An initial analysis of the UK Medical Cannabis Registry: Outcomes analysis of first 129 patients

Erridge, Simon; Salazar, Oliver; Kawka, Michal; Holvey, Carl; Coomber, Ross; Usmani, Azfer; Sajad, Mohammed; Beri, Sushil; Hoare, Jonathan; Khan, Saira; Weatherall, Mark; Platt, Michael; Rucker, James

doi:10.1002/npr2.12183

Cited by 37 publications

(33 citation statements)

References 39 publications

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“…Chronic pain is a common condition that is increasingly managed with CBMPs. Our data supports findings of other RWE databases ( 22 ), and international evidence that, with changes in the legal status and availability of these medications, they are increasingly being used to treat pain and other conditions.…”

Section: Discussionsupporting

confidence: 90%

“…Currently, up to 90% of patients in state-level medical cannabis registries list chronic pain as their qualifying condition for the medical program ( 21 ). Emerging observational data of UK based registries corroborate these findings ( 22 , 23 ). Additionally, an increasing number of observational studies highlight that CBMPs may be used as an alternative treatment by intermittent or chronic opioid users to mitigate their pain ( 24 ).…”

Section: Introductionmentioning

confidence: 55%

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Characteristics of People Seeking Prescribed Cannabinoids for the Treatment of Chronic Pain: Evidence From Project Twenty 21

Schlag

Lynskey²,

Fayaz

et al. 2022

Front. Pain Res.

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BackgroundPrescribed cannabinoids are now legal in the UK and increasingly being used for a variety of conditions, with one of the most frequent conditions being chronic pain. This paper describes the characteristics of individuals seeking prescribed cannabinoids for the treatment of chronic pain in Project Twenty 21, a UK based real world data registry of prescribed cannabis patients.MethodBy 1st November 2021 data were available for 1,782 people who had sought treatment with medical cannabis as part of Project Twenty 21. The most common diagnosis among this cohort was chronic pain with 949 (53.5%) of the cohort reporting a primary condition related to chronic pain. Medical and self-report data on the characteristics of these patients, their health status and type/s of cannabinoid/s prescribed are summarized in this report.ResultsOf the 949 people reporting chronic pain as a primary condition 54.7% were male and their average age was 42.0 years (range = 18–84). Patients reported a low quality of life and high levels of comorbidity: people reported an average of 4.6 comorbid conditions with the most common comorbid conditions including anxiety, depression, insomnia and stress. A range of cannabinoid products were prescribed with the most common products being classified as high THC flower (48.5%). The majority of patients also reported using at least one other prescribed medication (68.7%).ConclusionsConsistent with findings in other national and international databases, chronic pain was the most common primary condition in this real world study of prescribed cannabinoids. There was considerable variation in the types of chronic pain, comorbid pathology and in the characteristics of products being prescribed to treat these conditions. Together, this evidence supports the utility of real world evidence, as opposed to clinical trial approaches to studying the potential benefits of prescribed cannabinoids in treating chronic pain.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 55%

Characteristics of People Seeking Prescribed Cannabinoids for the Treatment of Chronic Pain: Evidence From Project Twenty 21

Schlag

Lynskey²,

Fayaz

et al. 2022

Front. Pain Res.

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“…Clinicopathological information, comorbidities, drug and alcohol history and medication details are inputted into the registry prospectively by clinical staff. Data on cannabis use status was also collected, and for those who had previously or were presently taking non-prescription cannabis, a novel metric of “gram years” was calculated as previously described by our group (Erridge et al, 2021 ). Pseudonymised clinical data on patient-reported outcome measures (PROMs) and adverse events were collected.…”

Section: Methodsmentioning

confidence: 99%

UK Medical Cannabis Registry palliative care patients cohort: initial experience and outcomes

