Dr Jubb said: "The results from the first controlled study of CBM in rheumatoid arthritis are encouraging, with overall improvements in pain on movement and at rest, improvement in the quality of sleep and improvement in the overall condition of the patients' arthritis. Whilst the differences are small and variable across the patient group, they represent benefits of clinical relevance and indicate the need for more detailed investigation through larger trials to see exactly where CBM could be best used with minimum side effects."
If further trials are run, researchers will probably extend the dosing period over the full 24-hour period. Dr Robson said: "The beneficial effects in this study occurred in the context of a dosing regime restricted to evening dosing in order to minimise any possible intoxication-type reactions. However, 24-hour dosing with Sativex, using a self-titration regime, in trials for multiple sclerosis resulted in only minimal intoxication scores."
He continued: "The element that can cause the 'high' in cannabis THC also has valuable pharmacological activity. It is thought to be an essential therapeutic component and therefore it can't be removed from the medicine. However, the method of giving the doses, via the mouth spray, and the principle of self-titration, where each patient gradually determined their own optimal dose level up to a maximum of six doses a day, minimised the risk of intoxication."
Dr Robson said that fears that the CBM could be abused by patients hoping to get a "high" were probably unfounded. "It seems that in practice this is a very rare event. More than 1,000-patient years of treatment with Sa
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Contact: Emma Mason
wordmason@mac.com
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Oxford University Press
8-Nov-2005