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What is cachexia – and could cannabis be a potential treatment?

The condition affects approximately nine million people globally.

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The “wasting” condition causes muscle and fat loss, typically as a result of a chronic disease

Researchers at Imperial College London are presenting an overview of existing research on the effects of cannabis on cachexia at this year’s International Cannabinoid Research Society Conference in July. Lead researcher, Dr Simon Erridge, says there is potential but further research is needed.

Cachexia affects approximately nine million people globally.

The “wasting” condition causes muscle and fat loss, typically as a result of a chronic disease such as heart disease, AIDS and chronic obtrusive pulmonary disease (COPD).

Even those who are getting the right amount of nutrition will experience involuntary weight loss that can lead to a deterioration in the patient’s health.

Most people associate cachexia with cancer, with an estimated 80 percent of those with advanced cancer being diagnosed with the condition.

Current medications that are used to treat cachexia fall into several categories.

Some work by boosting appetite stimulation, encouraging the patient to eat more and, in turn, put on weight. Other medications aim to reduce the inflammation that is associated with the condition.

Although treatments exist, the number of options available are limited. Researchers at Imperial College London are now turning their attention to the potential of cannabis to treat the condition.

Scientists at the University’s Medical Cannabis Research Group have completed a systematic review and meta-analysis of the current research to gain a better understanding of what is known about the use of cannabis in treating cachexia.

Dr Simon Erridge

Dr Simon Erridge

Led by Dr Simon Erridge, researchers found that the quality of evidence was “relatively low”, with just five studies looking at the relationship between cannabis and cachexia.

All five of the studies included a variant of THC (nabilone or dronabinol) as the active compound, which were compared against a placebo or a known active treatment for cachexia.

Imperial’s researchers were looking for improvement in appetite, weight and quality of life, but despite seeing very small improvements in appetite, the group were not able to find any “statistically significant” benefits.

However, Dr Erridge believes there is still potential for cannabis in the treatment of the condition.

As the existing research focuses purely on THC, the scientists concluded that further research is needed into the potential of CBD.

“The main conclusion we drew was that more research is needed,” Dr Erridge says.

“Secondly, there needs to be a better understanding of the appropriate regimens for this condition.

“A lot of the driving factors for [cachexia] are associated with a high inflammatory state. We understand how THC is affecting appetite stimulation, but we feel as a group that incorporating CBD, whether that be CBD on its own or alongside THC and other cannabinoids, may help elucidate different outcomes because of CBD’s known anti-inflammatory effects.”

The main driving factor behind the study, Dr Erridge says, was the preliminary evidence that suggested a molecular basis for cannabis’ effect in cachexia.

“There’s a lot of scope in terms of improving the availability of different management options for those with cachexia,” Dr Erridge continues.

“That was one of the main things that drew us to this field. We have an interest in both cancer and inflammation and the use of cannabis in those [areas]. As a condition, it covered all of those three bases and crosses that bridge quite nicely.”

In addition to his work at Imperial College London, Dr Erridge is also head of research and access at Sapphire Medical Clinics, a medical cannabis clinic offering private consultations and prescriptions to patients across the UK.

Aside from this study, Dr Erridge believes there is further potential based on patient outcomes at the clinic.

“I think there is there is potential in terms of the work that we’ve done at Sapphire with our registry,” Dr Erridge says.

“We’ve seen improvements in quality of life in patients with palliative care needs, whether that is from increased appetite or increased weight gain,”

“We are yet to dig down into it but hopefully, once we do a focused analysis of our palliative care patient outcomes, that might be something that we are able to look at from a real-world evidence point of view at Sapphire.”

The study, titled The effect of cannabis-based medicine in the treatment of cachexia: a systematic review and meta-analysis, has been submitted for publication and is awaiting peer review.

It has also been accepted for this year’s International Cannabinoid Research Society Conference in July, where Dr Erridge and his team will present their findings.

As with many areas of medical cannabis research, evidence is lacking.

The five studies included in the literature review differed significantly in terms of the medication used, the dosing regimen and the types of patients included, making it difficult for researchers to draw definite conclusions.

Following the publication of the literature review, The Medical Cannabis Research Group intends to carry out further research subject to funding.

Dr Erridge adds: “It’s been really difficult trying to get a lot of our clinical research off the ground over the past year due to Covid-19.

“Now we’ve been able to start getting them up and running, we can turn our attention to some of the other things that we want to study like cachexia.

“I think the next stages are to run randomised controlled trials studying medical cannabis regimens against both placebo and active treatment for cachexia.”

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Weekend digest: Six big stories from the cannabis world you might have missed

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Another week, another rollercoaster in the fast-moving world of cannabis.

At Cannabis Health, our in depth coverage of the ongoing growth of cannabis as a medical and wellness product continues

Meanwhile, over at Cannabis Wealth, we’ve been following all the big industry and policy news in a week which has seen some important developments..

Been busy and want to get caught up in a hurry?

Here are the six things you need to read to stay in the loop this week.

1. Products pulled from shelves

Two batches of medical cannabis products have been recalled by regulators as investigations are carried out, following reports they may be contaminated with mould.

Medical cannabis pharmacy, Dispensary Green and the Medicines and Healthcare products Regulatory Agency (MHRA) have issued a ‘precautionary’ product recall since being made aware of ‘defects’ in patient’s medication.

Concerns were initially raised after a number of medical cannabis patients spotted what they believed to be mould spores in their prescriptions.

Full story here.

2. NFL turns to medical cannabis

The National Football League (NFL) in America is providing $1 million in funding for research into pain management and cannabinoids.

The NFL is funding research into medical cannabis.

