Cannabis-Containing Cream for CKD-Associated Pruritus: A Double-Blind, Placebo Controlled Trial

IF 3.2 Q1 UROLOGY & NEPHROLOGY
Suthiya Anumas , Pranporn Kuropakornpong , Panlop Chakkavittumrong , Adis Tasanarong , Pattharawin Pattharanitima
{"title":"Cannabis-Containing Cream for CKD-Associated Pruritus: A Double-Blind, Placebo Controlled Trial","authors":"Suthiya Anumas ,&nbsp;Pranporn Kuropakornpong ,&nbsp;Panlop Chakkavittumrong ,&nbsp;Adis Tasanarong ,&nbsp;Pattharawin Pattharanitima","doi":"10.1016/j.xkme.2024.100894","DOIUrl":null,"url":null,"abstract":"<div><h3>Rationale &amp; Objective</h3><p>This study aims to compare the efficacy of a cannabis cream and a placebo in the treatment of chronic kidney disease (CKD)-associated pruritus.</p></div><div><h3>Study Design</h3><p>A double-blind randomized controlled study.</p></div><div><h3>Setting &amp; Participants</h3><p>Sixty hemodialysis patients with the worst itching intensity numerical rating scale (WI-NRS) ≥3.</p></div><div><h3>Exposure</h3><p>Patients received cannabis cream or placebo.</p></div><div><h3>Outcomes</h3><p>The primary endpoint was the WI-NRS score at week 4. The secondary endpoints included the WI-NRS at week 2, the Skindex-10 score at weeks 2 and 4, and the mean difference score between baseline and week 4 for the WI-NRS and the Skindex-10 score.</p></div><div><h3>Analytical Approach</h3><p>We used unpaired t tests or Mann Whitney U tests, along with χ<sup>2</sup> or Fisher exact tests as appropriate. The adjusted mean differences were determined using ANCOVA, adjusting for baseline scores.</p></div><div><h3>Results</h3><p>Among 60 participants, the mean age was 61.6<!--> <!-->±<!--> <!-->14.4 years and the mean baseline WI-NRS was 6.7<!--> <!-->±<!--> <!-->1.7. The placebo and cannabis cream groups were similar at baseline, although more individuals in the placebo group had diabetes. At 4 weeks, the WI-NRS dropped to 2.6 in the cannabis group and 3.6 in the placebo group (the mean difference after adjustment for baseline scores:−1.1, 95% CI, −2.1 to<!--> <!-->−0.2; <em>P</em> <!-->=<!--> <!-->0.02). Skindex-10 scores at week 4 were also lower in the cannabis group, but after adjustment for baseline scores, statistical significance was not maintained. No side effects were observed in either group.</p></div><div><h3>Limitations</h3><p>A single study with a small sample size restricts its generalizability. Variances in participants’ diabetes statuses might have affected the itch outcomes. The absence of cannabinoid level assessment in blood prevents conclusive determination of the potential systemic impacts. A 4-week follow-up period inadequately captures long-term effect.</p></div><div><h3>Conclusions</h3><p>In CKD-associated pruritus, the topical cream containing cannabis significantly reduced the severity of itching symptoms compared to the placebo.</p></div><div><h3>Trial Registration</h3><p><span><span>clinicaltrials.gov</span><svg><path></path></svg></span> Identifier: <span><span>NCT06159686</span><svg><path></path></svg></span></p></div><div><h3>Plain Language Summary</h3><p>Chronic kidney disease (CKD)-associated pruritus presents a significant burden to hemodialysis patients, with current medications often falling short in alleviating symptoms. Cannabinoids, with their anti-inflammatory, antioxidative, and peripheral nerve activation reduction properties, hold promise in treating CKD-associated pruritus. Especially when applied topically, cannabinoids could provide moisturized skin along with their other effects. We analyzed the efficacy of cannabis cream compared to a placebo, demonstrating that the cannabis cream could improve the severity of itch, as reported by the WI-NRS score at the end of the fourth week of treatment. This innovative therapeutic approach has the potential to pave the way for new drugs aimed at effectively treating CKD-associated pruritus, ultimately reducing symptom severity, and potentially enhancing patients’ quality of life.</p></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524001055/pdfft?md5=9ebd8c183076a7f011c19ee48f1febdc&pid=1-s2.0-S2590059524001055-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590059524001055","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Rationale & Objective

This study aims to compare the efficacy of a cannabis cream and a placebo in the treatment of chronic kidney disease (CKD)-associated pruritus.

Study Design

A double-blind randomized controlled study.

Setting & Participants

Sixty hemodialysis patients with the worst itching intensity numerical rating scale (WI-NRS) ≥3.

