From endometriosis to back pain: the medical cannabis trials to watch in 2026

Meanwhile, German pharmaceutical company Vertanical has reached a later milestone, securing authorisation for its cannabis-based back-pain medicine Exilby.

Cannabis Health examines these programmes to explain what researchers are trying to establish, what they have found and how the results could inform treatment.

Medical cannabis trials at a glance

Last checked: 22 October 2026

Programme	What is being tested?	Where does it stand?	What comes next?
ENDOCAN-1 — UK	MRX1 CBD solution for endometriosis-associated pain	Phase 2 feasibility study; registry lists recruiting	Findings to help design a larger trial
ACTiON — UK	MRX1 for chemotherapy-induced peripheral neuropathy	Phase 2; registry lists recruiting; first dosing reported in July 2026	Recruitment completion and clinical results
VER-CLBP-001 — Europe	VER-01 cannabis extract against placebo for chronic low back pain	Results published; initial pain endpoint met, later withdrawal endpoint missed	Further controlled evidence and safety follow-up
ELEVATE — Europe	VER-01 compared with opioids	Results published; less constipation, with more qualified pain findings	Longer-term comparative evidence
EXPAND — US	VER-01 against placebo, supporting its US development	Listed in Vertanical’s programme; current recruitment details unconfirmed here	Trial results and a possible FDA application
DGS programmes — Germany	Cannabis treatments for several chronic pain conditions	Plans announced in June 2026; subsequent starts unconfirmed	Protocols and recruitment updates

What is the endometriosis study testing?

A clinical trial in Scotland is investigating whether cannabidiol (CBD), a non-intoxicating compound found in cannabis, could help relieve pain associated with endometriosis.

The condition occurs when tissue similar to the lining of the womb grows elsewhere in the body. It can cause severe pelvic pain, heavy periods and fertility problems.

Known as ENDOCAN-1, the study is being led by Dr Lucy Whitaker, a senior clinical lecturer at the University of Edinburgh and consultant gynaecologist with NHS Lothian.

Researchers aim to recruit 100 participants from hospitals in Edinburgh and Aberdeen. They will receive either Ananda Pharma’s MRX1 CBD solution or an identical placebo, containing no active drug, for 12 weeks.

The study will look for evidence of pain relief and improvements in quality of life, while also examining patients’ use of other painkillers. Researchers will monitor side effects, sleep, fatigue and treatment satisfaction.

However, the trial’s main purpose is to establish whether a larger study would be practical.

According to its registration, the primary objective is to measure eligibility, recruitment and retention rates — in other words, how many patients qualify, agree to participate and complete the study.

The findings will help inform a larger trial designed to establish whether CBD is an effective treatment for endometriosis-associated pain.

The study is sponsored by the University of Edinburgh and NHS Lothian and funded by Scotland’s Chief Scientist Office. Ananda supplies the MRX1 formulation.

Status at 22 October 2026: the registry lists ENDOCAN-1 as recruiting, with overall completion recorded for March 2028. No results were identified.

What comes next: recruitment and retention findings, alongside preliminary symptom and safety data, will help determine how a larger trial could proceed.

What is MRX1 being tested for after chemotherapy?

A second clinical trial at the University of Edinburgh is investigating whether UK-based pharmaceutical company Ananda Pharma’s CBD-based medicine can relieve nerve symptoms caused by chemotherapy.

The condition, known as chemotherapy-induced peripheral neuropathy (CIPN), can cause persistent pain, numbness and tingling in the hands and feet, sometimes lasting long after cancer treatment has ended.

Known as ACTiON, the phase 2 study is led by Professor Marie Fallon, a specialist in palliative medicine at the University of Edinburgh, and funded by the National Institute for Health and Care Research (NIHR).

According to its registration, participants receive the CBD-based medicine, known as MRX1, and a placebo in separate five-week periods, with a two-week break between treatments.

Researchers will assess whether CBD improves nerve symptoms, pain, sleep, mood and quality of life. They will also use MRI brain scans to investigate whether treatment changes activity in areas associated with pain and mood.

The registered primary outcomes measure sensory neuropathy using a questionnaire and changes in connectivity in the anterior cingulate cortex, a brain region associated with pain and mood. Pain severity is among the secondary outcomes.

The study aims to investigate whether MRX1 improves chemotherapy-related nerve symptoms and explore how CBD might affect the body’s response to pain.

As Cannabis Health reported in July 2026, Ananda announced that the first participant had received treatment.

Chief executive Melissa Sturgess welcomed the milestone, describing the research as “gold standard work”.

Status at 22 October 2026: the registry lists ACTiON as recruiting, with overall completion recorded for October 2027. No results were identified.

What comes next: completion of recruitment, followed by the clinical and brain-imaging findings. These will help establish whether MRX1 offers a benefit worth investigating further.

What have the back-pain trials found?

German pharmaceutical company Vertanical has published results from two clinical trials investigating whether its cannabis-based medicine, VER-01, could offer an alternative treatment for chronic lower back pain.

The medicine, marketed under the brand name Exilby, contains a standardised cannabis extract, meaning its composition is controlled.

In a phase 3 trial published in Nature Medicine in September 2025, researchers studied 820 adults with chronic lower back pain.

