint replacement lists can exceed 52 weeks. Surgery is also not appropriate for all individuals. This is why a holistic approach is so important.
UK Medical Cannabis Registry & Osteoarthritis
In 2019, Curaleaf Clinic (formerly Sapphire Medical Clinics) established the UK Medical Cannabis Registry to collect real-world data on the clinical outcomes of medical cannabis patients in the UK. A recent analysis looked at patients enrolled on the Registry with osteoarthritis. This study aimed to monitor changes in pain levels, anxiety, sleep quality, and overall quality of life through patient-reported outcome measures (PROMs). It also aimed to review the adverse events reported by patients.
Results of the Analysis
The study included 77 patients. Changes were noted in pain severity, pain interference, and overall quality of life at various follow-up points. Pain measurements were assessed using the Brief Pain Inventory -Short Form and other validated measures. Whilst quali;ty of life was assessed using the EQ-5D-5L.
A total of 218 adverse events were recorded by 17 patients. The most common adverse event was fatigue (7.8%). Most were mild to moderate in severity (82.57%), aligning with the findings from similar studies.
Conclusions
This study contributes valuable data to the ongoing discussion regarding the use of medical cannabis in patients with chronic pain conditions like osteoarthritis. While the results are promising, they come with caveats. The study’s observational design means that while associations can be observed, causal relationships between medical cannabis and improved outcomes cannot be definitively established. Patients and healthcare providers must consider potential biases and placebo effects, which are common challenges in studies involving pain and medical cannabis.
This study highlights the need for more randomised controlled trials to better understand the effects of medical cannabis further in osteoarthritis.