Exposure

Patients received cannabis cream or placebo.

Outcomes

The primary endpoint was the WI-NRS score at week 4. The secondary endpoints included the WI-NRS at week 2, the Skindex-10 score at weeks 2 and 4, and the mean difference score between baseline and week 4 for the WI-NRS and the Skindex-10 score.

Analytical Approach

We used unpaired t tests or Mann Whitney U tests, along with χ2 or Fisher exact tests as appropriate. The adjusted mean differences were determined using ANCOVA, adjusting for baseline scores.

Results

Among 60 participants, the mean age was 61.6 ± 14.4 years and the mean baseline WI-NRS was 6.7 ± 1.7. The placebo and cannabis cream groups were similar at baseline, although more individuals in the placebo group had diabetes. At 4 weeks, the WI-NRS dropped to 2.6 in the cannabis group and 3.6 in the placebo group (the mean difference after adjustment for baseline scores:−1.1, 95% CI, −2.1 to −0.2; P = 0.02). Skindex-10 scores at week 4 were also lower in the cannabis group, but after adjustment for baseline scores, statistical significance was not maintained. No side effects were observed in either group.

Limitations

A single study with a small sample size restricts its generalizability. Variances in participants’ diabetes statuses might have affected the itch outcomes. The absence of cannabinoid level assessment in blood prevents conclusive determination of the potential systemic impacts. A 4-week follow-up period inadequately captures long-term effect.

Conclusions

In CKD-associated pruritus, the topical cream containing cannabis significantly reduced the severity of itching symptoms compared to the placebo.

Trial Registration

clinicaltrials.gov Identifier: NCT06159686

Plain Language Summary

Chronic kidney disease (CKD)-associated pruritus presents a significant burden to hemodialysis patients, with current medications often falling short in alleviating symptoms. Cannabinoids, with their anti-inflammatory, antioxidative, and peripheral nerve activation reduction properties, hold promise in treating CKD-associated pruritus. Especially when applied topically, cannabinoids could provide moisturized skin along with their other effects. We analyzed the efficacy of cannabis cream compared to a placebo, demonstrating that the cannabis cream could improve the severity of itch, as reported by the WI-NRS score at the end of the fourth week of treatment. This innovative therapeutic approach has the potential to pave the way for new drugs aimed at effectively treating CKD-associated pruritus, ultimately reducing symptom severity, and potentially enhancing patients’ quality of life.

治疗慢性肾脏病相关性瘙痒的含大麻药膏:双盲安慰剂对照试验
本研究旨在比较大麻膏和安慰剂在治疗慢性肾病 (CKD) 相关瘙痒症方面的疗效。研究设计双盲随机对照研究。次要终点包括第 2 周的 WI-NRS、第 2 周和第 4 周的 Skindex-10 评分,以及 WI-NRS 和 Skindex-10 评分在基线和第 4 周之间的平均差异。结果在 60 名参与者中,平均年龄为 61.6 ± 14.4 岁,平均基线 WI-NRS 为 6.7 ± 1.7。安慰剂组和大麻膏组的基线相似,但安慰剂组中有更多人患有糖尿病。4 周后,大麻组的 WI-NRS 降至 2.6,安慰剂组降至 3.6(调整基线分数后的平均差异:-1.1,95% CI,-2.1 至 -0.2;P = 0.02)。大麻组在第 4 周的 Skindex-10 评分也较低,但在对基线评分进行调整后,统计学意义并未保持。两组均未观察到副作用。参与者糖尿病状况的差异可能会影响瘙痒的结果。由于没有对血液中的大麻素水平进行评估,因此无法对潜在的系统性影响做出定论。结论与安慰剂相比,在慢性肾功能衰竭相关性瘙痒症中,含有大麻成分的外用药膏能显著减轻瘙痒症状的严重程度:NCT06159686白皮书摘要慢性肾脏病(CKD)相关瘙痒症给血液透析患者带来了沉重的负担,目前的药物往往无法缓解症状。大麻素具有抗炎、抗氧化和减少外周神经激活的特性,有望治疗慢性肾病相关性瘙痒症。尤其是在局部使用时,大麻素在发挥其他功效的同时还能滋润皮肤。我们分析了大麻膏与安慰剂相比的疗效,结果表明大麻膏可以改善瘙痒的严重程度,正如治疗第四周结束时的 WI-NRS 评分所报告的那样。这种创新的治疗方法有望为有效治疗慢性肾功能衰竭相关瘙痒症的新药铺平道路,最终减轻症状的严重程度,并有可能提高患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Kidney Medicine
Kidney Medicine Medicine-Internal Medicine
CiteScore
4.80
自引率
5.10%
发文量
176
审稿时长
12 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信