During the initial blinded treatment phase, patients receiving VER-01 reported greater pain relief than those given a placebo, although the average difference was relatively small – equivalent to 0.6 points on a 0–10 pain scale.

Treatment-emergent adverse events were also more common among patients taking VER-01, affecting 83.3% compared with 67.3% of those receiving a placebo. These events were not necessarily all caused by treatment.

A later stage of the trial, which examined what happened when treatment was withdrawn, failed to meet its primary endpoint of time to treatment failure. A secondary pain measure favoured continued VER-01 treatment, but did not change that primary finding.

Researchers also investigated how VER-01 compared with opioid painkillers in a separate trial involving 384 patients.

The ELEVATE study found that constipation, its primary endpoint, was less frequent among patients receiving VER-01.

Patients taking the cannabis-based medicine also reported slightly greater pain relief on average across the treatment period. However, the first key secondary endpoint – the proportion achieving at least a 30% reduction in pain at week 27 – was not statistically significant. Subsequent endpoints in the testing sequence were therefore exploratory.

Unlike the placebo-controlled study, both patients and researchers knew which treatment was being given, potentially influencing how symptoms and side effects were reported.

Both trials were funded by Vertanical.

Together, the findings suggest VER-01 may offer modest pain relief for some patients and cause less constipation than the opioid treatments studied. Further research would help establish its longer-term benefits and how it compares with existing treatments.

Status at 22 October 2026: results from both trials were published in September 2025.

What comes next: further comparative evidence and safety monitoring will help clarify the medicine’s role in treatment following authorisation.

Has Exilby been approved?

Vertanical’s cannabis-based medicine Exilby has received marketing authorisation in Germany and Austria for adults with chronic lower back pain with a radicular, neuropathic component.

The German product information records authorisation on 30 May 2026. It is indicated as monotherapy for patients whose pain has not responded adequately to non-opioid painkillers, or who cannot tolerate them.

The approval covers this specific condition, rather than chronic pain generally. The patient leaflet lists Germany and Austria; this does not amount to EU-wide authorisation.

As Cannabis Health reported in June, Vertanical was also hoping to secure UK approval by the end of 2026. No MHRA authorisation was verified for this update.

The company has also reported progress in the United States, announcing that the Food and Drug Administration (FDA) had granted VER-01 Breakthrough Therapy Designation.

The designation is intended to accelerate development and regulatory review. It is not US marketing approval.

Vertanical is continuing its clinical research programme, including a phase 3 study known as EXPAND, as it works towards potential US approval.

In its June announcement, the company forecast an initial US readout in 2027 and a possible regulatory application in 2028, subject to positive results.

Status at 22 October 2026: EXPAND is listed in Vertanical’s development programme, but its current recruitment details and completion date were not independently confirmed for this update. The UK and US timelines remain company targets.

What comes next: additional trial results and regulatory decisions. Authorisation, availability and reimbursement remain separate milestones in each market.

What is the German Pain Society planning?

The Deutsche Gesellschaft für Schmerzmedizin (DGS), a professional association representing doctors specialising in pain treatment, has announced plans for three studies investigating medicinal cannabis for chronic pain.

The research forms part of an initiative launched in 2026 to strengthen the clinical evidence supporting cannabis-based treatments and help inform prescribing guidelines.

In a June announcement, the organisation outlined plans for:

• Fibromyalgia: a study targeting 225 patients with the condition, which causes widespread pain, fatigue and sleep problems. It was scheduled to begin in September 2026 and last between 22 and 26 weeks.
• Spinal, back and osteoarthritis pain: a larger study targeting at least 1,500 patients, with a proposed June 2026 start.
• Inhaled cannabis extracts: a third study investigating a standardised inhalation system for a THC-rich cannabis extract. This was described as being in the planning stages.

DGS president Dr Richard Ibrahim said the organisation wanted to generate more reliable evidence to help doctors assess the role of medicinal cannabis in pain treatment.

Status at 22 October 2026: subsequent study starts and recruitment have not been confirmed. The announcement does not provide enough detail to classify all three programmes as randomised controlled trials.

What comes next: published protocols and recruitment updates establishing how the studies will be conducted.

Further discussion in London

How clinical trials and evidence from everyday prescribing should inform treatment will be discussed at the Cannabis Health Symposium in London on 26 November 2026.

Professor David Nutt is listed for a session asking whether it is time to look beyond the placebo-controlled trial. The discussion will examine the place of randomised trials alongside evidence collected from patients receiving treatment in routine clinical practice.

Secure your place at the Cannabis Health Symposium London.

Frequently asked questions

What do phase 2 and phase 3 mean?

Phase 2 studies investigate treatment effects and safety in patients. Phase 3 studies generally involve larger groups and provide further evidence about benefits and risks. Reaching a later phase does not guarantee success.

Does a recruiting trial mean the treatment works?

No. Recruitment means researchers are enrolling participants to investigate a question. The study may find a benefit, no benefit or unacceptable side effects.

Does a positive trial mean a medicine will be available on the NHS?

No. Approval, assessment of value for money and NHS funding involve separate decisions.

Do results for one cannabis medicine apply to every product?

No. Formulations, doses and patient groups differ. A result for a particular medicine cannot establish that other cannabis or CBD products have the same effects.