Topical cannabis‐based medicines – A novel paradigm and treatment for non‐uremic calciphylaxis leg ulcers: An open label trial
| Autor: | Francesco Gabriele Tatangelo Fazzari, Vincent Maida, Lydia Zomparelli, Runjie Bill Shi |
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| Rok vydání: | 2020 |
| Předmět: |
topical cannabis‐based medicines
medicine.medical_specialty Analgesic Dermatology wound closure wound‐related pain Cohort Studies non‐uremic Calciphylaxis 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Prospective Studies 030212 general & internal medicine endocannabinoid system Aged Cannabis Analgesics Wound Healing Calciphylaxis integumentary system biology business.industry Leg Ulcer Integumentary system Original Articles biology.organism_classification medicine.disease Cohort Original Article Female Surgery Wound closure Open label business Cohort study |
| Zdroj: | International Wound Journal |
| ISSN: | 1742-481X 1742-4801 |
| DOI: | 10.1111/iwj.13484 |
| Popis: | Non‐Uremic Calciphylaxis (NUC) is a rare condition that often manifests as intractable and painful integumentary wounds, afflicting patients with a high burden of co‐morbidity. The Endocannabinoid System (ECS) is a ubiquitous signalling system that is theorised to be dysregulated within wound beds and associated peri‐wound tissues. Preclinical research has shown that the dominant chemical classes derived from the cannabis plant, cannabinoids, terpenes, and flavonoids, interact with the integumentary ECS to promote wound closure and analgesia. This is a prospective open label cohort study involving two elderly Caucasian females with recalcitrant NUC leg ulcers of greater than 6 months duration. Topical Cannabis‐Based Medicines (TCBM) composed of cannabinoids, terpenes, and flavonoids were applied daily to both the wound bed and peri‐wound tissues until complete wound closure was achieved. Wounds were photographed regularly, and the digital images were subjected to planimetric analysis to objectively quantify the degree of granulation and epithelization. Analgesic utilisation, as a surrogate/proxy for pain scores, was also tracked. The cohort had a mean M3 multimorbidity index score of 3.31. Complete wound closure was achieved in a mean of 76.3 days. Additionally, no analgesics were required after a mean of 63 days. The treatments were well tolerated with no adverse reactions. The positive results demonstrated in very challenging wounds such as NUC, among highly complex patients, suggest that TCBM may have an even broader role within integumentary and wound management. This treatment paradigm warrants being trialled in other wound types and classes, and ultimately should be subjected to randomised controlled trials. |
| Databáze: | OpenAIRE |
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