Rheumatoid Arthritis – Cannabis Research

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CannaKeys has 81 studies associated with Rheumatoid Arthritis.

Here is a small sampling of Rheumatoid Arthritis studies by title:

Components of the Rheumatoid Arthritis Research Dashboard

  • Dosing information available for Rheumatoid Arthritis
  • Chemotype guidance for treating Rheumatoid Arthritis with cannabis
  • Synopsis of cannabis research for Rheumatoid Arthritis
  • Individual study details for Rheumatoid Arthritis

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Overview - Rheumatoid Arthritis

Description of Rheumatoid Arthritis

Rheumatoid arthritis (RA) is the most crippling form of arthritis, deforming joints and bending bodies over time. It typically causes pain, swelling, and stiffness in symmetric joints in the early stages.

RA is considered a systemic autoimmune disorder. Early diagnosis using multiple approaches like clinical exams, imaging, and biomarkers is essential because starting traditional medications like disease-modifying antirheumatic drugs (DMARDs) in the beginning can help mitigate worsening complications and permanent joint damage, such as:

  • Chronic pain

  • Swelling around the joints

  • Trouble balancing

  • Joint deformity

  • Loss of cartilage

  • Bone erosion

  • In late-stage, fatal cardiac events

According to orthodox medicine, RA occurs when the immune system malfunctions and attacks healthy parts of the body, especially the synovium (i.e., the lining of the membranes surrounding the joints).

More specifically, RA is posited to be an immune system-mediated chronic inflammatory disease associated with a complex underlying pathology involving a significant number of specific tissues/cell types, such as osteoclasts, fibroblast-like synoviocytes, T cells, B cells, and macrophages. Various inflammatory cytokines, such as interleukin-1β, interleukin-6, tumor necrosis factor-α, and chemokines, are also involved.

However, its precise causes are poorly understood and still subject to scientific inquiry. Because of this, RA can frequently flare and go into remission spontaneously, with or without known causes.

Associated risk factors for developing RA include:

  • Smoking

  • Early life exposure to second-hand smoke

  • Age: most risk around ages 50-59

  • Biologically female sex

  • Nulliparity Family history of RA HLA class II gene inheritance

  • Families with lower income

Disease Classification

Condition: Arthritis - Rheumatoid
Disease Family: Autoimmune Disorder
Organ System: Skeletal System
ICD-10 Chapter: Diseases of the Musculoskeletal System and Connective Tissue
ICD-10 Code: M05-M06

Rheumatoid Arthritis Symptoms:

Swollen joints (e.g., painful, feeling hot, symmetric), generalized weakness, fever. RA can also progress to affect organs (e.g., CAD and the heart, pleuritis, bronchiolitis, interstitial lung disease, skin, lymphoproliferative disorders, and cancers like NHL)

Also known as:

Rheumatoid Arthritis, RA, rheumatoid arthritis with rheumatoid factor, rheumatoid arthritis without rheumatoid factor, rheumatoid myopathy, juvenile rheumatoid arthritis, Rheumatoid polyneuropathy with rheumatoid arthritis, Rheumatoid myopathy with rheumatoid arthritis, Rheumatoid vasculitis

Drug Interactions

THC Interaction with Pharmaceutical Drugs

  • Tetrahydrocannabinol (THC) can enhance the effects of drugs that cause sedation and depress the central nervous system, such as benzodiazepines, barbiturates, and alcohol. 
  • THC is metabolized by an inhibitor of several enzymatic liver pathways referred to as cytochrome P450 (aka CYP450). There are more than 50 enzymes belonging to this enzyme family, several of which are responsible for the breakdown of common drugs such as antidepressants (e.g., amitriptyline, doxepin, fluvoxamine), antipsychotics (haloperidol, clozapine, Stelazine), beta-blockers (e.g., propranolol), bronchodilators (e.g., theophylline), or blood thinners (e.g., warfarin). Thus, patients taking these medication classes may find that THC increases the concentration and effects of these drugs and the impact duration.
  • Clinical observation (not yet confirmed by clinical trials) suggests no likely interactions with other pharmaceuticals at a total daily dose of up to 20mg THC.

If you are interested in the interaction potential of specific pharmaceuticals with THC, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

CBD Interaction with Pharmaceutical Drugs

  • Cannabidiol (CBD) may alter the action of metabolic enzymes (specific drug-transport mechanisms) and alter interactions with other drugs, some of which may produce therapeutic or adverse effects. For instance, CBD interacts with the enzyme cytochrome P450 3A4 and cytochrome P450 2C19, increasing the bioavailability of anti-epileptic drugs such as clobazam (a benzodiazepine). This makes it possible to achieve the same results at significantly lower dosages, reducing treatment costs and risks of adverse effects. 
  • Groups of drugs affected include anti-epileptics, psychiatric drugs, and drugs affecting metabolic enzymes.
  • Clinical observations (not yet confirmed by clinical trials) suggest no likely interactions with other pharmaceuticals at a total daily dose of up to 100mg CBD.

If you are interested in the interaction potential of specific pharmaceuticals with CBD, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

THC/CBD Interaction with Pharmaceutical Drugs

In general, when using cannabinoid-based therapeutics that contain both THC and CBD consider the ratio between them and weigh the relevant information displayed in the individual THC and CBD Drug Interaction windows accordingly.

If you are interested in the interaction potential of specific pharmaceuticals with both primary cannabinoids and THC/CBD, consider visiting these free drug interaction checkers: Drugs.com or DrugBank Online.

Concerns about Cannabis and Cancer-related Immunotherapies:
Some recent clinical observational studies have suggested that the co-administration of cannabinoid-based therapeutics and immunotherapy or immune checkpoint inhibitors in the treatment of certain types of cancer has been associated with worse overall survival rates (T. Taha et al., 2019; A. Biedny et al., 2020; G. Bar-Sela et al., 2020).

However, other studies have suggested that the co-commitment use of immune checkpoint inhibitors and cannabis-induced no such deleterious effects. More specifically, one trial was conducted on animals resulting in data suggesting that cannabis did not negatively affect the properties of immune checkpoint inhibitors (B. Waissengrin et al., 2023). The same authors compared the previous study results with findings from a cohort of 201 patients with metastatic non-small cell lung cancer who received treatment with monotherapy pembrolizumab as a first-line treatment and adjunct cannabis to treat mainly pain and loss of appetite. Their time to tumor progression was 6.1 versus 5.6 months, and overall survival differed between 54.9 versus 23.6 months in cannabis-naïve patients and cannabis-using patients, respectively. However, while numerically different, the authors write that these differences were not statistically significant, leading them to suggest that “These data provide reassurance regarding the absence of a deleterious effect of cannabis in this clinical setting.”

Dosing Considerations

THC Dosage Considerations

  • THC micro dose:  0.1 mg to 0.4 mg
  • THC low dose:  0.5 mg to 5 mg
  • THC medium dose:  6 mg to 20 mg
  • THC high dose:  21 mg to 50+ mg

CBD Dosage Considerations

  • CBD low dose:  0.4 mg to 19 mg
  • CBD medium dose: 20 mg to 99 mg
  • CBD high dose:  100 mg to 800+ mg (upper limits tested ~1,500mg)

Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own licensed physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease. If using a product, you should read carefully all product packaging. If you have or suspect that you have a medical problem, promptly contact your health care provider.

Information on this site is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your physician, nutritionally oriented health care practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.