PubMed Central, : RMMJ Rambam Maimonides Medical Journal Rambam Health Care Campus 2023 October; 14(4): e0022. ISSN: 2076-9172Published online 2023 October 29. doi: 10.5041/RMMJ.10509

Table 3.

Clinical Trials on Pain.

Reference Research Goal Study Design Intervention Participants n (F/M) Cannabis Application Tx Duration Efficacy
Notcutt et al. (2004)48 Comparison of three CBME variants Randomized, double-blind, placebo-controlled crossover trial THC, CBD, THC+CBD, placebo n=34 Sublingual spray 12 weeks Highest efficacy of THC-based cannabis shown in pain regulation with only very mild side effects
Blake et al. (2006)49 Effectiveness of the CBME Sativex® on pain and morning stiffness Randomized, double-blind, parallel-group trial Sativex®, THC-based CBME
McGill questionnaire		 n=58:
31 CBME
27 placebo		 Oromucosal spray 5 weeks
  • - Improvement in pain on movement and rest but no change in morning stiffness
  • - No side effects or withdrawal signs
Wilsey et al. (2013)50 Short-term effects of CBME for neuropathic pain Randomized, double-blind, placebo-controlled, crossover study THC-based
Medium dose (3.53%); low dose (1.29%)
Placebo		 n=35 Vaporizer
3–6 inhalations		 300 min
  • - Cannabis had similar effects to conventional painkillers
  • - Mild reversible psychoactive effects of limited duration
van de Donk et al. (2019)51 Comparison of four cannabis variants with known THC and CBD content Randomized, placebo-controlled 4-way crossover study Bedrocan* (22.4 mg THC, <1 mg CBD); Bediol* (13.4 mg THC, 17.8 mg CBD); Bedrolite* (18.4 mg CBD, <1 mg THC) n=20 fibromyalgia patients Vaporizer
One single inhalation		 3 hours
  • - No effect of treatments on spontaneous or electrical pain responses except 30% pain reduction in patients receiving Bediol
  • - THC-containing varieties attained significant pressure pain reduction
  • - Increment of THC plasma concentrations by CBD-containing varieties, but THC-induced analgesic effects were diminished
Haleem and Wright (2020)52 Effect of herbal cannabis and CBMEs on pain Scoping review Herbal cannabis and CBMEs 34 studies (30 RCTs, 4 non-RCTs) Diverse Diverse
  • - More promising results obtained from non-RCTs than from RCTs
  • - Most promising results obtained for pain treatment as adjuvant therapy in refractory multiple sclerosis and rheumatoid pain
* Manufactured by Bedrocan International BV, Veendam, the Netherlands.

CBD, cannabidiol; CBME, cannabis-based medicinal extract; RCT(s), randomized controlled trial(s); THC, tetrahydrocannabinol.

RMMJ Rambam Maimonides Medical Journal Rambam Health Care Campus 2023 October; 14(4): e0022. ISSN: 2076-9172
Published online 2023 October 29. doi: 10.5041/RMMJ.10509
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