Cannabis-Containing Cream for CKD-Associated Pruritus: A Double-Blind, Placebo Controlled Trial
Suthiya Anumas 1 , Pranporn Kuropakornpong 2 , Panlop Chakkavittumrong 3 , Adis Tasanarong 3 , Pattharawin Pattharanitima 3
- 1
- Chulabhorn International College of Medicine, Thammasat University, Rangsit, Pathum Thani, Thailand
- 2
- Department of Applied Thai Traditional Medicine, Faculty of Medicine, Thammasat University, Rangsit, Pathum Thani, Thailand
- 3
- Department of Internal Medicine, Faculty of Medicine, Thammasat University, Rangsit, Pathum Thani, Thailand
Affiliationer
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.
