While cannabidiol (CBD) is currently rarely used for the treatment of juvenile idiopathic arthritis (JIA), there is great interest in integrating CBD among caregivers of this patient population, according to a published study. in Pediatric Rheumatology.1 These results indicate a need for future studies and to educate pediatric rheumatologists about the benefits of CBD.
“Effective treatments for JIA include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying anti-rheumatic drugs (FAMEs), and biological agents, but each has potential adverse effects. In fact, parents and children often have they are concerned about the side effects and long-term safety of medicines prescribed for JIA, “the researchers said. “As a result, many parents and children (34-92%) use complementary and integrative medicine (CIM) [such as CBD] separately or in conjunction with standard JIA treatment. “
The researchers searched the University of Michigan database to identify all children ages 0 to 17 with an ICD-10 code for the JIA between January 2017 and December 2019. Eligible participants were parents or guardians. of patients with clinically diagnosed AJI who were under 18 years of age. , had at least 1 visit to the Pediatric Rheumatology Clinic and had been evaluated by a rheumatologist in the last 18 months. Participants were invited to complete an 83-item online survey between December 2019 and February 2020. Questions included both caregiver and patient demographics, such as age, gender, education, family income, and ethnicity, experience with CIM, CBD product for parents and cannabis use and characteristics of the disease.
Information was gathered, such as perceptions of CBD safety and efficacy, the sources of your information, and whether you had talked to your child’s rheumatologist about CBD. Those who were currently treating their child’s JIA with CBD were asked about administration, frequency, disease activity, and daily dose.
Demographics were similar among participants, and most reported using at least 1 CIM therapy over their lifetime. Most had a bachelor’s degree or higher, had an annual income of more than $ 50,000 a year, and more than 95% were white. High disease activity was more common in families who were interested in or currently using CBD products.
A total of 422 patients with JIA met the inclusion criteria, of which 236 caregivers agreed to participate and 136 (58%) completed the survey. Although only 7% (n = 10) of participants had experience using CBD products to treat JIA, 54% (n = 79) had contemplated CBD use. Forty-seven (34.5%) had no interest in CBD.
Most caregivers learned about CBD on television (66%), online or blog support groups (35%), or through a friend or family member (34%). About half (52%) of respondents used at least 2 sources when researching CBD, but only 2% learned about CBD through their child’s rheumatologist. Not surprisingly, 63% (n = 56) of caregivers did not discuss CBD with a rheumatologist. These reasons include fear of judgment (35%), worries about not being taken seriously (29%), or not believing that the rheumatologist has the right knowledge on the subject (18%). Despite this, 75% of respondents thought that CBD would be able to reduce JIA-related joint pain.
More than half of participants are confident in the safety of CBD because it is a natural product, with only 15% believing that CBD had side effects. Products of interest include CBD oil balm (30%), oil drops (25%), oil roll on (23%), jelly beans (15%) or soft gels / capsules (6.5%) .
Of the 10 respondents who currently used CBD products to treat their child’s JIA, 50% administered CBD orally and 50% used it topically. Most (60%) only used CBD “as needed” to relieve joint pain, swelling, and stiffness. Well-being (calculated on a scale of 0 to 10) before CBD was recorded as an average of 3.6 and increased to 5.3 after administration. However, only half of caregivers reported a marked improvement in their child, while 30% noticed no change and 20% saw a decrease in well-being. Only one parent knew their child’s CBD dose.
More than 95% of the participants were white, which does not represent the typical population of patients with JIA and therefore makes generalization difficult. Because parents decided to participate in the survey, there may be an element of selection bias. Another limitation is that the parents / guardians of patients with JIA were surveyed, as opposed to the patients themselves, so that the researchers were unable to determine the individual’s interest in CBD.
“It is important for pediatric rheumatologists and other pediatric providers to be educated about CBD to increase their comfort when talking about CBD and its potential safety issues with their patients and / or parents,” they concluded. the investigators. “These efforts should focus on reducing harm, communicating uncertainty without harming the patient-physician relationship, and guiding stakeholders to reliable sources about CBD (e.g., the Arthritis Foundation) to ensure “In addition, they provide information based on scientific evidence. In addition, rigorous clinical studies are warranted to investigate both the safety and efficacy of CBD in JIA in bridging the knowledge gap.”
Reference:
If not CJ, Boehnke KF, Riebschleger M. Cannabidiol (CBD) Use among children with juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2021; 19 (1): 171. Published December 13, 2021. doi: 10.1186 / s12969-021-00656-5
