{
  "abstract": "Introduction Pain is a common and disabling feature of systemic sclerosis (SSc), arising from diverse mechanisms including musculoskeletal, vascular, and skin involvement. Current analgesic options are often inadequate. Cannabinoids, particularly cannabidiol (CBD), possess anti-inflammatory and neuromodulatory properties and may provide analgesic benefit. We aimed to evaluate the efficacy of cannabis oil on pain outcomes in SSc patients compared with placebo.Material and Methods We conducted a randomized, placebo-controlled trial in adult SSc patients with anorexia or malnutrition at a tertiary care center. Participants received either cannabis oil (2.7 mg/mL tetrahydrocannabinol [THC] and 2.5 mg/mL CBD, sublingual, up-titrated to two drops twice daily) or placebo for four weeks. Pain was assessed at baseline and at week 4 using a validated pain questionnaire, which included last week’s pain (VAS 0–10), overall pain, and joint pain (VAS 0–100). The primary endpoint was the comparison of between-group differences in overall and joint pain scores; secondary endpoints included within-group changes.Results Twenty-seven participants were randomized (treatment, n = 14; placebo, n = 13); one participant was withdrawn, leaving 26 for analysis. Baseline characteristics were comparable between groups. At week 4, the cannabis group showed a significant reduction in joint pain compared with the placebo group (mean VAS 11.8 vs. 33.1; p = 0.01). However, no significant between-group differences were observed for overall pain (mean VAS 28.3 vs. 38.9; p = 0.23) or last-week pain (p = 0.65). Within-group analyses revealed no statistically significant improvements from baseline in either group, although the cannabis group showed a trend toward reduced joint pain (mean difference -10.8, 95% CI -22.8 to 1.1; p = 0.07).Conclusions Cannabis oil demonstrated potential benefit in reducing joint pain in SSc patients, while no significant effect was observed on overall pain. Larger and longer studies are needed to confirm efficacy and define subgroups most likely to benefit.",
  "authors": [
    {
      "affiliations": [
        "Division of Nursing, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"
      ],
      "name": "Orathai Wantha"
    },
    {
      "affiliations": [
        "Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"
      ],
      "name": "Siraphop Suwanaroj"
    },
    {
      "affiliations": [
        "Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"
      ],
      "name": "Chingching Foocharoen"
    },
    {
      "affiliations": [
        "Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"
      ],
      "name": "Ajanee Mahakkanukrauh"
    }
  ],
  "title": "P.289 Cannabis oil in systemic sclerosis: exploratory evaluation of subjective pain outcomes in a placebo-controlled trial",
  "uid": "2e9891f2-ce22-5d34-bd6f-7b6fcdad271c"
}