The pain management committee of the NFL and the NFL Players Association announced it would stump up the funding on Tuesday 8 June.

According to the organisation’s news platform, the move is the next step in a shifting attitude towards players who use medicinal cannabis to manage pain from injuries.

You can read more here.

3. More medical cannabis evidence

Researchers have found that the cannabinoids CBD and CBG, when used in combination, are beneficial for treating inflammation in the lungs.

Scientists at King’s College London, working in collaboration with Sativa Wellness Group have published the first results from a study into the impact of cannabinoids on respiratory diseases.

It aimed to investigate the anti-inflammatory effects of the two non-psychotropic cannabinoids alone and in combination, in a model of pulmonary inflammation.

Full details here.

4. Germany to vote for reform?

Germany’s national election on September 26 could be a landmark moment for Europe’s cannabis industry.

As Chancellor Angela Merkel prepares to leave the stage, the European Union’s most influential country looks destined for a political shakeup.

Annalena Baerbock could become Germany’s first pro-drug reform Chancellor.

It could mark a huge moment for the cannabis industry as Germany’s parliament might swing in favour of legislation.

Here’s everything you need to know about it.

5. Adapt or fail

The pro-drug reform lobby must accept it has failed and change to push its agenda ahead, leading experts have warned.

Speaking at a Global Cannabis Intelligence event about the state of advocacy in the UK, three leading policy advocates set out how they think greater access can be achieved.

The discussion comes week after the 50-year anniversary of the passage of the The Misuse of Drugs Act.

Read the full story here.

6. Isle of Man steps up

The Isle of Man government has declared it is open for business to the medical cannabis industry.

In a big to create 250 new jobs and generate £3m a year for the island, policymakers want it to become ‘a world-leading exporter’.

Applications are now open for licences to produce and distribute treatments on the island, as well as to use it as an export base.

Full details here.

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New tracking app launches for UK medical cannabis patients

Through the app patients will be able to monitor their own symptoms and medication usage

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The free health monitoring app is already being used elsewhere in the world.

UK medical cannabis suppliers Grow Pharma have teamed up with an Australian tech firm to launch a new app for patients.

The partnership with OnTracka will see them launch Calyx, a free health monitoring app already being used elsewhere in the world.

Users will be able to monitor their own symptoms and medication usage, speak securely with their doctor and contribute to gathering evidence about the use of medical cannabis.

The app will also be available in Ireland and the Channel Islands after successful launches in Australia, the US and South America.

Users will be able to monitor their own symptoms and medication usage

Pierre Van Weperen, CEO of Grow Pharma said: “Grow Pharma is currently fulfilling around a third of all prescriptions for the UK’s medicinal cannabis patients.

“Our prominent role gives us a significant advantage to building data insights into how patients are managing their health.

“This is integral to pave the way towards increasing access for patients in the UK through providing doctors with confidence around the safety and efficacy of these products.

“Using the app will generate important insights to provide real-time evidence to doctors and regulators.”

Grow Pharma hopes the app will help ‘rapidly accelerate an understanding of the safety, quality, and efficacy’ of medical cannabis.

Insights gained via the app will ‘advance the industry forward in the service of patients, shaping future legislation and policy based on patient experiences’ by providing real-world data to regulators.

Grow is in the process of raising £6 million worth of capital via a private funding round expect to be completed later this month.

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Isle of Man launches medical cannabis export sector

The Isle of Man is open for business to the medical cannabis industry.

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The move could 250 new jobs and generate £3 million a year for the island

The Isle of Man government has declared it is open for business to the medical cannabis industry.

In a big to create 250 new jobs and generate £3 million a year for the island, policymakers want it to become ‘a world-leading exporter’.

Applications are now open for licences to produce and distribute treatments on the island, as well as to use it as an export base.

The island’s regulator – the Gambling Supervision Commission – has set out conditions for the licensing of high-THC cannabis and hemp.

Enterprise minister Laurence Skelly said: “The growing global medicinal cannabis market provides significant opportunity for economic development in the Isle of Man, and the new regulatory framework and guidance will offer stringent and flexible licensing of a broad range of cannabis products, which ranges from outdoor grown industrial hemp to indoor grown medicinal products.

“The Isle of Man Government has every confidence that the GSC will provide a world class regulatory structure required to regulate this new and complex industry.

The Isle of Man wants to be a major player in Europe’s growing medical cannabis industry.

“I am delighted to welcome licence applications and look forward to attracting quality businesses to the Island, transforming the cannabis export sector into a key contributor to the Isle of Man’s post-Covid economic recovery.”

The self-governing British Crown Dependency, which has a population of 83,000, approved new medical cannabis laws in January.

The island’s parliament – the Tynwald – moved to attract the industry to its shores after a public consultation showed 95 percent of residents were in favour of the policy.

Mark Rutherford, director of policy at the island’s regulator, said: “The GSC already has a sophisticated framework for supervising gambling.

‘We have worked carefully to apply the best of that framework to the risks in the new sector and we have educated ourselves in the technical areas that are new to us.

“What we now have will ensure that all stakeholders will be competent, crime free and capable of building a sector that is safe, trusted and efficient.

“As regulators, we aspire to put our regulatory umbrella above as many consumers as possible so that they can benefit from regulations that are well thought out and properly supervised.

“Years of prohibition mean that the markets in which our licensees will be participating are still in their infancy and still contain many uncertainties.

“To address this situation, it is our aim to ensure that consumers who purchase Isle of Man products will be able to understand exactly what their product contains through accurate labelling and independent testing.

“The GSC recognises there are many stakeholders in this newly created field and intends to extend its ethos of cooperation with other government authorities into its approach to cannabis regulation.”

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