Exploring cannabis use and perspectives among psoriatic disease patients

Jackie Tsang; Orli Silverberg; Rohan Machhar; Remy Pollock; Daniel Pereira; Mitchell Sutton; Dafna D Gladman; Cheryl F Rosen

doi:10.1007/s10067-022-06066-6

Exploring cannabis use and perspectives among psoriatic disease patients

Clin Rheumatol. 2022 May;41(5):1431-1437. doi: 10.1007/s10067-022-06066-6. Epub 2022 Jan 20.

Authors

Jackie Tsang¹, Orli Silverberg¹, Rohan Machhar², Remy Pollock², Daniel Pereira³, Mitchell Sutton³, Dafna D Gladman^{4

5

6}, Cheryl F Rosen^{1

7}

Affiliations

¹ Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
² Psoriatic Arthritis Program, Krembil Research Institute, University Health Network, Toronto, ON, Canada.
³ Psoriatic Arthritis Program, Centre for Prognosis Studies in the Rheumatic Diseases, University Health Network, Toronto, ON, Canada.
⁴ Faculty of Medicine, University of Toronto, Toronto, ON, Canada. dafna.gladman@utoronto.ca.
⁵ Krembil Research Institute, University Health Network, Toronto, ON, Canada. dafna.gladman@utoronto.ca.
⁶ Psoriatic Arthritis Program, Centre for Prognosis Studies in The Rheumatic Diseases, Toronto Western Hospital, University Health Network, Toronto, ON, Canada. dafna.gladman@utoronto.ca.
⁷ Psoriatic Arthritis Program, Division of Dermatology, University Health Network, Toronto Western Hospital, Toronto, ON, Canada.

PMID: 35050419
DOI: 10.1007/s10067-022-06066-6

Abstract

Objective: To assess the correlation between cannabis use and psoriatic disease severity, health-related quality of life, pain, psychosocial outcomes, and cytokine levels in psoriasis (PsC) and psoriatic arthritis (PsA) patients.

Methods: PsC and PsA patients enrolled in the International Psoriasis and Arthritis Research Team (IPART) program were surveyed on cannabis use and were asked to provide a serum and urine sample. Demographic and clinical variables were compared between users and non-users using Student's t-test or Mann-Whitney U test for continuous variables, and chi-square or Fisher's exact test for categorical variables.

Results: Of 151 respondents, 30% reported current cannabis use within the last year. Compared to non-users, cannabis users were younger and had a shorter PsA duration and poorer mental health as measured by the SF-36. Other measures of health-related quality of life and pain were comparable between the groups. Respondents' primary perceived benefits of cannabis use were aid in sleep and arthritis pain relief, but there was no difference in pain between users and non-users. No THC was detected in the urine of non-users while users had a mean level of 19.6 ng/ml. Serum IL-23 levels were statistically significantly higher in non-users than in users.

Conclusion: A third of the patients used cannabis within the past year, and 54.3% of users reported the use of cannabis for arthritis pain relief. However, there was no difference in pain scores. Comprehensive education for providers on the current body of evidence and further studies on cannabis use and outcomes in psoriatic disease are needed. Key Points • A third of patients with psoriatic arthritis have used cannabis in the past year. • Most used it for better sleep and control of pain. • There was no difference in pain scores between users and non-users. • IL-23 levels were significantly higher in non-users.

Keywords: Cannabis; IL-23; Pain; Psoriasis; Psoriatic arthritis.

MeSH terms

Analgesics / therapeutic use
Arthritis, Psoriatic* / drug therapy
Cannabis* / adverse effects
Humans
Interleukin-23
Male
Pain / drug therapy
Prostate-Specific Antigen
Psoriasis* / drug therapy
Quality of Life

Substances

Analgesics
Interleukin-23
Prostate-Specific Antigen