How clinical trials can help us understand the potential of cannabis

Estimated reading time: 5 minutes

Eurocan explores the ongoing research on cannabis, and how these trials can help us understand the therapeutic potential of cannabinoids.

As licensing and legal accessibility to cannabis increase, academics and academic institutions have greater opportunities to explore clinically relevant properties of cannabis compounds with a view to understanding the effects of different cannabinoids within the body. 

Some of these studies will reveal information significant to the development of cannabis-based therapies (whether pharmaceutical API development or direct plant/extract administration) and as a consequence, the output from these studies has the potential to be extremely disruptive to the traditional healthcare industry. 

Status and progress of registered clinical trials

Latest information shows that a significant portion of the cannabinoid studies registered with relevant authorities [1] around the world have already completed with a large number currently in the “active recruitment” phase. 

This engagement and follow-through demonstrates the desire of the scientific, medical & industry communities to prioritise clinical research into cannabinoid efficacy, so as to demonstrate clinical relevance and move towards therapeutic deployment of cannabinoid compounds. 

In line with regulatory preference, the majority of on-going cannabinoid studies are classified as “interventional”, which require the highest standards and produce the most reliable results and conclusions.

Among active trials, different amounts of progress has been made. With significant interest around the therapeutic benefits of cannabinoids growing, we can expect this trend to continue as trials complete, results are digested and further trials are commenced.

Which medical conditions are being studied?

The recent explosion of clinical cannabis trials and studies has produced important new data and opened up different avenues for exploration as the community seeks to understand the full therapeutic potential  cannabinoid compounds

Neuropathic pain

Cannabis may be able to provide a long-term reduction in pain severity. A recent mouse model study showed a long-lasting relief of allodynia (a form of touch-sensitive neuropathic pain) after oral cannabinoid administration.

Seizures and epilepsy

CBD has been demonstrated to prevent the opening of voltage-gated channels in neurons, giving rise to the idea that CBD might prevent seizures. However, a recent study shows that CBD alone does not halt seizures, supporting the suggestion of its use as an adjunctive therapy.

Depression, anxiety and PTSD

Cannabinoids are being researched as alternatives to conventional medications for psychiatric disorders, as part of broader therapies that may be more effective at treating these issues.

Alzheimer’s disease & other neurodegenerative disorders

THC has been shown to reduce the build-up of amyloid protein in vitro studies of neurones. THC has also been shown to improve the symptoms of mice exhibiting Alzheimer’s-like symptoms, increasing their ability to learn.

Opioid dependence

Cannabis has the potential to help persons with opioid dependency to reduce their usage and detoxify. Recent studies established links between the function of CB1 receptors and opioid receptors, giving insight into the mechanics of cannabis as form of pain relief. Cannabis use appears to enhance the pain-relieving effects of opioids, if used alongside cannabis, as an adjunctive therapy.

Increasing the understanding of cannabinoids

Clinical trials are vital to developing a full understanding of different cannabinoids. In addition to some examples discussed below, there are many more cannabis compounds with proven bioactivity, but most are extremely poorly characterised, and further research is needed to determine their potential physiological effects & benefits.

Cannabinoid acids are the cannabinoids that are biosynthesised in the plant; cannabigerolic acid (CBGA), is considered the “mother of all cannabinoids” being the precursor molecule to the creation of better-known cannabinoids, like cannabidiol (CBD) and tetrahydrocannabinol (THC).

Three acidic cannabinoids (cannabigerolic acid (CBGA), cannadivarinic acid (CBDVA), and cannabigerovarinic acid (CBGVA)) and cannabidivarin (CBDV) found in cannabis reduced seizures in a mouse model of Dravet syndrome, an intractable form of childhood epilepsy.

Cannabinol (CBN) is a biological by-product of THC degradation, that has significant affinities for CB1 and CB2 receptors. Whilst thought to be mildly psychoactive, it has significant anti-convulsive, sedative and anti-inflammatory effects (although data is limited).

Cannabigerol (CBG) is a cannabinoid similar to CBD, having anxiolytic and anti-inflammatory properties without causing intoxication and has been shown to significantly reduce inflammation in the chronic condition inflammatory bowel disease.

Conclusion

It is safe to say that clinical trials and studies, alongside socio-economic and policy research, will shape the cannabis industry and may help shepherd the world towards a new therapeutic landscape.

Continued commitment from institutions (governments, academic institutions and public markets amongst others) will assist in ensuring that the growing knowledge and understanding of cannabinoids can be put to practical use for benefit of end-use consumers – as such, clinical trials will remain a vital component of the industry for years to come.

info@euro-can.eu  /  www.euro-can.eu

References:  U.S. Department of Health & Human Services / Clinicaltrials.gov  / WHO /  INFARMED / NICE ¹ Clincaltrials.gov, clinicaltrialsregister.eu and health-products.canada.ca

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