All 26 fibromyalgia patients improved on every measure after starting medical cannabis, with half stopping other medications | Research

The takeaway

A small Israeli study of 26 fibromyalgia patients found that all reported significant improvement on every Fibromyalgia Impact Questionnaire parameter after starting medical cannabis, with 50% discontinuing all other fibromyalgia medications.

Read this if you have fibromyalgia and are considering medical cannabis as a treatment option.

100% improved on all measures; 50% stopped all other medications

What the researchers found

Researchers collected data from registries at two Israeli hospitals on fibromyalgia patients treated with medical cannabis.

Of 30 identified patients, 26 were included. All completed the Revised Fibromyalgia Impact Questionnaire for the period before and after starting medical cannabis treatment.

Every patient reported significant improvement on every parameter of the questionnaire after commencing medical cannabis. The mean dosage was 26 grams per month with an average treatment duration of 10.4 months.

Remarkably, 13 patients (50%) stopped taking all other fibromyalgia medications after starting medical cannabis. Only 8 patients (30%) experienced adverse effects, described as very mild.

Why it matters

While small and uncontrolled, the finding that 50% of patients could stop all other medications is clinically notable. Fibromyalgia medications often carry significant side effect burdens, and if cannabis can serve as a replacement therapy for some patients, this warrants investigation in controlled trials.

The numbers in context

26 patients (73% female, mean age 37.8). Mean dose 26g/month. Mean duration 10.4 months. 100% improvement on all questionnaire parameters. 50% stopped all other medications. 30% had mild adverse effects.

How the study worked

Retrospective observational study of 26 fibromyalgia patients (73% female, mean age 37.8) from registries at two Israeli hospitals. Patients completed the Revised Fibromyalgia Impact Questionnaire for pre- and post-medical cannabis periods. Mean cannabis dose 26g/month, mean treatment duration 10.4 months.

What this study cannot tell us

Very small sample (26 patients) with no control group. Retrospective questionnaire comparing recalled pre-treatment status to current status introduces recall bias. No blinding or placebo control. Hospital registry patients may not represent all fibromyalgia patients. The 100% improvement rate is unusual and may reflect selection or reporting biases.

How to read the evidence

Very small uncontrolled observational study provides preliminary evidence, with results that require confirmation in randomized controlled trials.

When this study was published

Published in 2018. Controlled trials of cannabis for fibromyalgia have begun to emerge since.

The bigger picture

This study adds to a pattern of small observational studies showing dramatic patient-reported improvement with medical cannabis for fibromyalgia. The consistency of this finding across studies strengthens the case for properly controlled trials, which remain scarce.

Questions still open

Would a placebo-controlled trial replicate these results? Which fibromyalgia symptoms respond most to medical cannabis? What is the optimal dose and formulation for fibromyalgia? Can the medication-stopping finding be replicated safely?

Common questions

Did medical cannabis help all fibromyalgia patients?

In this small study of 26 patients, yes, all reported significant improvement. However, the lack of a control group and the retrospective design mean these results may be influenced by placebo effects and recall bias.

Could patients stop their other medications?

Half (50%) of the patients stopped taking all other fibromyalgia medications after starting medical cannabis. Only 30% experienced adverse effects, and those were described as very mild.

Read the original research

Medical Cannabis for the Treatment of Fibromyalgia.

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 24(5), 255-258

View on PubMed ↗Publisher’s paper ↗

Citation

Habib, George; Artul, Suheil. (2018). Medical Cannabis for the Treatment of Fibromyalgia.. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 24(5), 255-258. https://doi.org/10.1097/RHU.0000000000000702