Tuesday, 12 Nov 2019

You are here

Arthritis Foundation Releases First CBD Guidance for Adults With Arthritis

As the leading organization for people with arthritis, the Arthritis Foundation has just released the first CBD guidance for adults with arthritis. CBD, or cannabidiol, a plant-based compound, has become popular among people with arthritis seeking to ease chronic joint pain. With no federal oversight of CBD products, a lack of scientific evidence for safety or effectiveness, and even uncertainty about its legality, there has been vast confusion for patients with arthritis and health care providers too. 

“While CBD is controversial and its effectiveness inconclusive, people with arthritis aren’t waiting to try it to treat their pain,” said Cindy McDaniel, Arthritis Foundation senior vice president of consumer health and impact. “To help gain a deeper understanding about how people with arthritis feel about using CBD, we conducted a national survey in July. Our survey results confirmed the need to push for more regulation and provide useful CBD guidance.”  

Of the 2,600 people who responded to the survey*, 79% are currently using CBD, have used it in the past or are considering using it as an alternative therapy to help manage their arthritis pain.  

To develop the CBD guidance for adults with arthritis, the Arthritis Foundation partnered with leading CBD and arthritis pain experts – Daniel Clauw, MD, Mary Ann Fitzcharles, MD, and Kevin Boehnke, PhD – to develop practical guidance that addresses top questions. 

“Millions of people in the U.S. are likely trying to use cannabinoids to treat pain, and many are doing this in ways that might cause more harm than good, especially when they use high doses of THC,” said Daniel Clauw, MD, a professor of anesthesiology, rheumatology and psychiatry at the University of Michigan and director of the Chronic Pain and Fatigue Research Center. (CBD is one of the more than 100 cannabinoids, or active compounds, in cannabis. THC, another compound, is the chemical in marijuana that gets users high. CBD is not intoxicating.) 

“It’s important that the Arthritis Foundation has taken a stand on CBD,” Dr. Clauw said. “Right now, it appears to be fairly safe and might help certain types of pain. It’s far better to give this guidance, even if preliminary, because otherwise people will have no guidance whatsoever.”    

The Arthritis Foundation also sent a formal comment to the U.S. Food and Drug Administration (FDA) in July urging the agency to expedite the study and regulation of CBD products to help make them a safe option for the 54 million people with arthritis.   

The official statement from the Arthritis Foundation reads:   

As the largest organization representing the voice and needs of people with arthritis, the Arthritis Foundation has always welcomed new treatment options because no single drug, supplement or therapy works for everyone. We believe patients should be empowered to find safe management strategies that are appropriate for them. The more options available, the likelier it is that more people will benefit.   

We are intrigued by the potential of CBD to help people find pain relief and are on record urging the FDA to expedite the study and regulation of these products. While currently there is limited scientific evidence about CBD’s ability to help ease arthritis symptoms, and no universal quality standards or regulations exist, we have listened to our constituents and consulted with leading experts** to develop these general recommendations for adults who are interested in trying CBD.  

“Listening to people with arthritis – using data (surveys and Live Yes! INSIGHTS), patient listening sessions and testimonies – drives our work, from science to programming to setting our advocacy agenda,” said the Arthritis Foundation’s McDaniel.   

The Arthritis Foundation continues to ask people with arthritis to raise their voice and share their day-to-day experiences via Live Yes! INSIGHTS, so the organization can continue to break down barriers to care, accelerate research and tailor local and national programs that fit the needs of people with arthritis.   

“The Arthritis Foundation values the patient voice,” said Stacy Courtnay, rheumatoid arthritis patient and a member of the Arthritis Foundation Patient Leadership Council. “Some doctors aren’t open to discussing CBD with patients, and it’s fantastic and encouraging that the Arthritis Foundation is helping people with arthritis gain access to whatever treatments might help them.”   

While there are no established clinical guidelines for CBD use, the medical experts who worked in partnership with the Arthritis Foundation agree on the following points: 

  • CBD may help with arthritis-related symptoms, such as pain, insomnia and anxiety, but there have been no rigorous clinical studies in people with arthritis to confirm this.   
  • While no major safety issues have been found with CBD when taken in moderate doses, potential drug interactions have been identified.  
  • CBD should never be used to replace disease-modifying drugs that help prevent permanent joint damage in inflammatory types of arthritis.  
  • CBD use should be discussed with your doctor in advance, with follow-up evaluations every three months or so, as would be done for any new treatment.  

There are no established clinical guidelines to inform usage. Experts recommend starting with a low dose, and if relief is inadequate, increase in small increments weekly.   

Buy from a reputable company that has each batch tested for purity, potency and safety by an independent laboratory and provides a certificate of analysis.  

Beyond providing CBD guidance for people with arthritis, the Arthritis Foundation has a track record for bringing important issues that people with arthritis face into the public dialogue, including authoring the Osteoarthritis (OA) Voice of the Patient Report that presented treatment options most important to patients with OA and helped influence the FDA’s updated osteoarthritis research and treatment guidance and legislation calling for transparency at the pharmacy counter. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Frequent DMARD Discontinuations During Rheumatoid Pregnancies

A Canadian population-based study shows that pregnant women with rheumatoid arthritis (RA) frequently discontinue their DMARD medications, especially in the first trimester.

An administrative data study looked at women with RA with a singleton pregnancy who were studied for utilization of RA medications, including conventional synthetic DMARDs, biologics, glucocorticosteroids and NSAIDs.

Methotrexate and the Risk of Lung Disease

Rheumatology has a comprehensive overview of methotrexate (MTX) and the risk of lung injury, MTX-related pneumonitis and interstitial lung disease (RA-ILD) with rheumatoid arthritis (RA). Past reports suggest the frequence of MTX-pneumonitis to be between 0.3 and 11.6%; recent studies suggest it may be much lower.

Common Physician HIPAA Violations

A nice review by Physician Sense and MDLinx discusses potential physician violations of current HIPAA law, largely driven by the digital age and common work flows. Several mistakes you you be aware of and avoid, include:

Forwarding PHI to a personal email account

FDA Issues Boxed Warning and Recommendations for Breast Implant Use

The U.S. Food and Drug Administration has issued a new draft guidance document calling for a boxed warning and delineation of risks with breast implants.

Voluntary Recall of Zantac by Sanofi/FDA

Sanofi has initiated a voluntary recall of all Zantac OTC (over-the-counter) products in the United States. This includes Zantac 150®, Zantac 150® Cool Mint, and Zantac 75®. Zantac tablets are an oral, over-the-counter product to prevent and relieve heartburn associated with acid ingestion and sour stomach.