Effective cannabidiol treatment for arthritic thumb basal joint pain, disability

According to the results of the study published in The Journal of Hand Surgery.

The researchers sought to explore the therapeutic potential of CBD for the treatment of pain associated with basal joint arthritis of the thumb. The phase 2, single-center, double-blind, randomized study (ClinicalTrials.gov identifier: NCT04611347) was conducted in people recruited from a hand surgery clinic at the University of Virginia.

A phase 1 skin test was initially performed in 10 healthy control participants, who were monitored for 1 week after twice daily application of 1 mL of topical CBD (6.2 mg/mL) with butter of shea. Since no AEs were identified, the researchers pursued a phase 2 trial, in which a total of 18 participants with symptomatic basal arthritis of the thumb were randomized to receive 2 weeks of twice-daily treatment with CBD (6.2 mg/mL) with shea butter or only shea butter. This was followed by a 1 week washout period and then a 2 week transition period with the other treatment. Physical examination measurements and safety data were obtained at baseline and after the end of each treatment arm.


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The average age of the participants was 64.2 years. The mean Charlson Comorbidity Index score was 2.3 (range 0 to 31, with a lower score predictive of increased 10-year survival). Of the 18 participants, 10 were non-smokers, 5 were former smokers, and 3 were current smokers. Overall, 10 of the participants reported a history of corticosteroid injections into the basal thumb joint, although none had received an injection within 3 months prior to study enrollment.

No AEs were reported for mean heart rate, blood pressure, Columbia Suicide Severity Rating Scale scores, laboratory tests, skin changes, or patient-reported side effects . CBD treatment was associated with significant improvements in visual analog scale (VAS) pain score, arm, shoulder, and hand disability score (DASH), and assessment scores unique number (SANE) compared to the control group (P <.05 for all>

Mean VAS pain scores (range 0-10, with a lower score indicating less pain) were 5 at baseline, 5 with control cream (0% reduction), and 2 with cream at baseline. CBD (60% decrease; P <.05 mean dash scores with lower score indicating less disability were at baseline control cream decrease and cbd>P =.05). Mean SANE scores (range 0-100, with a higher score indicating greater overall well-being) were 67.5 at baseline, 67.5 with control cream (0% increase) and 78.5 with CBD Cream (16% increase; P =.05).

CBD treatment was associated with improved upper extremity scores (range 0-100, with higher score indicating greater function), with scores of 39 at baseline, 38 with control cream (3% decrease), and 42 with the CBD cream (8% increase). This difference, however, was not statistically significant. Similar parameters were reported across the groups for range of motion, grip, and pinch strength.

A major limitation of the study included the fact that the co-interventions used among participants (i.e. confounding variables. Additional limitations included small sample size and short duration of treatment.

The study authors concluded, “Larger, multicenter clinical trials are warranted to further investigate the safety, therapeutic potential, and dose-response of CBD for musculoskeletal pain.”

Disclosure: None of the study authors declared any affiliation with any biotechnology, pharmaceutical and/or device companies.

Reference

Heineman JT, Forster GL, Stephens KL, Cottler PS, Timko MP, DeGeorge BR Jr. A randomized controlled trial of topical cannabidiol for the treatment of basal joint arthritis of the thumb. J Hand Surg Am. Published online May 27, 2022. doi:10.1016/j.jhsa.2022.03.002

About Antoine L. Cassell

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