People living with hypermobility disorders such as Ehlers-Danlos syndrome (hEDS) experienced sustained improvements in symptoms after being prescribed cannabis-based medicines, according to a study published in Clinical Rheumatology.
The study analysed patient-reported outcome measures from 240 UK-based hEDS patients over 24 months, making it the largest and longest-duration observational study of medical cannabis therapy specifically for hypermobility spectrum disorders and Ehlers-Danlos syndrome to date.
Researchers used data supplied by patients registered on the UK Medical Cannabis Registry (UKMCR), the largest patient registry in Europe that collects real-world data on patient outcomes and cannabis treatment. Patient health was monitored using standardised tests including the Brief Pain Inventory (BPI) and the Pain Visual Analogue Scale (VAS). Participants were asked to complete these questionnaires at the beginning of the study and at several regular intervals during the 24 months.
The results showed that patients experienced positive changes in all of the reported outcome measures, including sleep, pain, and anxiety, and that approximately 60% of the cohort achieved clinically significant levels of pain reduction. Opioid use was also shown to reduce after 12 months and continued to decline at all subsequent follow-ups.
Hypermobility disorders are hereditary connective tissue disorders characterised by chronic pain, gastrointestinal issues, joint hypermobility – being “double-jointed” – and an increased risk of dislocations.
Despite an estimated 20-30% of Brits being classed as hypermobile, hEDS is a rare disorder which is thought to affect only 0.2% of the population.
Due to the lack of treatment options for patients, and mounting clinical evidence demonstrating how the body’s endocannabinoid system is involved in the modulation of pain, researchers felt there was a sufficient reason to investigate how cannabis can be used to treat patients living with hEDS and other hypermobility disorders.
Researchers identified improvements across patient outcomes in all of the measures, including pain, anxiety, and sleep outcomes, and boosted health-related quality of life. Participants were shown to experience sustained improvements at all of the follow-up appointments spanning 24 months, and approximately 60% achieved a clinically significant level of improvement in their pain.
Opioid use was shown to reduce after 12 months, and continued to be reduced at all subsequent follow-ups.
“This study provides a 24-month real-world evaluation of cannabis-based medicinal products in patients with hypermobility-associated chronic pain. It demonstrates long-term sustained improvement in pain, anxiety and sleep-related outcomes, underpinning health-related quality of life. Despite its observational design, the study provides important insight into potentially addressing an area of significantly unmet therapeutic need,” the study said.
However, the researchers cautioned against indiscriminate prescription. “These findings should not be interpreted as advocating for indiscriminate prescription of cannabis-based medicinal products in hypermobility-associated chronic pain. Age over 50 years was associated with greater odds of adverse events and merits closer post-prescription monitoring, particularly for somnolence, fatigue, and orthostatic symptoms. Future randomised controlled trials will be necessary to evaluate the efficacy of cannabis-based medicinal products to determine their future utilisation, without the inherent limitations of observational studies.”
