The therapeutic potential of purifed cannabidiol
Saoirse Elizabeth O’Sullivan1 , Sanne Skov Jensen2 , Gitte Nykjaer Nikolajsen2 , Heidi Ziegler Bruun2 , Rhenu Bhuller3 and Julia Hoeng3
1 CanPharmaConsulting, Nottingham NG9 3BB, UK
2 Fertin Pharma, Dandyvej 19, Vejle 7100, Denmark
3 Vectura Fertin Pharma, Basel, Switzerland
Affiliationer
The use of cannabidiol (CBD) for therapeutic purposes is receiving considerable attention, with speculation that
CBD can be useful in a wide range of conditions. Only one product, a purifed form of plant-derived CBD in solution
(Epidiolex), is approved for the treatment of seizures in patients with Lennox-Gastaut syndrome, Dravet syndrome, or
tuberous sclerosis complex. Appraisal of the therapeutic evidence base for CBD is complicated by the fact that CBD
products sometimes have additional phytochemicals (like tetrahydrocannabinol (THC)) present, which can make the
identifcation of the active pharmaceutical ingredient (API) in positive studies difcult. The aim of the present review
is to critically review clinical studies using purifed CBD products only, in order to establish the upcoming indications for which purifed CBD might be benefcial. The areas in which there is the most clinical evidence to support
the use of CBD are in the treatment of anxiety (positive data in 7 uncontrolled studies and 17 randomised controlled
trials (RCTs)), psychosis and schizophrenia (positive data in 1 uncontrolled study and 8 RCTs), PTSD (positive data in
2 uncontrolled studies and 4 RCTs) and substance abuse (positive data in 2 uncontrolled studies and 3 RCTs). Seven
uncontrolled studies support the use of CBD to improve sleep quality, but this has only been verifed in one small RCT.
Limited evidence supports the use of CBD for the treatment of Parkinson’s (3 positive uncontrolled studies and 2 positive RCTs), autism (3 positive RCTs), smoking cessation (2 positive RCTs), graft-versus-host disease and intestinal permeability (1 positive RCT each). Current RCT evidence does not support the use of purifed oral CBD in pain (at least
as an acute analgesic) or for the treatment of COVID symptoms, cancer, Huntington’s or type 2 diabetes. In conclusion,
published clinical evidence does support the use of purifed CBD in multiple indications beyond epilepsy. However,
the evidence base is limited by the number of trials only investigating the acute efects of CBD, testing CBD in healthy
volunteers, or in very small patient numbers. Large confrmatory phase 3 trials are required in all indications