et al. 2022

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Introduction Palliative care aims to improve quality of life through optimal symptom control and pain management. Cannabis-based medicinal products (CBMPs) have a proven role in the treatment of chemotherapy-induced nausea and vomiting. However, there is a paucity of high-quality evidence with regards to the optimal therapeutic regimen, safety, and effectiveness of CBMPs in palliative care, as existing clinical trials are limited by methodological heterogeneity. The aim of this study is to summarise the outcomes of the initial subgroup of patients from the UK Medical Cannabis Registry who were prescribed CBMPs for a primary indication of palliative care, cancer pain and chemotherapy-induced nausea and vomiting, including effects on health-related quality of life and clinical safety. Methods A case series from the UK Medical Cannabis Registry of patients, who were receiving CBMPs for the indication of palliative care was undertaken. The primary outcome consisted of changes in patient-reported outcome measures including EQ-5D-5L, General Anxiety Disorder-7 (GAD-7), Single-Item Sleep Quality Scale (SQS), Pain Visual Analog Scale (VAS) and the Australia-Modified Karnofsky Performance Scale at 1 and 3 months compared to baseline. Secondary outcomes included the incidence and characteristics of adverse events. Statistical significance was defined by p-value< 0.050. Results Sixteen patients were included in the analysis, with a mean age of 63.25 years. Patients were predominantly prescribed CBMPs for cancer-related palliative care (n = 15, 94%). The median initial CBD and THC daily doses were 32.0 mg (Range: 20.0–384.0 mg) and 1.3 mg (Range: 1.0–16.0 mg) respectively. Improvements in patient reported health outcomes were observed according to SQS, EQ-5D-5L mobility, pain and discomfort, and anxiety and depression subdomains, EQ-5D-5L index, EQ-VAS and Pain VAS validated scales at both 1-month and 3-months, however, the changes were not statistically significant. Three adverse events (18.75%) were reported, all of which were either mild or moderate in severity. Conclusion This small study provides an exploratory analysis of the role of CBMPs in palliative care in the first cohort of patients since CBMPs legalisation in the UK. CBMPs were tolerated with few adverse events, all of which were mild or moderate and resolved spontaneously. Further long-term safety and efficacy studies involving larger cohorts are needed to establish CBMPs role in palliative care, including comparisons with standard treatments.

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“…For those who had previously or were presently taking nonprescription cannabis, a novel metric of “gram years” was calculated as previously described by our group. 42 All CBMP prescriptions were recorded and analyzed, including company, formulation, method of administration, CBD concentration, THC concentration, and strain.…”

Section: Methodsmentioning

confidence: 99%

“…The UK Medical Cannabis Registry, set up in 2019, captures longitudinal data of patients prescribed CBMPs in the United Kingdom outside of the National Health Service (NHS) and has published outcomes related to health‐related quality of life (HRQoL) across all conditions. 42 Following legalization of medical cannabis in the United Kingdom in 2019, many doctors have preferred sublingual oil as a mode of administration of CBMPs. This study aims to investigate the safety and clinical outcomes of patients with chronic pain enrolled in the UK Medical Cannabis Registry who were treated with cannabis‐based medium‐chain triglyceride oils (Adven, Curaleaf International, Guernsey, UK).…”

mentioning

confidence: 99%

Clinical Outcome Data of First Cohort of Chronic Pain Patients Treated With Cannabis‐Based Sublingual Oils in the United Kingdom: Analysis From the UK Medical Cannabis Registry

Kawka

Erridge

Holvey

et al. 2021

The Journal of Clinical Pharma

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Cannabis‐based medicinal products (CBMPs) are an emerging therapeutic option in the management of primary chronic pain, using the role of the endocannabinoid system in modulating central and peripheral pain processes. Despite promising preclinical data, there is a paucity of high‐quality evidence to support the use of CBMPs for chronic pain. This study aimed to investigate the health‐related quality‐of‐life outcomes of patients with chronic pain who were prescribed CBMP oil preparations (Adven, Curaleaf International, Guernsey, UK). This study is a case series of patients from the UK Medical Cannabis Registry, who were treated with CBMP oils for an indication of chronic pain. The primary outcomes were the changes in Brief Pain Inventory short form, Short‐Form McGill Pain Questionnaire‐2, Visual Analog Scale Pain, General Anxiety Disorder‐7, Sleep Quality Scale, and EQ‐5D‐5L, at 1, 3, and 6 months. One hundred ten patients were included. Significant improvements in Sleep Quality Scale, EQ‐5D‐5L pain and discomfort subscale, and Brief Pain Inventory Interference Subscale (P < .05) at 1, 3, and 6 months were demonstrated. There were no notable differences between cannabis‐naïve and previous cannabis users in quality‐of‐life outcomes. The adverse event incidence was 30.0%, with most (n = 58; 92.1%) adverse events being mild or moderate in intensity. Treatment of chronic pain with Adven CBMP oils was associated with an improvement in pain‐specific outcomes, health‐related quality of life, and self‐reported sleep quality. Relative safety was demonstrated over medium‐term prescribed use. While these findings must be treated with caution considering the limitations of study design, they can inform future clinical trials.

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An initial analysis of the UK Medical Cannabis Registry: Outcomes analysis of first 129 patients

Cited by 37 publications

References 39 publications

Characteristics of People Seeking Prescribed Cannabinoids for the Treatment of Chronic Pain: Evidence From Project Twenty 21

Characteristics of People Seeking Prescribed Cannabinoids for the Treatment of Chronic Pain: Evidence From Project Twenty 21

UK Medical Cannabis Registry palliative care patients cohort: initial experience and outcomes

Clinical Outcome Data of First Cohort of Chronic Pain Patients Treated With Cannabis‐Based Sublingual Oils in the United Kingdom: Analysis From the UK Medical Cannabis Registry

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