Hypermobility Patients See Sustained Pain Relief with Cannabis Medicines

People living with hypermobility disorders such as Ehlers-Danlos syndrome (hEDS) experienced sustained improvements in symptoms after being prescribed cannabis-based medicines, according to a study published in Clinical Rheumatology.

The study analysed patient-reported outcome measures from 240 UK-based hEDS patients over 24 months, making it the largest and longest-duration observational study of medical cannabis therapy specifically for hypermobility spectrum disorders and Ehlers-Danlos syndrome to date.

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Tracking Real-World Outcomes

Researchers used data supplied by patients registered on the UK Medical Cannabis Registry (UKMCR), the largest patient registry in Europe that collects real-world data on patient outcomes and cannabis treatment.

Patient health was monitored using standardised clinical questionnaires, including:

• Brief Pain Inventory (BPI)
• Pain Visual Analogue Scale (VAS)

Participants completed these assessments at the beginning of the study and at regular intervals during the 24-month study period.

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Sustained Symptom Improvements

The results showed positive changes in all of the reported outcome measures:

• Pain Reduction: Approximately 60% of the cohort achieved clinically significant levels of pain reduction.
• Opioid Reduction: Opioid use reduced significantly after 12 months and continued to decline at all subsequent follow-ups.
• Quality of Life: Patients reported sustained improvements in sleep quality, anxiety, and general health-related quality of life.

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Addressing an Unmet Therapeutic Need

Hypermobility disorders are hereditary connective tissue disorders characterised by chronic pain, gastrointestinal issues, joint hypermobility – being "double-jointed" – and an increased risk of joint dislocations.

Despite an estimated 20-30% of Brits being classed as hypermobile, hEDS is a rare disorder that is thought to affect only 0.2% of the population. Due to the lack of conventional treatment options, researchers investigated medical cannabis as a targeted option:

"This study provides a 24-month real-world evaluation of cannabis-based medicinal products in patients with hypermobility-associated chronic pain. It demonstrates long-term sustained improvement in pain, anxiety and sleep-related outcomes, underpinning health-related quality of life. Despite its observational design, the study provides important insight into potentially addressing an area of significantly unmet therapeutic need."

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Cautions and Future Directions

The researchers cautioned against indiscriminate prescription and highlighted the need for careful patient monitoring:

• Age Factors: Age over 50 years was associated with greater odds of adverse events, requiring closer post-prescription monitoring (specifically for somnolence, fatigue, and orthostatic symptoms).
• Call for RCTs: Future randomised controlled trials (RCTs) will be necessary to evaluate the precise efficacy of cannabis-based medicinal products and determine their standard clinical utilization.